Whitening

How can I make my teeth whiter?

Did you see the trend on a popular social media platform where the user applies a selective color filter to show only yellow, and then smiles to see if their teeth are yellow? If you happen to have tried this or have been wondering about improving the shade of your teeth, you are not alone! Practically everyone wants a white smile.
First, please be aware that at Johnston Dental, we never harass or shame our patients regarding their tooth shade (or about anything!). As part of an exam, we ask if there is anything you would like to change about your smile. If you are interested in whitening we have information and tools for you! We have seen great results from whitening and are happy to help you achieve your most beautiful smile. That being said, if you’re already happy with your current shade, we are happy too! Whitening is cosmetic and can be a great confidence boost, but what matters most is a healthy mouth.

First things first-are your teeth clean?

You are (hopefully!) already brushing your teeth, but if you are noticing tooth discoloration the first step you should take is a review of their cleanliness.
Plaque collects on your teeth in a matter of hours and contains bacteria that forms a slime over your teeth. This plaque slime can be off-white, yellow, orange, or even brown or black. With the removal of plaque there is often a significant boost in appearance!
Are you using an electric brush? A Sonicare or Oral B electric brush removes more plaque than a manual brush alone. Also, set a timer on your phone while you brush. 2 minutes actually feels like a long time when you are brushing and many people rush without realizing it.
Flossing is important too. The stain and plaque can accumulate in between the teeth and as well as being detrimental to your oral health, actually shows in your smile as well.
If dental plaque is left undisturbed for 24 hours it hardens into calculus (tartar). Seeing your hygienist for regular cleanings to professionally remove plaque, calculus and stain will help keep your teeth bright!

Stain prevention

Of course, removing stain is only part of the solution. Preventing the stain from coming back is equally important. Feel free to make an appointment with our hygienist to discuss your individual situation. Some examples that have been discovered to stain a patient’s teeth are blackberries, tea, iron supplements, coffee, and tobacco stain. You can limit these items, or discuss alternatives (tea with a straw, smoking cessation support) with your hygienist.

Whitening toothpaste

There are two kinds of stain on teeth, intrinsic and extrinsic. Intrinsic means inside the tooth, and extrinsic means a surface stain. Whitening toothpaste will only help with extrinsic stain. It achieves this because it is more abrasive than regular toothpaste and helps polish off stained plaque. (Personally, I like Arm and Hammer whitening toothpaste as it has helped a lot with my coffee stains). It is important to be wary of fad toothpastes that may be untested and too abrasive for your teeth. For example, many charcoal toothpastes are actually harmful to your teeth and gums. The ADA seal is a good clue that this toothpaste has an acceptable level of abrasiveness that will remove stain but not damage enamel.
There are other products as well that advertise whitening, such as mouthwash and chewing gum. These may help with the surface stain but will provide subtle results.
Whitening toothpaste is milder than other methods of whitening, so if you have teeth that are very sensitive, try a toothpaste first and see if you can get the bright results you want.

Over the counter whitening

Bleach whitening can be bought over the counter. Bleach opens up pores in enamel and whitens into the tooth, causing a significant difference. There are several variations available for purchase, with trays, whitening strips, and even a cure light. Please note that at this time there is no evidence that a cure light will help whiten teeth. Personally I have tried Crest White Strips and it needed more time and more applications than professional whitening, but I was happy with my results at the time. One thing to be careful of is application error. Since these are not custom fit to your teeth it is easy to accidentally bleach your gums. If that happens, they do heal up in a couple weeks with no permanent damage. Another caution is to follow the instructions for duration of use. Some people constantly bleach their teeth and cause damage when not following instructions, leaving a product on their teeth overnight when it was intended to be placed for an hour, or bleaching for several months instead of a few weeks. There are some great products out there when used carefully, but if you are going to use an over the counter whitening product we do recommend discussing with your hygienist or dentist for cautions and instructions.

Professional whitening

The option that we offer at our office is what we believe is the safest and most effective way to achieve a bright smile. First, we discuss with patients their goals and individual needs and recommend what will fit them best. Sometimes that is a diet change, sometimes an over the counter product, and sometimes it is our professional bleaching. We are not a sales-driven dental office so you can rest assured that we will discuss all options honestly with you and help you decide what works for you.

Before prescribing whitening, we do an exam evaluating the type of stain present, check for crowns and fillings in the front that will not whiten, discuss possible tooth sensitivity issues and come up with a plan to support you if you do experience sensitivity. We have had good success with a lower percentage of bleach, shorter duration of application, and fluoride treatments for sensitive teeth so do not let that concern hold you back from giving it a try! If you have gray stain due to a “dead” tooth we may recommend a procedure called internal bleaching. If you have white stains, bleaching may be the first step in your plan and then placing a few tooth colored restorations to smooth and protect the area may be needed. If you have traditional browning or yellowing of the teeth, bleaching alone will yield great results. If you have off colored restorations, we can plan for whitening and replacing the restorations with a brighter matching shade. When whitening through our dental office, we evaluate your whole mouth and the steps you need to get your dazzling white smile.

Our whitening system includes custom bleach trays and take home bleach. We take a dental impression and make trays that fit to each tooth. This is important because even slightly misaligned teeth need custom trays. Whitening strips may not adhere well to all angles, and one size fits all trays will not completely cover your teeth. Custom trays are great for perfectly straight teeth as well, since they are easy to use and they help protect your gums from getting any bleach on them. We match your current tooth shade on a guide and show you the projected new shade. We have different percentages of bleach available to match your timing needs or sensitivity needs, and we have frequent shade check appointments to see how your process is coming along and address any questions you may have. Many patients whiten to their expected shade, and keep their trays and yearly do a touch up of a couple applications of bleach to maintain their bright shade.

A white, bright smile makes a wonderful first impression and can give you a major confidence boost. Give us a call and make an appointment to see if whitening is right for you! We would love to help you shine.

Bleaching Instructions:

1. You should only use 1/3 to 1/2 of a syringe per application. Place a drop of tooth whitening bleach into each tooth area that you want to bleach in your custom tray. Generally, you do not need to bleach your back teeth.

2. After brushing your teeth, insert the tray. Using your fingers, gently push up on the tray to get a secure fit all around. Use a moistened washcloth or a Q-tip to remove excess bleach that may come out of the top. Bleach may irritate gums if not wiped off.

3. The strength of your bleach will help determine how long you should wear your custom trays.
• 10%-15% – 2 to 4 hours, can be worn 1 hour, 2 times daily.
• 20% – 1-2 hours, can be worn 1 hour, 2 times daily.
• 35% – 30 minutes to start up to 1 hour daily, great for touch ups.

4. Remove tray from mouth. Remove excess bleach with a clean finger or toothbrush. Rinse twice, do not swallow – just rinse.

Average Whitening Time:

1. Younger patients with lighter teeth will bleach faster, 4-7 nights

2. Darker teeth may take 7-14 days, possibly longer.

3. Sensitivity is temporary. If you experience more than normal sensitivity, discontinue for 1 to 2 days if sensitivity becomes intense.

4. Please call Johnston Dental Care at 541-479-6623 if you have any questions or concerns.

Further reading:
https://www.rdhmag.com/career-profession/personal-wellness/article/16409524/tooth-whitening-and-total-patient-care