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 All About Teeth Whitening  
The following is one in an ongoing series of columns entitled Integrative Dentistry by . View all columns in series
A common question I often get from patients is to explain the difference between over-the-counter teeth whitening systems and the ones you get from the dental offices. There are numerous infomercials on the kits available and their availability in the stores makes it very confusing as to which is best. The cost being a major factor, since the over-the-counter ones are less expensive than the ones available from the dentist.

People who consider whitening their teeth already know they need it. They smile and notice their teeth just aren't as white as they used to be, or as white as they’d like them to be.

What causes teeth to stain and get yellow are:

  • Beverages such as soft drinks, coffee, tea, red wine
  • Foods such as berries
  • Age
  • Certain medications
  • Colored mouthwashes
  • Excessive amounts of fluoride
  • Tobacco

Everything on this list contributes to staining of the teeth. The amount of staining will vary based on the frequency of exposure of the items and the home care hygiene and professional cleanings of the person.

There are two types of teeth whitening available from the dentist. One is a bleaching kit the patient takes home (at-home bleaching kit) and the in-office (a.k.a. chair side). The at-home bleaching kit consists of 10% to 16% carbamide peroxide gel applied in a fitted mouth tray. The tray and gel are left in the mouth from two hours to overnight for up to two weeks. The chair side bleaching uses a much stronger chemical of 30-35% hydrogen peroxide. With the chair side treatment a shield lines the base of the teeth and gums, while hydrogen peroxide solution is painted on. A special light is used to activate the chemicals. Laser bleaching is another form of chair side bleaching. The chair side bleaching is usually completed within one hour; however, sometimes a second appointment may be needed.

The over-the-counter kits have the disadvantage of not being supervised. Not everyone is a good candidate for teeth whitening. This is why it’s better to get an evaluation from the dentist. If receded gums are present or the teeth have been eroded due to a variety of reasons, sensitivity could result.

Whichever method you choose, you can expect your teeth to become 2-3 shades whiter. Not all natural teeth are the same color. The advantage of the chair side bleaching is that a more uniform color can be established, since the teeth are done individually. The disadvantage is that since it's usually done in one appointment, there is a noticeably quick change in your smile.

Teeth whitening systems, whether the take home or in-office type, are generally safe to use, unless you have sensitive teeth. The take home kits usually cost from $199-$500. The chased an laser whitening systems vary from $600-$1,000.

Some stains are very difficult to whiten, and an alternative choice would be some form of cosmetic dentistry, such as porcelain veneers. Before you decide to whiten your teeth, get a professional opinion from your dentist.

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 About The Author
Flora Stay, DDS holds a doctor of dental surgery degree from University of California, San Francisco. She is the founder of ...moreFlora Stay DDS
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