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  • Writer's pictureJohn Skvorak Jr DMD

Tooth Whitening

Your teeth are made of many layers of tooth structure. Enamel, the outermost layer of tooth structure, appears beautifully white when clean and healthy. Naturally, over time your teeth become less white. This happens when stains cling to the enamel surface or become incorporated in the underlying tooth structure called dentin, which is naturally yellow in color. This can happen as a result of aging, or chromogenic agents.

Chromogenic agents are any substances that have the potential to stain your teeth. Several common chromogenic agents include: coffee, tea, wine, tobacco, cannabis or metals. These substances bind to the tooth surface and cause discoloration with repeated exposure over time.

There are two primary methods to whiten teeth. Removing stain can be achieved through mechanical action (toothpastes or brushing) or chemical reactions (whitening solutions).

Whitening toothpastes commonly use slightly abrasive particles to polish off stains on the external surface of your tooth enamel. Commonly used abrasives in today's toothpastes are hydrated silica, calcium carbonate or dicalcium phosphates. The abrasive particles coupled with the mechanical action of the toothbrush abrades away stains on outside surface of teeth.

The active ingredient in whitening toothpastes or other whitening solutions such as custom whitening trays, professional pre-loaded whitening trays, or over-the-counter whitening strips is either carbamide peroxide or hydrogen peroxide.

Peroxides used in whitening solutions can pass through your enamel into dentin and react with large organic molecules contributing to the discoloration of your teeth to make them appear lighter and whiter in color. The reaction that occurs to cause this change in tooth color is called a redox reaction. This is why many whitening commercials use phrases like "whiten your teeth from the inside out".

Unfortunately, whitening can sometimes cause transient sensitivity. The good news is: studies on whitening have shown that tooth sensitivity resulting from whitening of healthy tooth structure does not have any significant long term effects. Additionally, data from the last 20 years show that whitening poses no significant systemic health risks either. (Research has not been done on children or pregnant or nursing mothers. For this reason, these groups should refrain from whitening.)

Studies have shown that whitening shortly before receiving restorative dental procedures can adversely affect the bond strength of tooth colored fillings and other bonded restorations. To avoid the potential adverse effects of whitening on bond strength, Dr. Skvorak always recommends that patients complete any desired whitening at least 3 weeks prior to their appointment for fillings, crowns or other restorative procedures.

For individuals who already have fillings, crowns, or other restorations, it is important to keep in mind that whitening only changes the color of natural tooth structure. Restorations will not whiten, although the nearby natural tooth structures will. For this reason, it is wise to consult with your dentist before whitening if you have any restorations, especially in the front of your mouth.

The difference between a professional whitening solution and over the counter solutions is the professional solutions - available through dental offices - have a higher concentration of peroxides, so your teeth will get whiter, faster. Professional solutions also contain potassium nitrate to help prevent transient post-whitening sensitivity. We offer many whitening options in our office.

We carry Opalescence products in our office. All of our Opalescence products contain potassium nitrate and fluoride to help reduce post-whitening sensitivity and to strengthen teeth. There are three delivery methods for Opalescence whitening solutions. The first is Opalescence Go, which are professional strength, pre-loaded whitening trays.

We also create custom whitening trays for patients. Custom whitening trays are created by taking an impression of your teeth, then the trays are fabricated in the lab from your impressions. The final product is a clear retainer-like tray with a reservoir for whitening solution. Custom trays are generally more comfortable for patients to wear. There is substantially less post-whitening gum sensitivity due to the reservoir keeping the whitening solution off of your gums. Custom trays can be used over and over again. Refills of Opalescence PF whitening solution can be purchased whenever a patient would like to whiten their teeth again.

Lastly, we provide in-house professional whitening with Opalescence Boost. While the same results can be accomplished with at home whitening systems, such as Opalescence Go or Opalescence PF whitening solutions, in house whitening achieves the results faster. It has been our personal experience that custom whitening trays achieve the same results over a few applications. Custom trays are also more economical. However, we offer in-house whitening for patients who cannot find time to whiten at home. Multiple in-house whitening sessions may be necessary, depending on your starting shade.

If you have any questions regarding whitening, please contact us (207-797-7400) or request an appointment today.

Stay tuned to our blog for future information on keeping your teeth healthy and your smiles bright!

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