Tooth Bleaching - Teeth Whitening

     There are several ways to make your teeth whiter:  Bonding, Porcelain Veneers (Laminates), Porcelain Crowns (Caps) and Bleaching (Whitening).  Bleaching involves changing the color of the teeth without changing their physical structure.  For example only, if you put a blue shirt in Clorox bleach (this is not what we use) it would turn white but the fabric would remain intact. [By the way, Clorox is poisonous and will not bleach your teeth; it should NEVER be attempted to change your tooth color!]
     There are two ways patients can choose to bleach their teeth:  home or office bleaching.  Home bleaching involves the fabrication of plastic mouthpieces that look like protective sport mouthguards.  The patient must wear these mouthpieces with hydrogen peroxide based bleach for two to four hours a day for four to eight weeks.
     Office bleaching is much simpler for patients though a little more expensive.  Patients typically come in for one or several forty-five minute appointments depending upon the amount of color change desired. The bleach is applied directly to the teeth while a lip retractor holds the lips away from the teeth and a suction drains excess saliva.  There are no shots or drilling. Patients will commonly relax to Nitrous Oxide gas and music during the procedure.  Significant color changes are usually apparent after the first visit.
     Office bleaching is preferable to home bleaching because of the fast results and patient convenience.  One main reason for the better results with office bleaching is because of the duration that the bleach is in direct contact with the teeth.  When someone puts bleach in a home bleaching tray and then puts that tray in their mouth most of that bleach is immediately pushed out of the tray and either spit out or (hopefully not) swallowed.  Very little remains in the bleaching tray, and any that does remain, is washed out by saliva.  In contrast, the amount of bleach applied to the teeth during office bleaching is carefully controlled and remains in full contact with the teeth throughout the duration of the visit.  Nothing should be swallowed especially with a suction in the mouth.  We've been bleaching a lot of teeth for a long time and have found office bleaching to be both safe and effective.
     Many companies falsely promote the benefits of using laser light and/or their own special brand of light to increase tooth whitening.  Actual scientific research shows no added benefit.  The only factors that increase tooth whitening are the concentration of the bleaching material, the duration that the material is in contact with the teeth, and the skill and experience of the cosmetic dentist.  People will be in far better shape seeking an experienced cosmetic dentist to bleach their teeth rather than responding to corporate advertising promotions and being treated by recent dental school grads in retail clinics using fancy lights or lasers.
     Only natural tooth structure responds to bleaching. Bonding and porcelain will NOT bleach.  Patients need to consider this before bleaching because significantly whiter teeth may cause your old porcelain and/or bonding to look fairly yellow.

--Dr. Jeffrey Dorfman, Director
The Center for Special Dentistry
NYC