Dental aesthetics is increasingly in demand in all fields of medicine and especially in dentistry. As Dr. Javier Sola, director and specialist of his own private clinic, Centro Dental Especializado Dr. Javier Sola Alonso, explains, patients have become aware that improving their smile not only increases their dental health, but also provides important psychological support and better social acceptance in a world where social networks also enhance this facet of our lives.
What does dental whitening consist of?
Teeth whitening is a technique based on a chemical oxide-reduction process that provides whiter teeth.
The most commonly used bleaches are hydrogen peroxide and carbamide peroxide, which is hydrogen peroxide + urea that serves to increase the duration of its effectiveness.
These solutions must be handled with extreme care as they are highly unstable and will volatilize unless refrigerated and/or kept in a dark container.
Why do teeth darken?
The causes of tooth darkening are multiple, they can be due to extrinsic factors such as the consumption of tea, coffee, etc.; or to intrinsic factors such as dentinogenesis imperfecta, trauma, fluorosis and staining by tetracyclines.
The best candidates for treatment are young teeth with recent stains, former smokers or stains from tea, coffee or wine tannins, older people with darkened teeth, root canal teeth that have darkened especially if they are recent and even yellowish or brownish teeth that have always been that less attractive color.
Why have teeth whitening?
It is a treatment that improves our esthetics quickly, is not very bothersome (slight temporary sensitivity), economical and not very traumatic for the tooth.
Can everyone undergo dental whitening?
It cannot be done during pregnancy or breastfeeding, in patients who smoke, under 18 years of age and when in the exploration we see marked fracture lines, defective restorations, dental caries or uncontrolled periodontal disease.
What precautions should we take?
We must have good oral hygiene, do not take acidic foods during treatment and any product that stains the teeth: coffee, tea, colas or red wine and application of neutral fluoride at the end of treatment or fluoride rinse for two weeks.
Decrease the dose, time or suspend temporarily, if there is too much sensitivity.
How to maintain the white color?
In addition to following the above advice, we can use ambulatory splints and give ourselves reminder doses at home for a week every year.
Is it bad for the tooth?
The most frequent dental clinical complications are tooth sensitivity and lack of duration of the effect if the patient does not take care of himself.
On dental tissues, the demineralization of the enamel and the decrease in the hardness of the dentin, although the latest studies doubt the latter due to the constant remineralization provided by the saliva.
What types of whitening are there?
- In-office bleaching: It is performed under strict isolation for the protection of the soft tissues. The whitening gel is applied during most of the clinical session (usually 2 hours).
- Outpatient whitening: We give the patient custom-made splints and instructions for use with the whitening gel appropriate to their dental conditions and they use it at home depending on the product, carbamide peroxide at 10% for 2 hours or hydrogen peroxide at 3.5% for 3 hours.
We can vary the concentrations or the time depending on each case to obtain better results or to reduce sensitivity.
How much does teeth whitening cost?
It depends on the case and the number of sessions that are necessary, but in general the outpatient costs about 400 euros and the clinic 800 euros.
Does teeth whitening always work?
Not all teeth respond well to treatment, which is why specialists in dentistry stress the importance of individualized study, although most teeth whiten adequately.
Do home whitening treatments work?
Enamel is the only human tissue that does not regenerate if we lose it, it is forever.
Some treatments based on sodium perborate, lemon, vinegar, etc. can make our teeth look whiter but they can damage not only the enamel, but also the roots if they are exposed, causing abrasions and erosions and the gums causing gingivitis and recession.
If we want to use the products used in the clinics on our own, we must know that these solutions must be handled with extreme care, as they are highly unstable, they volatilize unless they are refrigerated and/or kept in a dark container. They are also highly caustic to the gums.
What other tooth whitening alternatives are there?
In type III and IV stains caused by tetracyclines, dental fluorosis, generalized hypoplasias, amelogenesis imperfecta, or discolorations caused by metallic pigments we will use other restorative techniques such as veneers or full crowns.