Teeth whitening
 

This information is provided to give the patient insight into professional methods of teeth whitening. As in all health care, there are limitations and risks. Absolute success cannot be guaranteed.

Teeth whitening, as performed in the dental office, has been in existence for many years. Its safety is considered very high.

There are variables which can affect the outcome of the procedure, such as the type of discoloration that affects your teeth, the degree to which you follow our instructions and the overall condition of your teeth.
 
1. Who are the best candidates for whitening?

Almost anyone is a candidate for whitening. Experience shows that people with dark yellow oryellowish brown teeth sometimes achieve better whitening results that those with gray or bluish gray teeth. Multi-colored teeth, especially if stained due to tetracycline, do not whiten as well.

In addition, teeth with many fillings, cavities, chips, etc., are usually best treated through porcelain veneers, or porcelain crowns. A medical history form is also required to be completed prior to treatment. Some medical conditions may exclude you from treatment.
 
2. What system of teeth whitening are we offering?
We have extensively researched the market to find the quickest, most convenient, most effective and most painless teeth whitening system... and found it! We use the IMDS system, which is a revolutionary in-office system widely used in USA but just very recently imported to the UK. It is a virtually pain-free system that involves the use of mouth trays pre-loaded with 44% encapsulated Carbamide Peroxide, which is activated with exposure to "Cool Blue" light for 20 minutes. No lip or gums retractors are required.
 
3. What should be expected upon completion of professional whitening?
We have obtained excellent results in most cases, but there is not a definite way to predict how light your teeth will get. Teeth in the yellow shade range tend to whiten better than those in the gray or gray brown ranges. Teeth discolored by certain antibiotics, decalcification, root canal therapy or trauma do not respond as predictably, and often require additional treatment. Although the in-office whitening is generally safe and all St Mark's dentists have been trained in the proper use of the IMDS system the results of the IMDS teeth whitening system cannot be guaranteed.
 
4. What are the potential side effects of whitening teeth?
1. Tooth sensitivity/pain: although we have personally tested that this tooth whitening system hardly causes any teeth sensitivity, it still can be experienced by some patients during the first 24 hours after bleaching, is mild and usually subsides in one or two days. It can be worse in cases of existing sensitivity, recession, exposed dentin, exposed root surfaces, recently cracked teeth, open cavities, leaking fillings or other dental conditions that cause sensitivity or allow penetration of the gel into the teeth.
2. Gum/lip/cheek inflammation: it may occur due to exposure of the tissues to the whitening gel or the light. It is usually temporary and subsides in a few days but may persist longer and result in significant discomfort.
3. Cervical abrasion/erosion: Even if these areas are not sensitive they allow the whitening gel to penetrate the teeth causing sensitivity.
4. Root resorption: it is the situation where the root of the tooth dissolves either from the inside or outside. There is some evidence that its incidence is higher in patients who have undergone bleaching although its cause is still uncertain.
5. Relapse: the results of the bleaching are not permanent and the teeth regress somewhat in their shading after bleaching. This can be accelerated by exposing the teeth to various staining agents. The in-office treatment may need to be repeated in order to maintain the desirable shade of the teeth.
 
5. What sort of maintenance and relapse can be expected?
Your teeth shade will revert back slightly, in the first 24 hours. This is due to slight dehydration of your teeth during the In-Office procedure. Also, through the normal staining process of daily eating and drinking, a slight regression may occur. This will depend on the frequency of your use of tobacco products, coffee, tea, red wine, and other staining foods/drinks.
 
6. What are some alternative treatment options?
Although teeth whitening is effective in many cases, other options do exist for whitening teeth.
These include:
A. Porcelain Fused to Metal crowns
B. All porcelain crowns
C. Porcelain Veneers
D. Composite Bonding
E. Other brands of In-Office and Take-Home products
 
7. What are the special considerations?
1. Some whitening systems use a light source that emits ultraviolet light. Although the output is less than half of the typical UVA exposure of commonly used facial and full body tanning units, the procedure incorporates significant protective and precautionary measures, all of which, our office follows.
2. Nevertheless, individuals undergoing PUVA therapy (Psoralen & UV Radiation), or other photochemotherapy, as well as those with melanoma should consult their physician prior to treatment.
3. Patients taking light sensitive drugs should also consult with their physician regarding possible photo-reaction.
1. People with fillings that may be breaking down with cavities in their teeth, or with chipped or worn teeth may be better treated with restorative procedures first.
2. Pregnant women, should obtain permission from their doctor before whitening.
 
8. Other Considerations
1. Peroxide solutions have been available for many years as an antiseptic in the mouth and it is widely used for its effect on teeth whitening.
2. If tooth sensitivity develops, fluoride home care gels may be used to reduce sensitivity. Also frequent gargling/rinsing mouth with luke-warm salt water will ease sensitivity.
3. Temporary inflammation of and or white spots on your gums can be caused by the Whitening procedure. This should resolve within 7-10 days.
4. If you have fillings that are breaking down, decay in your teeth, erosions of the teeth or exposed root surfaces, due to periodontal disease, the peroxide may cause tooth sensitivity. Such conditions need correction, prior to the whitening procedure. Please inform your dentist.
5. The whitening procedure, can be very effective at whitening the teeth, but will not change the colour of the fillings or crowns already in your teeth. For aesthetic reasons such fillings may need changing after the whitening procedures.
 
9. Patient Responsibilities
1. Avoid the use of tobacco, tea, coffee, red wine and other teeth staining foods i.e. tomato paste and dark green vegetables for 1-2 days after whitening.
2. Never place household or commercial bleaches in your mouth.
3. Keep your recall appointments with your dentist.