Tooth Whitening Using Custom Fitted Bleaching Trays

Sameer Puri, DDS

by Sameer Puri, DDS | August 17, 2010 @ 11:00AM

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Look around you in a crowded room, whether at a party, business meeting, or restaurant. Out of the faces of the people that you see, more than likely the ones that will most catch your eye are the people with the attractive smile. One of the prerequisites and foundation of an attractive smile is bright white teeth. Most often, these people have had their teeth whitened by their dentist.

In the past, tooth whitening was reserved for the rich and famous, and celebrities. The process was long and painful and the results left a lot to be desired. With inconsistent results and the excessive expense, whitening your teeth was something that many people talked about but very few did.

Now with the advent of new whitening technology, even the most stubborn teeth can be whitened safely and relatively quickly with dramatic results. This article will discuss the technique of custom tray bleaching. The advantage of this technique over others is that it is done in the comfort of your own home. It is less expensive than other techniques and it is easier to maintain the whiteness of the teeth by doing a touch up treatment as needed.

There are two main reasons that teeth are discolored. They can be discolored from internal and external staining. While external stains respond very well to tooth bleaching, teeth that have internal stains usually require more aggressive therapy to lighten them. It is important to have the teeth evaluated by your dentist before whitening to determine if in fact you would be a candidate for the procedure.

Internal staining is caused by a problem during the development of the teeth. One common cause is the use of the antibiotic tetracycline during tooth development. This antibiotic is notorious for severe staining of the teeth. Teeth appear almost black in the more advanced cases. Although tray whitening does work in some of these cases, the teeth are usually best treated with porcelain veneers. Recent studies have shown promising results with tray bleaching when the trays have been worn for a period of 6 months or longer.

External staining responds extremely well to bleaching. The whiteness of your teeth depends on your eating and drinking habits. Although teeth start out as white, they don't stay that way. The more we smoke, the more coffee, tea, red wine, and blueberry pie etc. we eat and drink, the more stained and dark the teeth become. A good rule of thumb to remember is that anything that will stain a white shirt will most likely stain your teeth. The good news is that these external stains and discolorations are easily removed with tooth whitening.

Although the bleaching process is relatively harmless, there are a few conditions that are a contraindication to treatment. Tooth sensitivity is one concern for patients. Some patients will experience tooth sensitivity but this is a relatively minor occurrence. The older formulations of bleach were notorious for causing sensitivity. The ingredients would tend to dehydrate the teeth, which would lead to the sensitivity and discomfort. Manufacturers have, however, improved the formulations of their bleaching gel and the discomfort is not much of an issue any longer.

If you are one of the few patients that still has sensitivity when you bleach, then try one of two things. First reduce the amount of bleaching gel that is being placed in the trays. Excess gel will overflow out of the trays and irritate the gum tissue. If the sensitivity continues, then bleach every other day. This will allow the teeth to become rehydrated and reduce or even eliminate the discomfort.

Another contraindication is pregnancy. If you are pregnant, wait until after you deliver your baby before you whiten your teeth. Although there is no study that indicates that the bleaching gel will harm the fetus, whitening your teeth is an elective procedure that should be delayed until after term. Because there is not enough research to indicate whether or not the gel is actually safe to use during pregnancy, it is safer to wait.

Finally, if you have fillings or crowns on your front teeth, know that those restorations will have to be replaced after the bleaching process is finished. While the bleaching gel works great on teeth, the color of the fillings or crowns is not affected by the gel. Mismatched fillings or crowns will not look attractive no matter how white the rest of the teeth are.

As far as the actual bleaching gel is concerned, there are two basic formulations that are used. Although basically the same in terms of efficacy, they are indicated for different situations. The first formulation is carbamide peroxide. Carbamide peroxide takes approximately 3 to 4 hours to break down by the saliva and lose its effectiveness when placed in the bleaching trays. This makes it the proper gel to use if you will be wearing the trays overnight. Treatment usually takes 10 to 14 days depending on the amount of whitening desired.

The second formulation is hydrogen peroxide. Developed more recently, hydrogen peroxide is broken down in approximately 30 minutes before it is simply an inert gel in the trays. This gel is used if you want faster results and don't want to wear the bleaching trays as often. Wearing the trays twice a day for half an hour can complete treatment with a hydrogen peroxide based gel. Again, treatment takes about 10 to 14 days. Both types of gel will give equal results if the directions from the dental office are followed precisely.

No matter which gel is used, the teeth will not stay white forever. Depending on your habits, you will need to do a touch up treatment anywhere from once a month, to once every 6 months. The more staining foods that you eat and drink, the more often you will need to touch up. Touching up consists of wearing the trays with the bleaching gel for one session (either 30 minutes or overnight depending on the type of whitening gel used).

The whitening process itself is quite simple. Your dental office makes a mold of your teeth. That mold is then used to fabricate a thin tray that fits precisely over the teeth. The material that is used is a thin flexible plastic so that the tray is comfortable to wear. Once the tray is fitted to your teeth, your dentist will then dispense the bleaching gel. The bleach is placed in the trays for the prescribed amount of time and the teeth are whitened.

Whitening your teeth is a safe procedure that will give you dramatic results. Proper diagnosis is vital to determine if the bleaching gel will be effective in treating your condition. It is also important to visit your dentist to ensure that a quality-bleaching product is used. Store bought brands have only a fraction of the peroxide agent that is found in the gel available in dental offices, often making them ineffective at whitening the teeth.

So go ahead,whiten your teeth and dazzle the world with your smile. It's safe and fun!

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