How can you brighten your smile?

Your wedding is coming up and you want your smile to be its brightest. Or maybe you have an important speaking engagement. Whatever the reason, tooth bleaching isn't just for the movie stars, and it isn't just for one day. Millions of people have had their teeth bleached, and probably millions more are thinking about it. The desire for whiter teeth is very strong, and tooth bleaching safely lightens the color of the teeth, lasting for up to three years. The most effective and safest method of tooth bleaching is dentist-supervised.

Is bleaching for you?

Generally, bleaching is successful in at least 90 percent of patients. Consider tooth bleaching if your teeth are darkened from age, coffee, tea, or smoking. Teeth darkened with the color of yellow, brown or orange respond better to lightening. Other types of gray stains caused by fluorosis, smoking, or tetracyline are lightened, but results are not as dramatic. If you have very sensitive teeth, periodontal disease, or teeth with worn enamel, your dentist may discourage bleaching.

What's involved?

Step one: First, the dentist will record your medical history to determine whether you are a candidate for tooth bleaching and what type of bleaching system should be used. Next, you'll decide if you want all of your teeth bleached, or just the uppers. If you're in a big hurry for whiter teeth, you may decide to have in-office bleaching where the dentist will whiten your teeth while you sit in the dental chair. However, most patients choose dentist-supervised at-home bleaching, which is more economical.

Step two: At the next appointment, the dentist or hygienist will take impressions of your teeth to fabricate your mouthguard appliance. The mouthguard is custom made for your mouth only and is very lightweight, so that it can be conveniently worn. It is fabricated so that it can be comfortably worn while sleeping or while awake. You should even be able to talk with your mouthguard. Along with the mouthguard, you'll receive the  bleaching materials. You'll be instructed to wear the mouthguard for  two to four hours a day until your next appointment, generally within  one to two weeks. Generally this type of system requires three to six weeks to complete, and works best on patients with sensitive teeth.  Other systems recommend bleaching at night while you sleep with their mouthguard. This bleaching treatment usually requires only 10-14 days to complete.

How long does it last?

Lightness should last for about one to five years depending your personal habits such as smoking and drinking coffee and tea. At this point you  could use a touch up. The procedure will not be as costly the next time because you can probably still use the same mouthguard. The retreatment  time also is much shorter than the original treatment time.

How does it work?

The active ingredient in most of the   whitening agents is 10 percent carbamide peroxide (CH4N202), also known as urea peroxide; when water contacts this white crystal, the release of hydrogen peroxide lightens the teeth.

IS it safe? Any side effects?

Several studies have proven its safety during the past five years. The American Dental Association has also granted its seal of approval to some tooth bleaching products. Some patients may experience slight gum irritation or tooth sensitivity, which will resolve when the treatment ends.

What are realistic expectations?

No one can really predict how much lighter your teeth will become. Every case is different. However, typically there is a two-shade improvement as seen on a dentist's shade guide. The success rate depends upon the type of stain and your compliance. Bleaching can only provide a shift in color from gray to a lighter shade of gray, for example. Bleach
ing does not lighten artifical materials such as resins, silicates or porcelains.

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Send comments to:Dr. Jay Last Update February 16, 2006