Teeth Whitening

I was having dinner with my usual girlfriends and some new acquaintances when the conversation shifted to my interesting occupation as a dentist. New friends always get amused when they find out I am a dentist. They are always interested to know how one can stare at teeth for almost 365 days a year. This amusement is shortly followed by slight self-consciousness. Most try not to show too much of their teeth as they bombard me with questions about how I even thought of becoming a dentist. Surely the conversation will shift to personal dental questions (best way to get a free dental consult). Over the years, I have been asked countless “Do we really have to remove wisdom teeth?” and “I am afraid to whiten my teeth as I heard it can harm my teeth and make them thinner.”

I will leave the topic of wisdom teeth to my Oral Surgeon colleague who is definitely more qualified. Teeth whitening, however, is something I do almost daily in various smile makeover and rehabilitative procedures.

Does teeth whitening really eat away precious enamel?
Firstly, let us understand what makes a tooth appear white.The outer part of a human tooth is made of a tissue known as the enamel. The enamel is composed of different minerals – hydroxyapatite, which is a phosphate of calcium, is the most prominent mineral. Calcium is naturally white in color, and this explains the color of our teeth.

However, the enamel is not perfectly white and contains shades of gray and yellow as well. Though it’s the hardest human tissue, it allows light to travel through it and is translucent. This brings the layer under the enamel called dentin, into the picture. Darker and more yellow than enamel, dentin play a role in imparting color to your teeth. So, it’s a simple enough relationship – the thicker the enamel of the teeth, the whiter they are.

With this understanding, it definitely would not make sense to have a teeth whitening procedure that removes enamel, as the teeth will appear more and more yellow. Teeth whitening gels are very safe and are made of either Hydrogen peroxide or Carbamide peroxide.

25% hydrogen peroxide is commonly used for Chair-side whitening such as Zoom, while the milder carbamide peroxide is used for take-home kits. The products I use are often carefully curated and I would try procedures on myself first before deciding on the system of choice. Zoom whitening kits include a syringe of Relief® ACP Oral Care Gel which contains potassium nitrate, to help manage sensitivity. This is given to patients to bring home.

I use Opalescence gel for take-home whitening kits. Opalescence whitening gel contains PF (potassium nitrate and fluoride), which helps maintain the health of enamel throughout the whitening process. All gels are of neutral pH and are not acidic, which is the common misconception.

How does teeth whitening work then?
Oxygen molecules from the whitening agents react with the discolored molecules in your teeth, breaking the bonds that hold them together. The oxygen molecules spread, whitening the entire tooth. The other byproduct of the gel is water so the whole whitening process is really safe and non-invasive.

If it isn’t harmful, then why is it sensitive?
The sensitivity is due to the dehydration of the teeth as we whiten. As such, sensitivity is mild and temporary. Once the moisture returns over 24 hours, the sensitivity disappears. There are many ways to manage sensitivity. We give patients desensitising toothpaste to brush with over a week before whitening, desensitisers post treatment and if you are really nervous, we also offer anti-inflammatories you can take just before the whitening.

But teeth Whitening is not forever.
Well, I always tell patients, whitening is the reverse of suntanning. It can fade and it really depends on our diet and social habits. Does it mean we can no longer drink coffee and red wine? No, not at all. I do not abstain. I tell patients if you are not fussy, and just like things whiter than before, then just come in once a year, sit on the chair, enjoy movies on our overhead TV, relax, and leave with whiter teeth.

If you are fussy and really want your pearly whites white all the time, you have many options. Home white strips, customised take home maintenance kit, and even a chairside touch-up kit, Zoom Quickpro, which is new from Zoom.

White strips are like sticky tape with gel impregnated. I tell patients they do not work all the time as the gel concentration is the lowest, and really only work well for folks with straight teeth. But it is very economical as you can get a box for less than $80.

I prefer the take-home maintenance kit which I personally use for touch-up. The trays are customised for comfort and it ensures an even layer of gel over the teeth. I have a choice of doing it for 15 minutes a day, or to wear it overnight, depending on the gel concentration. I only need to do it every 3 months over 3 days to get my smile back to va va voom status.

Lastly, the Zoom Quickpro is great for touch up after each twice yearly cleaning. It whitens teeth up to 3 shades, and only takes 5 minutes to apply. The varnish is left on for 30 minutes. The patient has a choice to rest on the chair, or to continue with their daily activities. We provide our patients with a free toothbrush and toothpaste kit to brush the varnish layer off.

It’s the best pick me up!
I recently had a new mom come in. She said her daughter’s first-month celebration was a week away. Being a new mom, she was planning the full works, with a huge party,and a photographer to capture every precious moment. The only problem was she did not lose the weight as fast as she liked (I definitely felt that pressure- to look skinny like all those celebrities straight after popping a little human being out!) She said she was feeling depressed, before it dawned upon her that she could do other things to look pretty. She did her hair, went for a facial and decided to whiten her teeth! She knew there was no way she could lose 5kg in 1 week, but she knew there were many things she could do in a short time to look good. What a smart lady!

White teeth is really the best pick me up. You feel good about yourself, it makes you want to smile at everyone you meet, to show off those white teeth. And when you smile, your whole body fills up with natural feel good hormones.

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