Framingham Cosmetic Dentistry - The Amazing Art Of Teeth Whitening & Smile Makeover

General Patient Information And Instructions

 

General Information/Procedures

Teeth whitening is #1 requested and performed cosmetic (aesthetic) dental procedure. Think wedding, prom, major job interview, major date…This is an elective procedure which may not routinely be recommended by all dentists as part of their treatment plan, unless it is requested by the patient. For the same reason no dental insurance carrier will cover the cost of this procedure. Since there are different reasons for teeth to be dark, they have been classified to external (tooth surface), internal (within the tooth), or both. And, each type has a different cause or reason.

In general, there are different concentrations of Hydrogen Peroxide or Carbomide peroxide (HP plus gel thickened) used in most tooth whitening agents. Whitening products work like laundry bleach, they polish away, oxidize, and eliminate the superficial staining. They can also penetrate the tooth surface to reach deeper layers in order to tackle locked-in stains and clear away teeth’s structural discolorations, such as genetically yellow/brown teeth, marks of trauma, braces, high fever, antibiotics and other meds, fluoride treatment and aging effects.

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The secret to successful bleaching is the concentration and the length of the time it is in contact with the tooth. This effect of bleaching gel gets intensified by absorbing light as well as elevation of temperature.

Various Techniques

A variety of options are available today by patient to brighten their smiles, but dentist-supervised treatments remain the safest and most effective way to whiten teeth. These products are available to the patients either through p0harmacy (OTC/take-home) or through a dental office, as take-home, one-visit in-office, or combination therapy. They range from chemically-activated chewing gums, tooth pastes, mouthwashes, paint-on gels, strips, custom-fitted trays, to even more advanced power (UV light or laser) bleaching. One could reasonably expect less of the results on the low-concentrated OTC materials, available through beauty shops or drug stores. A patient may choose any of the above techniques, based on how much they are interested in brightening their smiles, and/or willing to take chance with their investments (time and money).

Pre-Operative Considerations

It is highly recommended to have a comprehensive oral exam with your dentist prior to bleaching. During this examination/consultation appointment a dentist will check for the nature, type and extend of the staining microcracks, decay, leaky old fillings, root canals, exposed roots, gum recession, worn down teeth, the among of tooth pulp (though radiographic x-rays) and even existing healthy restorations. All these conditions need to be diagnosed and discussed prior to bleaching. This evaluation would provide information and enable the dentist to present and discuss what should be done before or what possibly has to be done afterward (some crowns or filling may need to be replaced to match other teeth after bleaching).

Post-Operative Care & Maintenance

After the bleaching process, your dentist may provide you with a supplemental kit containing aftercare products. These products are used for possibly enhancing and maintenance of your smile makeover. There are some factors involved in how long bleaching effect and whitened teeth last. The next bleaching interval mostly depends on the following factors: quality (how good) and quantity (how often) of routine oral hygiene (brushing…), habits (smoking…), diet (certain food and beverages such as tea, coffee and wine. Some other factors such as aging, certain disease and medications, or even use of lipstick can affect it as well.

Side-Effects

Teeth whitening is a comparatively simple, non-invasive procedure. The main possible side effect is tooth sensitivity, due to irritation to the pulp, since the bleaching gel opens up the teeth’s natural channels to the pulp (nerve). A special rinse or toothpaste (such as Sensodyne) could be used till the sensitivity is resolved. You can also reduce the frequency of usage/application of the whitening agent, if the sensitivity persists. Some patients possible can also experience gum irritation or dry mouth .Is has also been hypothesized that bleaching material, if swallowed, may inhibit vitamin absorption. In most cases, any of these possible side effects are temporary and reversible in a few (1-3) days post-operatively. A patient is advised to avoid consuming citric acid, too hot, or too cold food or drinks after bleaching for at least two days. And, if it is really needed, a regular OTC pain medication such as aspirin, tylenol or advil should be sufficient to alleviate the discomfort.

Contra-Indications

Relatively, there is no known serious contra-indication for any kind of bleaching systems, and it is considered fairly safe. Yet, bleaching is not generally recommended for children, pregnant, lactating severely medically-compromised patients, or the ones with existing sensitivity or severe periodontal conditions. The ones with poor oral hygiene and tooth decays, or known allergies to the treatment should avoid this procedure. Also, patients with severe tooth abrasion (ground down) or gum recession will temporarily experience more tooth sensitivity.

Patients Expectations & Procedures' Limitations

In general, no prediction can be made prior to the procedure about the result of tooth whitening and there is no guarantee. In other words, your teeth can get as much whiter as they can, and this amount may vary from patient to patient, and depends on your teeth quality and nature of staining. Moreover, the result may or may not meet your expectations. Not everyone can have pearly, pearly or unnatural refrigerator white teeth. Simply, there is no magic involved, however one can reasonably expect to see some degree of whitening after the bleaching. Also, patients with severe internal tetracycline staining or the ones who have discoloration on the gingival third (gum line) of their teeth should be informed of guarded prognosis, since they may not get the result they expect. In addition, existing veneers, crowns and bridges or white composite/bonded fillings will not change color with bleaching. After your bleaching, if the existing restorations are too obvious, dark, or esthetically not pleasing, you may choose to replace them. If you have any questions or concerns regarding bleaching your teeth, or would like to have more information, please do not hesitate to consult and discuss them with Dr. Madani (617-216-TOOTH).