Teeth whitening is a procedure that aims to lighten tooth color with peroxide-containing gels. The in-office method is done under dentist control with the gum protected and differs from at-home tray methods (Haywood & Heymann, 1991). Results vary with tooth structure, the cause of discoloration and the person, and cannot be guaranteed.

Preliminary evaluation

• Gum and decay health: Problems needing treatment are resolved first.
• Determining the cause of discoloration: Surface stains, age-related color change and internal discoloration need different approaches (Kidd et al., 2003).
• Fillings and crowns are not affected by whitening; they may need to be renewed for color match.

Application

The gum is protected, the gel is applied and whether helpers such as light/heat will be used is determined by the dentist. In non-vital (root-treated) teeth, internal bleaching is a separate technique and requires care because of the risk of resorption (Fisher & Radford, 1990).

Risks

Temporary sensitivity and gum irritation are commonly reported (Dahl & Pallesen, 2003; Goldstein & Kiremidjian-Schumacher, 1993). For details see our article on sensitivity after whitening.

In-office whitening step by step

1. Examination and cleaning: Calculus and surface stains are cleaned; decay and gum problems are identified.
2. Shade recording: The starting shade is recorded; expectations are discussed.
3. Protection: The gum and lips are covered with a protective barrier.
4. Gel application: Peroxide-containing gel is applied to the teeth; the duration and number of repeats are determined by the dentist according to the product and the case.
5. Finish and instructions: The gel is cleaned off; short-term dietary instructions are given.

Who is whitening not suitable for?

In people with active decay, gum disease or exposed root surfaces, these problems are treated first. Whitening may need to be postponed during pregnancy, breastfeeding, a history of marked sensitivity and some special situations; talk to your dentist. Dark internal stains such as tetracycline may respond to whitening only to a limited degree; in such cases alternatives such as veneers are considered (see porcelain veneers and composite bonding).

In-office versus at-home tray method

At-home tray applications use lower-concentration products for longer periods (Haywood & Heymann, 1991). The in-office method is done under dentist control and in an environment where the gum is protected. The dentist decides which method suits you; sometimes the two methods are combined.

How long do results last?

Color can darken again over time according to tea, coffee, smoking and eating habits. Therefore no definite promise can be given for how long results last; regular cleaning and care help maintain color satisfaction.

Frequently asked questions

Does whitening harm teeth?

It must be applied under dentist control and with appropriate indication; temporary sensitivity can occur.

How long does the effect last?

It varies with diet and habits.

How is the fee determined?

Information is given after examination according to the scope of application; no fixed figure is given.

What can’t I eat or drink after whitening?

In the first days dark-colored drinks and foods and staining habits such as smoking are limited according to the dentist’s advice.

Does whitening also whiten fillings?

No; the colors of fillings and crowns do not change; they are renewed if needed.

How many sessions does whitening take?

The number of sessions is planned by the dentist according to the product and goal.

You can book an appointment or browse the other articles in our Dental Health section. You can reach us from Bahçelievler, Bakırköy, Güngören, Haznedar, İlkyuva, Basınsitesi and the European side.

References

• Kidd, E. A. M., Smith, B. G. N., & Watson, T. F. (2003). Pickard’s manual of operative dentistry (8th ed.). Oxford University Press.
• Kidd, E. A. M., Smith, B. G. N., & Watson, T. F. (2003). Treatment of approximal caries, trauma, developmental defects and bleaching of discoloured anterior teeth (Chapter 10). In Pickard’s manual of operative dentistry (8th ed., pp. 163–174). Oxford University Press.
• Sakaguchi, R. L., & Powers, J. M. (Eds.). (2012). Craig’s restorative dental materials (13th ed.). Elsevier Mosby.
• Haywood, V. B., & Heymann, H. O. (1991). Nightguard vital bleaching: How safe is it?. Quintessence International, 22(7), 515–523. PubMed ↗
• Dahl, J. E., & Pallesen, U. (2003). Tooth bleaching: A critical review of the biological aspects. Critical Reviews in Oral Biology & Medicine, 14(4), 292–304. PubMed ↗
• Goldstein, G. R., & Kiremidjian-Schumacher, L. (1993). Bleaching: Is it safe and effective?. Journal of Prosthetic Dentistry, 69(3), 325–328. PubMed ↗
• Fisher, N. L., & Radford, J. R. (1990). Internal bleaching of discoloured teeth. Dental Update, 17, 110–114. PubMed ↗

Note: Book chapter references follow the page ranges of the publisher’s edition; article links open the matching PubMed record.

This article is for information only and is not medical advice. See your dentist for diagnosis and treatment; no outcome is guaranteed.

This page was reviewed by Dr. Dt. Mehmet Fuat Bozaba, periodontist.