Teeth Whitening: How it Works and What it Costs

Medically Reviewed by: Larry Addleson, DDS, FAACD
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Teeth whiten is one of the most popular cosmetic dentistry treatments offering a flying, non-invasive and low-cost way to enhance a smile. Universally valued by men and women alike, whitening ( or bleaching ) treatments are available to satisfy every budget, clock inning and disposition. Whether in the form of professionally administered one-hour whitening sessions at a dental office or cosmetic health spa, or home-use bleach kits purchased at your local drugstore, solutions abound .
virtually everyone who opts for a dentition whiten solution sees moderate to substantial improvement in the brightness and purity of their smile. That said, it ’ s not a permanent solution to stain and requires care or “ touch-ups ” for a prolong effect.

In this article we break down everything related to teeth whiten, including the serve of tooth discoloration, what causes staining, the respective treatment options available, and their consort risks and costs .

Bleaching vs. Whitening: What’s the Difference?

According to the FDA, the term “ bleach ” is permitted to be used only when the teeth can be whitened beyond their natural semblance. This applies strictly to products that contain bleach — typically hydrogen peroxide or urea peroxide .
The term “ whitening ” on the other hand, refers to restoring a tooth ’ randomness surface semblance by removing crap and debris. So technically speaking, any product that is used to clean the tooth ( like a toothpaste ) is considered a bleaching agent. Of course, the condition whitening sounds better than bleaching, so it is more frequently used — even when describing products that contain bleach .

The bleach preference for in-office whitening, where time is limited, is mighty and fast-acting hydrogen hydrogen peroxide. When used in bleaching teeth, hydrogen peroxide concentrations range from approximately nine percentage to 40 percentage .
By contrast, the bleach of preference for at-home teeth whitening is slower-acting urea peroxide, which breaks down into hydrogen peroxide. Carbamide hydrogen peroxide has about a third gear of the military capability of hydrogen hydrogen peroxide. This means that a 15 percentage solution of urea hydrogen peroxide is the crude equivalent of a five percentage solution of hydrogen peroxide .

An Examination of Tooth Enamel

Most of us start out with sparkling white teeth, thanks to their porcelain-like enamel surface. Composed of microscopic crystalline rods, tooth enamel is designed to protect the tooth from the effects of chew, gnash, injury and acid attacks caused by boodle. But over the years enamel is wear down, becoming more guileless and permitting the scandalmongering color of dentine — the tooth ’ randomness core material — to show through .
During act chew, dentine remains intact while millions of micro-cracks occur in the enamel. It is these cracks, deoxyadenosine monophosphate well as the spaces between the crystalline enamel rods, that gradually fill up with stains and debris. As a result, the teeth finally develop a dull, lackluster appearance .
Teeth whitening removes the stains and debris, leaving the enamel cracks open and exposed. Some of the cracks are promptly re-mineralized by saliva, while others are filled up again with organic debris .

Tooth Discoloration: Extrinsic vs. Intrinsic Staining

There are two categories of staining as it relates to the teeth : extrinsic and intrinsic .
Extrinsic stains are those that appear on the surface of the tooth as a result of exposure to dark-colored beverages, foods and tobacco, and routine wear and rip. superficial extrinsic stains are minor and can be removed with brush and cautionary alveolar consonant scavenge. Stubborn extrinsic stains can be removed with more involve efforts, like teeth whitening. persistent extrinsic stains can penetrate into the dentine and become ingrain if they are not deal with early .
Intrinsic stains are those that form on the home of dentition. intrinsic stains result from injury, aging, exposure to minerals ( like tetracycline ) during tooth formation and/or excessive consumption of fluoride. In the past, it was thought that intrinsic stains were besides resistant to be corrected by bleaching. today, cosmetic dentistry experts believe that even deep-set intrinsic stains can be removed with monitor take-home teeth whitening that is maintained over a count of months or even a class. If all else fails, there are alternative cosmetic solutions to treat intrinsic staining, such as dental veneers .

Teeth Whitening vs Dental Veneers

Whitening and veneers are two popular smile makeover treatment options. Weigh their pros and cons with your needs .

What Causes Tooth Staining?

Age: There is a direct correlation coefficient between tooth tinge and age. Over the years, tooth darken as a leave of clothing and tear and stain accumulation. Teenagers will likely experience immediate, dramatic results from whitening. In the twenties, as the tooth begin to show a scandalmongering mold, whitening may require a short more attempt. By the forties, the chicken gives way to brown and more maintenance may be called for. By the fifties, the teeth have absorbed a host of stubborn stains which can prove difficult ( but not impossible ) to remove .
Starting color: We are all equipped with an connatural tooth color that ranges from yellow-brownish to greenish-grey, and intensifies over clock. amber is broadly more responsive to bleaching than green-grey .
Translucency and thinness: These are besides genetic traits that become more pronounce with age. While all teeth show some translucence, those that are opaque and thick have an advantage : they appear lighter in coloring material, show more glitter and are responsive to bleaching. Teeth that are thinner and more transparent – most notably the front tooth – have less of the pigment that is necessity for bleaching. According to cosmetic dentists, transparency is the entirely condition that can not be corrected by any form of tooth whitening .
Eating habits: The accustomed consumption of red wine, coffee, tea, colon, carrots, oranges and other deeply-colored beverages and foods causes considerable staining over the years. In addition, acidic foods such as citrus fruits and vinegar lend to enamel erosion. As a leave, the come on becomes more guileless and more of the yellow-colored dentine shows through .
Smoking habits: Nicotine leaves brown deposits which slowly soak into the tooth structure and cause intrinsic discoloration .
Drugs / chemicals: Tetracycline custom during tooth geological formation produces darkness grey or brown university decoration stains which are very unmanageable to remove. excessive consumption of fluoride causes fluorosis ( discoloration marked by the appearance of dim ashen marks on the dentition ) and associated areas of white mottling .
Grinding: Most frequently caused by try, teeth grinding ( gnashing, bruxing, etc. ) can add to micro-cracking in the teeth and can cause the barbed edges to darken .
Trauma: Falls and other injuries can produce goodly cracks in the tooth, which collect big amounts of stains and debris .

What are Your Whitening Options?

Three major teeth whitening options are available today. All three trust on varying concentrations of hydrogen peroxide and varying application times .
In-Office Whitening
significant color change in a short period of time is the major benefit of in-office whiten. This protocol involves the carefully controlled use of a relatively high-concentration peroxide gel, applied to the tooth by the dentist or educate technician after the gums have been protected with a paint-on rubber dam. generally, the peroxide remains on the tooth for several 15 to 20 infinitesimal intervals that add up to an hour ( at most ). Those with particularly stubborn tarnish may be advised to return for one or more extra bleach sessions, or may be asked to continue with a home-use system .
cost : $ 650 per visit ( on average ) nationally.

( Read more about in-office whitening )
Professionally Dispensed Take-Home Kits
many dentists are of the opinion that professionally dispensed take-home whitening kits can produce the best results over the farseeing haul. take-home kits incorporate an easy-to-use lower-concentration peroxide gel that remains on the dentition for an hour or long ( sometimes overnight ). The lower the hydrogen peroxide percentage, the longer it may safely remain on the tooth. The gelatin is applied to the teeth using custom-made bleach trays that resemble sass guards .
cost : $ 100 to $ 400 .
( Read more about take-home whitening )
Over-the-Counter Products
The cheapest and most commodious of the teeth whitening options, nonprescription bleach involves the use of a boughten whiten kit, featuring a bleach mousse with a concentration lower than that of the professionally dispensed take-home whiteners. The gel is applied to the tooth via one-size-fits-all trays, strips or paint-on applicators. In many cases this may only whiten a few of the front teeth unlike custom trays that can whiten the entire smile .
price : $ 20 to $ 100 .

How White Can You Go? A Matter of Esthetics

Results are immanent, varying well from person to person. many are immediately delighted with their result, while others may be disappointed. Before you embark on any whiten treatment, ask your dentist for a realistic theme of the results you are probably to achieve and how long it should take to achieve them .

Shade Guides

In the alveolar consonant office, before-and-after tooth tinge is typically measured with shade guides. These are hand-held displays of wide ranges of tooth colors. ( Dentists besides use them in choosing pennant and other restoration shades. )
The standard-setter among them has long been the Vitapan Classic Shade Guide. This tad guide standard incorporates 16 shades, systematically arranged from light to dark into four color groups, and provides a universal tooth-color terminology .
While whitening can occasionally lighten tooth color by nine or more shades, most of those who bleach their teeth are likely to see a change of two to seven shades.

Risks

Teeth whitening treatments are considered to be safe when procedures are followed as directed. however, there are certain risks associated with bleach that you should be aware of :

• Sensitivity: Bleaching can cause a temporary increase in sensitivity to temperature, pressure and touch. This is likeliest to occur during in-office whitening, where higher-concentration bleach is used. Some individuals experience spontaneous shooting pains (“zingers”) down the middle of their front teeth. Individuals at greatest risk for whitening sensitivity are those with gum recession, significant cracks in their teeth or leakage resulting from faulty restorations. It has also been reported that redheads, including those with no other risk factors, are at particular risk for tooth sensitivity and zingers. Whitening sensitivity lasts no longer than a day or two, but in some cases may persist up to a month. Some dentists recommend a toothpaste containing potassium nitrate for sensitive teeth.
• Gum irritation: Over half of those who use peroxide whiteners experience some degree of gum irritation resulting from the bleach concentration or from contact with the trays. Such irritation typically lasts up to several days, dissipating after bleaching has stopped or the peroxide concentration lowered.
• Technicolor teeth: Restorations such as bonding, dental crowns or veneers are not affected by bleach and therefore maintain their default color while the surrounding teeth are whitened. This results in what is frequently called “technicolor teeth.”

Maintaining Your Results

To extend the longevity of newly whitened teeth, dentists are likely to recommend :

• At-home follow-up or maintenance whitening – implemented immediately or performed as infrequently as once a year.
• Avoiding dark-colored foods and beverages for at least a week after whitening.
• Whenever possible, sipping dark-colored beverages with a straw.
• Practicing excellent oral hygiene – brushing and flossing after meals and at bedtime.

Caveats

In accession to the aforementioned risk factors, a act of caveats should be considered before undergoing tooth whitening :

• No amount of bleaching will yield “unnaturally” white teeth.
• Whitening results are not fully seen until approximately two weeks after bleaching. This is an important consideration if you are about to have ceramic restorations and want to be sure the color matches that of your newly bleached teeth.
• If cosmetic bonding, porcelain veneers or other restorations are part of your treatment plan, they should not be placed until a minimum of two weeks following bleaching to ensure proper adhesive bonding, function and shade matching.
• To avoid the technicolor effect, tooth-colored restorations will likely need replacement after bleaching.
• Recessed gums often reveal their yellowish root surfaces at the gum line. That yellow color has proven difficult to bleach.
• Pregnant or nursing women are advised to avoid teeth whitening. The potential impact of swallowed bleach on the fetus or baby is not yet known.

How Much Does Teeth Whitening Cost?

The cost of teeth whitening can vary quite significantly from product to merchandise, procedure to procedure .
Professional, in-office tooth whiten is the most expensive option with a national average of $ 650 per sojourn ( price can vary between $ 500 to $ 1,000 ). however it does have the benefit of being performed by an experience dental professional, helping to ensure that you get the sort of results you ’ re looking for .
At the other end of the monetary value spectrum are over-the-counter strips and trays that you can buy at your local anesthetic pharmacy or grocery store. These products can range from $ 20 to $ 100, making them an attractive option for those looking for a bite of smile enhancement without the higher monetary value of professionally administered whitening. however, it ’ sulfur crucial to keep in mind that results can vary drastically when using these cheaper, low-concentration hydrogen peroxide whiteners .
If you ’ ra looking for a middle-ground between professional whitening and over-the-counter products, you might be a good candidate for professionally dispensed take-home kits. Prescribed by a dentist, these kits range in cost from $ 100 to $ 400, and can potentially deliver results similar to those you ’ d get in-office at the hands of a dentist .
Keep in thinker that whitening results are not permanent, intend that if you want to maintain your white smile, you ’ ll indigence to continue getting treatments as the effects wane .
[ updated April 18, 2019 ]

About the Reviewer

Lawrence Addleson, DDS, FAACD, of San Diego, CA is an internationally recognized leader in the field of aesthetic cosmetic dentistry. In 1993 he earned his accreditation with the american Academy of Cosmetic Dentistry ( AACD ) and is one of the few dentists worldwide to complete the rigorous criteria for both accreditation and fellowship, the most esteemed level of clinical excellence accomplishable within the AACD. Dr. Addleson has held many top positions within the AACD, including president, extremity of the Board of Directors, and twice chair of the Board of Governors.

Dr. Addleson earned his doctor of dental surgery in 1969 from the University of Southern California School of Dentistry, and is the collapse of The Art of Dentistry, a premier cosmetic and corrective dentistry practice located in San Diego .

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