Tooth Whitening blog
Dental Bleaching
Where to start on this one, when it is dentistry it is not ‘cosmetic tooth whitening’ it is therapeutic Dental Bleaching! Dental Bleaching is a treatment that improves oral health, rids you of halitosis (bad breath) AND lightens/whitens tooth colour.
I love the effects of dental bleaching - boosting the health of my mouth whilst also tooth whitening/lightening (especially as I also love black coffee and red wine), I could talk about dental bleaching all day….
My Background
(aka ..why you should trust me on this)
I am a Gold Member of The British Dental Bleaching Society. The Society is dedicated to training and educating to the highest standard, providing members with up to date information, current research, strategies and support to ensure safe and successful dental bleaching for patients.
I have been in Dentistry for over 34 years and have extensively trained in therapeutic dental bleaching ‘tooth whitening’ and have been successfully carrying out dental bleaching resulting in improved oral health and tooth whitening/lightening for over the last 24 of those years.
I have a professional duty of care to act in your best interests and i am held accountable as is every medical/dental professional. The medical model of treatment is different to non-medics who are not held accountable.
Optident and Opalescence are my Gold Standard choice. I have toyed with other systems in the past, but I always return.
I daughter test everything I do, and this passes my daughter test with ease.
Optident are the UK supplier, and active educator, for Ultradent in America – The World Leaders in Dental Bleaching ‘tooth whitening’!
Myths & Facts.
The Facts
In 2011 it became illegal for anybody other than a dental professional to carry out ‘tooth whitening’ in the UK - the law can impose penalties from a £1000 fine up to a prison term of 6 months.
A little prior to this, 4000 years ago, the Egyptians used pumice stone and wine vinegar to whiten teeth - as white teeth were viewed as a sign of beauty and wealth - yep this led to tooth rot!
Fast forward 2000 years ago to Ancient Rome and it gets worse, Goats milk and urine (human urine yep) hmm well ammonia is a bleaching agent and even though you might not want to go kissing someone who had just brushed their teeth this way it was actually surprisingly effective!
Press the fast forward again to 400 years ago - the 1600’s when ‘barber-surgeons’ not only sorted hair but medical and dental issues also! Remember there was no anaesthetic back then and in a barbaric way they would file down the teeth and apply nitric acid to wash away stain - yep stripped enamel = tooth rot again!
1914-1918 The so called Great War brought with it ‘Trench Mouth’ - in World War 1 (pre the existence of antibiotics not available until WW2) was treated with Hydrogen Peroxide by doctors/medics attending to the troops.
Modern day - in the 1960’s dental professionals stumbled upon the use of hydrogen peroxide in it’s use as an antiseptic to rid the mouth of gum disease they discovered a side effect of lighter/whiter teeth, hurrah! finally a safe effective, and most of all a urine free technique!
Hydrogen peroxide (H2O2) is still to this day the safest, most effective way to whiten the teeth. Evidence driven and proven time and time again to safely pass into the tooth to break down complex molecules and stains in addition it also has the ability to destroy a variety of germs ensuring that your mouth is healthy and reduces bad breath and other health problems such as gingivitis and tooth decay.
Hydrogen peroxide is trusted by dental professionals worldwide and is the gold standard active whitening ingredient and it breaks down cleanly into harmless oxygen and water as it oxidises the larger molecules releasing/removing stain.
Everyone if legally allowed to use peroxide would still to this day be doing so!
The reason for non-peroxide ‘cosmetic tooth whitening’ is to ‘get around’ the loophole in the legal system by non-dental professionals.
In order to create the oxygenation which breaks down the stain chromosome in non-dental bleaching/whitening without safely using peroxide in many cases the substitute is a chemical called Phthalimido-peroxy-caproic acid (PAP+) a synthetic acid found in laundry detergent.
A study in 2019 in the British Dental Journal found that PAP+ whitening had caused more damage to teeth than any other over the counter whitening products. PAP+ was also responsible for creating etching patterns in the tooth surface and reducing the hardness of the enamel.
Due to PAP+ use in teeth whitening being relatively new we do not yet and will not for many years fully understand how damaging it is.
PAP+ can be flammable, corrosive and an environmental hazard.
Social Media white teeth in a filter can not be achieved by tooth whitening.
The Myths
That non-peroxide versions of ‘tooth whitening’ are safer &/Or more effective.
That an LED light box will whiten your teeth.
That your teeth will be 16 shades lighter (teeth don’t work like that - dental shade guides don’t work like that).
That putting a solution on your tooth for less than 20 minutes will safely &/or effectively whiten teeth.
Why I choose Opalescence
(aka why you should also choose Opalescence)
AT £180.00 for a complete Kit of 10 x sets of trays it is Fabulously Affordable!
Opalescence was developed and produced by Ultradent, in 1990
it is a safe and effective product that protects the teeth from dehydration and increases shade stability.
It contains Potassium fluoride which has been found to contribute to an increase in enamel hardness, the prevention of dental caries and a decrease in tooth sensitivity.
Dehydration gives a false whitening effect, if I were to air dry your tooth, I could whiten it but shortly after it would re hydrate, and that effect would go.
No Bounce back is what I am aiming to avoid I do not want your immediate after picture to look fantastic then a day or so later you are back to where you started.
Ever sign up to a quick 15 minute whitening? That is dehydration!!!
Opalescence whitening is the number one recommended professional tooth whitening system in the World.
Opalescence Go, is the unique pre-loaded, UltraFit tray, which is great for immediate use, and where patients have a dislike of moulds being taking.
No trays to store and lose, or that no longer fit when your teeth change,
No cleaning of reusable trays, more comfortable, convenient, easily inserted & hygienic.
Noticeable true results.
Please Remember
Tooth Whitening is the practice of dentistry and can only be legally carried out by a registered dentist, dental hygienist, or dental therapist. A consultation is required as it is a prescription product. Dental Bleaching is therapeutic.
The GDC regards ALL tooth whitening procedures, including the use of light kits and laser whitening as the practice of dentistry. Dental professionals involved in tooth whitening must be trained and competent to carry out the procedure and have appropriate indemnity in place.
Patients can only be provided with a home whitening kit containing up to 6% hydrogen peroxide (equivalent to 18% carbamide peroxide) after they have had a consultation.
Also - hydrogen peroxide is rapid release each application requires a contact time of between 60-90 minutes to work - it is considered day time bleaching/whitening. Carbamide peroxide is slow release, normally provided in 10% or 16% as night time bleaching as it requires a minimum of between 4-6 hours contact time.
Anything that claims to work in 10 or 15 minutes will not work safely or effectively, light boxes do not work - my advice use my tooth whitening kit and use the light box for a disco effect to have a wee boogie whilst wearing my trays for 90 minutes.
THERE IS NO ONE SIZE FITS ALL APPROACH
Every mouth and set of teeth are different, so too the lifestyle of the person seeking whiter teeth, some people have minor discolouration of otherwise healthy teeth and gums, others might have gum disease and damaged teeth where there are issues to address before whitening is undertaken.
Some practices prefer what is known as ‘in-office’ or ‘chairside’ dental bleaching. This one-off treatment has an immediate visual impact but unfortunately one that can fade relatively quickly.
Why are my teeth changing colour?
There are many reasons why your teeth darken or stain they fall into 3 categories,
Extrinsic - staining on the outside enamel surface, builds up in biofilm that covers the tooth.
Intrinsic - staining caused by something inside the tooth, or body, often occurs during the formation of enamel or as result of damage/trauma to the tooth.
Age related changes – these happen later in life as the transparent enamel thins and the darker dentine shines through, dentine also darkens as it matures.
Intrinsic and age-related discolouration requires professional dental bleaching to improve appearance safely and effectively. Extrinsic is removed by Ohh! Flow.
What are Common causes of staining?
Tea, coffee, cola, red wine, green teas, red bush teas, any teas coffees without milk, these are the worst culprits. Generally, if it stains your cup it stains your teeth! Foods for example curries, especially those containing coloured spices like turmeric cardamom and saffron. Tomato based red sauces, soy sauce. Beetroot, red cabbage, and blueberries are other culprits, as a rule if an ingredient will stain your fingernails or a white t shirt generally it will stain your teeth!
Tobacco use, smoking pipes, cigars cigarettes and the use of chewing tobacco. Coloured vapes and e cig liquids are also staining. Nicotine replacement chewing gum and e cig liquids containing nicotine.
Regular use of some mouthwashes particularly those containing chlorhexidine – Corsodyl being the biggest culprit for many.
Swimming excessive exposure to chlorinated water can cause erosion and staining.
Poor dental hygiene, not brushing, or flossing your teeth daily. And/or correctly!
Medications, in particular liquid iron, antihistamines like Benadryl, antipsychotic drugs, some chemotherapy drugs, and some high blood pressure drugs. The antibiotics tetracycline and doxycycline can affect enamel formation and discolour teeth in the development stages in children.
Drug abuse, especially heroin, methamphetamine, cocaine, ecstasy, and marijuana - some of these like meth and cocaine are very acidic, others induce acid reflux and vomiting, all of which damage the enamel leading to rapid decay and demineralisation giving the teeth yellow and brown stained appearance.
Excessive fluoride from environmental sources such as naturally high levels in water, or from excessive use such as fluoride application or rinses, toothpastes and fluoride supplements can also cause discolouration.
Dry mouth with poor saliva flow rate. Mouth breathing and some medications may contribute to a dry mouth.
Dental materials, some amalgams can give a gray/black tone to your teeth and crowns with bonded metal under the porcelain can give appearance of unsightly stain at the gum margins.
Dental decay depending what stage the decay is at it can appear as a creamy white lesion to a very dark brown one.
What are my options for tooth whitening?
Proper diagnosis of the cause of the stain is essential. If it is extrinsic staining only then an Ohh! Flow and change to an Oral B Electric toothbrush, with a non-abrasive toothpaste, make changes to diet, but avoid the abrasives which will make it worse. If it is intrinsic or due to age changes then professional dental bleaching is your option.
Do tooth whitening treatments work?
Yes, Dental professional dental bleaching, using a peroxide-based gel to lighten the teeth safely and effectively. The product creates oxygen which passes through the tooth removing the stain chromosome (think oxy action on your stains in your washing).
Is Dental Bleaching safe?
Yes, if done properly. It is illegal for anyone other than registered dental professional with indemnity insurance to carry out tooth whitening/dental bleaching. This is limited to a Dentist, Dental Hygienist and Dental Therapist who have been trained in tooth whitening/dental bleaching and hold a current GDC registration and indemnity insurance to safeguard you. Dental professionals are held accountable for their actions that is why our medical/dental duty of care cannot be beaten.
What is the difference between shop bought products and professional whitening?
Shop bought should only contain 0.1% hydrogen peroxide as It is illegal to sell any kits higher than this in the UK. At these low levels it is impossible to achieve effective and stable results in the way professional whitening does. Some over the counter products are abrasive, or erosive, and work by wearing the enamel away, your teeth may initially look whiter but can cause long term irreversible surface loss.
What do the percentages mean?
Professional whitening can contain up to 6% hydrogen peroxide, this is equivalent to 18% carbamide peroxide, home whitening comes in 6% hydrogen, 10% & 16% carbamide. Carbamide is slow release and Hydrogen is quick release (relating to the production of the oxygen that breaks down the stain).
6% Hydrogen is therefore the highest % of tooth whitening for safe and legal use in the UK.
When I first started out in tooth whitening and for many years, in-office whitening allowed us to place (after safely preparing the mouth) 36% hydrogen peroxide on the tooth and then heat it with a specially designed type of lamp to try to increase its oxygenation properties (this concentration did not require any help from a strong lamp), dehydration +++, sensitivity +++, white teeth +++, patient leaving with a scarf over their mouth for the cold Scottish air +++, & a 6% hydrogen home kit to stabilise.
When the new laws came in to allow only 6% (which to me is the home kit and not in office strength) I found it difficult to justify charging the prices that in surgery whitening demands whilst placing 6% (the same at my home kit) on the teeth.
I am yet to be convinced otherwise but watch this space – dentistry is forever advancing! Add to that I know the ease of having someone do it for you, a quick fix, is appealing, but proof of the pudding for me is that Opalescence Go with a little bit of time investment will achieve goals.
Does Tooth Whitening hurt?
No, but it common to experience some mild sensitivity either during or after the initial treatment this should settle down after a couple of days, but we will give further advice and can recommend suitable toothpastes and other products to help if you do experience sensitivity. My reason for choosing Opalescence is because it contains a high-water content and desensitising ingredients to stop this from happening.
Am I suitable for dental bleaching?
Lots of people can have dental bleaching treatments, but some may not be suitable, an assessment is required to ensure suitability – I do not want you investing your hard-earned cash in the wrong thing, it may be that what you seek isn’t tooth whitening but a full smile makeover or it may be that there is tooth decay or crowns & veneers that will not change with whitening.
Will whitening change my restorations/fillings?
No, whitening only works on natural teeth. Restorations such as fillings, crowns, and dentures cannot be whitened.
How much whiter will my teeth look?
The outcome of whitening varies depending on your individual teeth, we will be able to advise you on the likely results following an initial consultation. For some 1 box of 10 sets of opalescence go is enough for others 2 boxes are required to get you to your desired shade, if I had a pound for everyone who says ‘I only want them a little whiter not too obvious’ and then on review appointment ‘I would like another box’ I would be a rich woman and not sat here writing this blog.
How long will it last?
When carried out well results should be permanent and only need simple top ups every 6-9 months. With no top-ups, it may last up to 3 years. It varies from person to person and will not last as long if you smoke, or drink red wine, black tea, or coffee, which can cause new staining on teeth. The stain chromosome you remove will not return but you can build up new stain. I drink black coffee and red wine and love a curry, but I use an oral b electric toothbrush and oral b toothpaste and I top up when I have a night out or a big occasion coming up and with at home whitening you can top up as and when required.
BRIGHTEN YOUR SMILE TODAY!
Dental Bleaching consultations are only carried out following an Ohh! Flow appointment at Ohh! to ensure health of the mouth and removal of all tooth surface deposits, full assessment to determine your suitability, your true dental shade following surface stain removal, discuss shade achievable by dental bleaching & your goals.
