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In-Office Teeth Whitening

Immediately visible teeth whitening in a single visit

Immediately visible teeth whitening in a single visit.

In-Office Teeth Whitening

Professional in-office teeth whitening is the most popular cosmetic dental procedure in the world today. Unlike home-use whitening systems that incorporate low-dose bleaching agents, in-office whitening (also known as power bleaching, power whitening, professional whitening or chairside whitening) takes place under carefully monitored conditions which allow for the safe, controlled, pain-free use of a relatively high concentration of bleaching gel – yielding results that are visible immediately.

Advantages of In-Office Whitening

  • No other teeth whitening procedure produces faster results.
  • This is the safest form of tooth bleaching.
  • Gum and tooth sensitivity (formerly drawbacks to in-office bleaching) are more controllable today due to thicker peroxide gels (that don’t soak into the teeth as much as previous gels) and the use of desensitizers such as potassium nitrate and fluoride.

Disadvantages of In-Office Whitening

  • In-office bleaching is more expensive than take-home alternatives. Its cost, on average, is $650, compared to $400 for take-home trays and under $100 for over-the-counter bleaching trays or whitening strips.
  • Results can be unpredictable, depending on factors such as age, heredity and the type of staining that is present.
  • In-office bleaching is not a permanent solution. Shortly after treatment is completed, the teeth resume accumulating stains. Many dentists therefore recommend home maintenance follow-up with a lower-percentage bleach that can be kept on the teeth for longer periods of time.

Stains that are Best Removed with In-Office Whitening

Chairside whitening removes organic stains or discolorations primarily caused by:

Aging

Over time, the teeth darken with a yellow, brown, green or grey cast (which may be due to heredity and/or eating habits). Yellowed teeth tend to whiten most readily.

Food Stains

Stains caused by consumption of certain foods (notably coffee, red wine, sodas and dark-colored vegetables and fruits) can be whitened.

Tobacco Stains

Both chewing and smoking related tobacco stains can be whitened.

Stains Resistant to In-Office Whitening

Teeth with certain stains – typically those that are inorganic – do not respond well to in-office whitening. In fact, these teeth may look even darker after the surrounding teeth have been whitened.

  • Trauma, which causes the dentin to darken.
  • Tetracycline antibiotics ingested during tooth-formation. These drugs chemically bind with the crystalline structure of both the tooth’s enamel and underlying dentin.
  • Overexposure to fluoride, which can cause fluorosis, resulting in tooth discoloration.

Is In-Office Whitening Right For You?

This procedure is not suitable for those with the following conditions:

  • Tooth and gum hypersensitivity. To avoid a hypersensitive reaction, your dentistis likely to recommend take-home bleaching trays with a low concentration of carbamide peroxide – which is not as potent as hydrogen peroxide.
  • Deep and intractable staining. Some stains are resistant to high-concentration in-office bleaches. In such cases, dentists may recommend a supervised regimen of intensive take-home bleaching or alternatives to peroxide bleaching such as bonding, crowns or porcelain veneers.
  • Teeth that have become transparent with age. This is particularly true of the front teeth, which are thin to begin with.

The In-Office Teeth Whitening Procedure

Prepping the Teeth

Your teeth will likely be given a prophylactic cleaning to clear away plaque and debris that have collected on the surface and between the teeth.

A dental exam will be performed (often in tandem with the prophylactic cleaning) to check for potential problems such as severe tooth decay, cracks and gum disease. Bleaches can cause varying degrees of irritation if these conditions are present. Your dentist will likely delay the whitening procedure until such problems have been corrected.

Photos may be taken of your teeth, and their color measured on a shade guide. This provides a benchmark for assessing your whitening progress.

First Treatment

While details may vary, a fairly standard routine is followed. Typically, the steps involved are not painful or uncomfortable; in fact, many patients doze or watch a DVD or TV during the procedure.

  • A cheek retractor is inserted into the mouth, exposing all the “esthetic zone” teeth (teeth that are visible when you smile).
  • A liquid rubber dam or hardening resin is painted onto the gum tissue to protect against any irritation caused by the bleaching gel.
  • A bleaching gel containing hydrogen peroxide is applied to the esthetic zone teeth and kept on for approximately 15 to 30 minutes.
  • The bleaching gel is suctioned or washed off, and fresh gel is applied for one or more additional periods of 15 to 30 minutes.
  • Some whitening treatments incorporate an intense light that is focused on the teeth and is said to activate or enhance the bleaching process. Opinions vary as to whether this light improves the bleaching outcome.
  • Between gel applications, the teeth are checked to see how well they have whitened, and whether more bleach needs to be applied.
  • After the final gel application, the cheek retractors are removed, the patient rinses and the immediate post-treatment shade change is measured. The teeth may whiten by as few as two to three shades or as many as eight (out of a total of 16). Part of the whitening effect is due to dehydration during the bleaching process, which makes the teeth look whiter than their true new color. That color will emerge after a couple of days.

If a satisfactory level of whitening hasn’t been achieved, your dentist may recommend follow-up in-office bleaching at a future date, and/or a regimen of take-home bleaching trays.