August 9, 2009

teeth whitening

Salam pretty people ;D
I've been nicely approached by 2 readers to blog on the above topic. Well, its rather a topic that i could really brag about, but i am not an aesthetic dentist (which they all lagi tahu the current trends and products and price etc) but still i can talk bout teeth whitening.. ngeh ngeh..

Yes, so here goes lovelies, some amount of information on teeth whitening that i know of. A private practitioner would really dig this lah since they do and promote lotsa cosmetic dentistry, which nothing wrong pun, it is us in Min of Health yang practice little cosmetic dentistry *sigh*. OK, so...

Bismillah.. =)

In the blossoming world of cosmetic dentistry, teeth whitening reigns supreme. Universally valued by men and women alike, whitening (or bleaching) treatments are available to satisfy every budget, time frame and temperament. Whether in the form of one-hour bleaching sessions at your dentist’s clinic, or home-use bleaching kits purchased at a pharmacy, teeth whitening solutions abound. Yet only 15 percent of the population has tried the cosmetic procedure, and misinformation on the subject is rife. The long and the short of it is that teeth whitening works. Virtually everyone who opts for this cosmetic treatment will see moderate to substantial improvement in the brightness and whiteness of their smile. However, teeth whitening is not a permanent solution and requires maintenance for a prolonged effect. Well, nothing lasts huh, everything needs touch-ups!!

The term "bleaching" is permitted to be used only when the teeth can be whitened beyond their natural color. This applies strictly to products containing bleach — typically hydrogen peroxide or carbamide peroxide. The term "whitening," on the other hand, refers to restoring a tooth’s surface color by removing dirt and debris. So any product that cleans (like a toothpaste) is considered a whitener. Of course, the term whitening sounds better than bleaching, so it is more frequently used - even when describing products that contain bleach!

Most of us start out with sparkling white teeth (i said most because there are a few people born with teeth that are slightly to the darker shades), thanks to their porcelain-like enamel surface. Composed of microscopic crystalline rods, tooth enamel is designed to protect the teeth from the effects of chewing, gnashing, trauma and acid attacks caused by sugar. But over the years enamel is worn down, becoming more transparent and permitting the yellow color of dentin — the tooth’s core material — to show through. During routine chewing, dentin remains intact while millions of micro-cracks occur in the enamel. It is these cracks, as well as the spaces between the crystalline enamel rods, that gradually fill up with stains and debris. As a result, the teeth eventually develop a dull, lackluster appearance. Teeth whitening removes the stains and debris, leaving the enamel cracks open and exposed. Some of the cracks are quickly re-mineralized by saliva, while others are filled up again with organic debris.

There are two types of discoloration - extrinsic and intrinsic. Extrinsic stains are those that appear on the surface of the teeth as a result of exposure to dark-colored beverages, foods and tobacco, and routine wear and tear. Superficial extrinsic stains are minor and can be removed with brushing and prophylactic dental cleaning. Stubborn extrinsic stains can be removed with more involved efforts, like teeth bleaching. Persistent extrinsic stains can penetrate into the dentin and become ingrained if they are not dealt with early. Intrinsic stains are those that form on the interior of teeth. Intrinsic stains result from trauma, aging, exposure to minerals (like tetracycline) during tooth formation and/or excessive ingestion of fluoride. In the past, it was thought that intrinsic stains were too resistant to be corrected by bleaching. Today, cosmetic dentistry experts believe that even deep-set intrinsic stains can be removed with supervised take-home teeth whitening that is maintained over a matter of months or even a year.

So, what can cause staining?
Age: There is a direct correlation between tooth color and age. Over the years, teeth darken as a result of wear and tear and stain accumulation. Teenagers will likely experience immediate, dramatic results from whitening. In the twenties, as the teeth begin to show a yellow cast, teeth-whitening may require a little more effort. By the forties, the yellow 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 inborn tooth color that ranges from yellow-brownish to greenish-grey (Yes sirree!!!), and intensifies over time. Yellow-brown is generally more responsive to bleaching than green-grey.
Translucency and thinness: These are also genetic traits that become more pronounced with age. While all teeth show some translucency, those that are opaque and thick have an advantage: they appear lighter in color, show more sparkle and are responsive to bleaching. Teeth that are thinner and more transparent — most notably the front teeth — have less of the pigment that is necessary for bleaching. According to aesthetic dentists, transparency is the only condition that cannot be corrected by any form of teeth whitening.
Eating habits: The habitual consumption of red wine, coffee, tea, cola, carrots, oranges and other deeply-colored beverages and foods causes considerable staining over the years. You know, i take coffee everyday, like twice a day!! Gosh, if i dont kan, my teeth will be sparkling and melepak!! *sigh* But i gotta have my caffeine dosage everyday, for my sanity!! LOL In addition, acidic foods such as citrus fruits and vinegar contribute to enamel erosion. As a result, the surface becomes more transparent and more of the yellow-colored dentin shows through.
Smoking habits: Nicotine leaves brownish deposits which slowly soak into the tooth structure and cause intrinsic discoloration.
Drugs / chemicals: Tetracycline usage during tooth formation produces dark grey or brown ribbon stains which are very difficult to remove. Excessive consumption of fluoride causes fluorosis and associated areas of white mottling.
Grinding: Most frequently caused by stress, teeth grinding (gnashing, bruxing, etc.) can add to micro-cracking in the teeth and can cause the biting edges to darken.
Trauma: Falls and other injuries can produce sizable cracks in the teeth, which collect large amounts of stains and debris.

Right. Next - what are the options? In-Office/Clinic Whitening - Significant color change in a short period of time is the major benefit of in-office whitening. This protocol involves the carefully controlled use of a relatively high-concentration peroxide gel, applied to the teeth by the dentist or trained technician after the gums have been protected with a paint-on rubber dam. Generally, the peroxide remains on the teeth for several 15 to 20 minute intervals that add up to an hour (at most). Those with particularly stubborn staining may be advised to return for one or more additional bleaching sessions, or may be asked to continue with a home-use whitening system.

It costs RM1200 and up (not so sure tho), available at your private GPs.

Professionally Dispensed Take-Home Whitening Kits - Many dentists are of the opinion that professionally dispensed take-home whitening kits can produce the best results over the long haul. Take-home kits incorporate an easy-to-use lower-concentration peroxide gel that remains on the teeth for an hour or longer (sometimes overnight). The lower the peroxide percentage, the longer it may safely remain on the teeth. The gel is applied to the teeth using custom-made bleaching trays that resemble mouth guards.

Take-home whitening kit cost: I really dont know exactly, but i reckon few RM hundreds (?).

Over-the-Counter Whitening - The cheapest and most convenient of the teeth whitening options, over-the-counter bleaching involves the use of a store-bought whitening kit, featuring a bleaching gel with a concentration lower than that of the professionally dispensed take-home whiteners. The gel is applied to the teeth via one-size-fits-all trays, whitening 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.

Over-the-counter teeth whitening - I think Colgate punye cost less than RM100, but again, i am just shooting here.

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

Yes, so.. How white can you go??
Teeth whitening results are subjective, varying considerably from person to person. Many are immediately delighted with their outcome, while others may be disappointed. Before you embark on any whitening treatment, ask your dentist for a realistic idea of the results you are likely to achieve and how long it should take to achieve them. Expectations play a major role in teeth whitening.

In the dental office, before-and-after tooth color is typically measured with shade guides. These are hand-held displays of wide ranges of tooth colors. Dentists also use them in choosing crown and other restoration shades. The standard-setter among them has long been the Vitapan Classic Shade Guide. This shade 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

Moving on... Hmm... ahaa, so what are the risks??!!
Teeth whitening treatments are considered to be safe when procedures are followed as directed. However, there are certain risks associated with bleaching 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 whitening 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 porcelain 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.”

And.... 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.

In addition to the aforementioned risk factors, a number of caveats should be considered before undergoing teeth 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.

Yes.. hmm..faham ke? Do ask if ada yang tak brape nak paham or my use of words are not public friendly, but i am pretty sure all of you reading understood kan kan?!! hehe..

(sparkling pearly teeth! Yes i chose Leighton Meester's photo because i simply cant wait for GG Season 3!!!)

*rasa mcm bagi CDE plak!!*


Pinkwatch said...

yaya, teringat kat citer friends yang ross terlebih putihkan gigi dia.. epas tu nampak freaky giler.. hahahaah! habis plan dia dating.. hahahahah!

Miss Moon said...

yaya thanks for the info ,moon pun banyak kali rasa nok tanya ...sebab jeles tgk gigi yaya hok comey ngan putih tew ...

waaaaaaaaaaaaa rupanya mahal jugok nok putih kan gigi nehhhhhhhhhhh

i_sofia said...

thanx for sharing..

zailamohamad said...

This is really good info doc;-)

patient to be said...

I'm so happy u blog about this..
tq doc yaya.. :) thanks so muchh!!
I nak ty org tapi segan.. :p
a lots of info here ...

any clinic yg u leh rekemen for this treatment?..

Anonymous said...

Macam copy and paste je. LOL

dentist in mission viejo said...

Thanks for the info about teeth whitening. I am trying some new stuff in my dentist office.

cosmetic dentist washington dc said...

Sounds like those are some pretty awesome methods to get your teeth whitened. I have only had the actual dentist give me some bleach and a tray to put it into for my teeth. It worked great, but i know of other people who prefer the over the counter stuff, or some that have even used apple cider vinegar. Kind of interesing

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Roy D. Slater said...

Thanks for the info on teeth whitening. I was headed to my dentist in meridian to ask him about teeth whitening but I think you answered all of my questions. Thanks.

Winner said...

Got my teeth whitening treatment at dentist in kuala lumpur last week . Hope it show a great result :D