Sparkle City

From dingy to dynamite — the latest in tooth whitening.
Want to look younger? Land a job? Attract a mate? Appear polished for a special business event? The motivations behind tooth whitening are as varied and seemingly endless as the array of tooth whitening products available today, from toothpastes, gels, rinses and strips available at retail stores, to dentist-supervised in-office and at-home whitening.
And no wonder. Discoloration tops the list of characteristics that can make a smile unattractive, followed by missing, crooked and decaying teeth, according to an American Academy of Cosmetic Dentistry (AACD) consumer poll. In fact, tooth whitening is the most requested cosmetic dental procedure, according to the AACD.
Whitening treatments allow patients to choose the degree of change they want, from a subtle brightening to noticeably higher wattage. Results can vary depending on the patient’s age and lifestyle habits, but in general “There’s almost no one that we can’t get white,” says Thomas P. Connelly, D.D.S., of Connelly General and Cosmetic Dentistry in Manchester.
The one instance in which even professional bleaching routinely fails to work is when it is applied to fillings, crowns, veneers and the like. Bleaching will not lighten artificial materials, an important consideration for anyone who wants to avoid what some have dubbed “Technicolor teeth.”
Decisions, decisions
Faced with a glut of whitening products and surrounded by hype, it’s easy for consumers to feel confused when weighing whitening options, but essentially there are three different routes to choose from: retail products, in-office whitening at a dentist’s office and take-home dentist kits.
Retail
Retail treatments are tempting because they’re relatively inexpensive and don’t require the hassle of dentist appointments, but users should prepare to be disappointed, experts warn. “Most of the time, the retail, store-bought products don’t work that effectively” because they contain a low concentration of bleaching agent, says Antonio Butura, D.D.S., of Preferred Family Dental in Bedford.
Cosmetic dentists point out that patients relying on retail remedies often end up purchasing kit after kit from the store, ultimately spending hundreds of dollars, and in the end, remaining unhappy with the whiteness of their teeth.
In-office
“Chairside” bleaching at a dentist’s office usually takes about an hour. During in-office bleaching, the dentist typically uses a gel or rubber shield to protect the patient’s gums and mouth, applies a bleaching gel to the teeth and then uses a special light or laser to speed up the bleaching process. This process is especially appealing to busy professionals who “just want to get it done quickly — one day, get it over with,” Butura says.
Take-home kits
While in-office whitening is the fastest way to get brighter teeth, it does not always offer the best results in the long run. In-office procedures focus on high-intensity bleaching to get the job done quickly, he says, whereas dentist-supplied, take-home treatments rely on lower concentrations of bleaching agent applied for longer periods of time. “All of the published studies show and prove that duration is the key [to successful bleaching], not intensity,” Connelly says.
Some patients also prefer take-home dentist kits because they like to have some control over the bleaching process, Butura says. Patients can use the bleaching gel when it is convenient for them. “Patients can stop and start whenever they want to, and sometimes people are happier with that,” Butura says.
Another benefit of at-home professional treatments is the mouthguard-like “tray” that dentists provide as part of the kit. Trays hold the bleaching agent against the teeth and dentist-supplied ones, unlike retail trays, are custom-made, based on an impression of the patient’s teeth. A properly-fitted tray helps keep the bleaching gel in place — in contact with the teeth and not so much with the gums. “It helps create a nice gasket seal between the junction of the gums and each tooth,” Connelly says.
Maintaining your pearly whites
Regardless of which option a patient chooses, maintenance will be necessary. “You need to do touch-up because teeth will stain again from food,” Butura says. What a touch-up entails varies with the type of treatment a patient chooses, but for patients using an at-home dentist kit, touch-ups simply require a couple of sessions with the tray and gel.
How often a touch-up is needed depends on individual habits, such as the amount of tea and coffee the patient drinks, or whether he or she uses tobacco products. Some patients, after an initial professional bleaching, might not require a touch-up for a year, whereas others might need more frequent boosts. But for most patients the results are worth the effort. People are really committed to doing whatever it takes to achieve and keep their preferred level of brightness, Connelly says. “Some people have internal stain that’s been a burden their entire life but they have beautiful teeth and a beautiful smile.” As long as their treatment plan works, “they stick to it,” he says.
Some experts recommend that, in addition to touch-ups, patients should avoid consuming foods and liquids that tend to stain teeth, or to sip dark liquids through a straw. If you worry about feeling foolish drinking your Cabernet Sauvignon through a bendy straw the next time you’re out on the town, don’t fret. Such extreme measures aren’t really necessary, say our local experts. “Life is too short,” Connelly says.
Butura agrees. “As long as you use a tooth-whitening toothpaste, which there are many of, and do occasional touch-ups, that should do it,” he says. NHCaveat Emptor
Although often used as interchangeable terms, bleaching and whitening are not synonymous, at least not in the FDA’s eyes. Any product, including toothpaste, that removes surface stains or debris can advertise itself as “whitening.” Only items that can alter the intrinsic color of teeth are allowed to bill themselves as “bleaching” products. Dentists, however, often will refer to “whitening” when discussing bleaching methods, possibly because it seems to be the more commonly used term (plus it sounds nicer).