"What kind of bleaching/whitening is best for my teeth?"
In the past, I was never quite sure how to answer this question. I feel like my primary goal as a dentist is to diagnose and treat disease, not to make recommendations on the pros and cons of bleaching options. In fact, I wasn't sure if I thought our professional system was worth the fee we needed to charge to cover our costs. This was especially true as the studies done on bleaching systems were inconclusive. However, the majority of new patients to our practice ask about whitening and so it was clearly an important topic that deserved an explanation.
So, what are the differences?
Professional bleaching systems have a higher concentration of bleach giving patients faster results. In addition, professional systems utilize a custom fitted appliance to deliver the bleach. Compare this to one of the most popular over-the-counter products, Crest White Strips. The strips are often difficult to keep in place and patients tell me they are uncomfortable to keep in place for very long. However, the initial cost is significantly different. Crest White Strips can be purchased for $60 compared to the average cost of professional bleaching in the Portland area of $420. However, there is often a difference between initial cost and value.
Most of my patients who ask about bleaching options have already tried an over the counter product with disappointing results. Common complaints we hear is that over the counter products do not whiten as expected and often cause discomfort and sensitivity to teeth and gums or the strips only cover the front six teeth....
I strongly recommend a professional bleaching system with custom trays for several reasons:
- The professional whitening gels have very good desensitizing agents which is a common complaint for patients who bleach their teeth
- The custom trays can also be used to deliver additional desensitizing medications further reducing sensitivity and can be used to deliver medications used to treat decay or gum disease or be converted into a nightguard to protect teeth from wear
- Custom trays limit the chances of a bleach burn to the gums that is common with over-the-counter products
- Probably the most important reason is that a thorough dental exam accompanies a professional whitening system, which often identifies previously unknown causes of tooth lose, gum disease, decay or discomfort and ensures optimal oral health. Small cavities, worn out teeth and early onset gum disease often do not have any noticeable symptoms and patients who have not had an exam is some time are often surprised to hear their oral health is not as good as it could be.
- New studies suggest that some bleaching products can acutally damage tooth structure. This makes it even more important that any bleching be done under the care of a dentist especially if unknown cavities or enamel defects are present.
In the end, over the counter products are inexpensive but relatively ineffective. A professional whitening system, on the other hand, represents a good value and is the safest most effective way to a white smile.
Kyle Valentine DMD