What You Need to Know about Tooth Whitening Systems

Note: Before using any whitening procedure, ADHA recommends that you first be evaluated by an oral health care professional to determine which application and program are best for you.

Why do my teeth have stains and discolorations?
Most stains are caused by age, tobacco, coffee, or tea. Other types of stains can be caused by antibiotics, such as tetracycline; or too much fluoride.

What treatments are used for stained teeth?
Ask your oral health care professional about tooth-whitening options. They include a number of over-the-counter whitening systems, whitening toothpastes, and the latest high-tech option--laser tooth whitening. For maximum whitening, experts agree that peroxide is usually the way to go.

Supervised bleaching procedures that are done in-office and at-home have become among the most popular treatment options. In some cases, the procedure is performed entirely in the office, using a light or heat source to speed up the bleaching process. In other cases, an oral health care professional gets the procedure started during an office visit and then gives you what you need to complete it at home. Still another popular procedure is one that you complete entirely at home.

At-home procedures, sometimes called nightguard vital bleaching, consist of placing a bleaching solution, usually a peroxide mixture, in a tray (nightguard) that has been custom fitted for your mouth by an oral health care professional. The bleaching solutions may vary in potency and may be worn for an hour, or throughout the night. Your oral health care professional can advise you on the appropriate type of application and the length of time needed to whiten your teeth, based on the severity of tooth discoloration and your specific needs.

How effective are bleaching systems?
Bleaching is effective in lightening most stains caused by age, tobacco, coffee, and tea. Based on clinical studies, 96 percent of patients with these kinds of stains experience some lightening effect. Other types of stains, such as those produced by tetracycline use or fluorosis (too much fluoride), respond to bleaching less reliably. And one cosmetic dentist points out that bleaching systems are not fully predictable. If you have a tooth-color filling when your teeth are bleached, the filling will stay yellow—dental restorations do not change color when tooth whitener is applied.

Are there any side effects to tooth bleaching?
In some studies, patients have experienced uncomfortable short-term side effects when having teeth bleached. Hydrogen peroxide can increase temperature sensitivity in the teeth, particularly at higher concentrations, and nightguards often cause gum irritation.

And overzealous use of over-the-counter home bleaching products can wear away tooth enamel, especially with solutions that contain acid. Therefore, bleaching is a procedure best done under the care of an oral health care professional.

Still, the general health risks of bleaching systems are minimal as far as your body is concerned. Applications are controlled so that you don't swallow hydrogen peroxide.

What's Available?
While research continues into all types of bleaching systems, tooth bleaching is sure to continue to grow in popularity. Here's a selection of what's currently available.

At-home bleaching kits—the most popular whitening option. Mouth trays are usually made in one office visit, and your oral health care professional will provide a whitening brand suitable to your needs. Some trays are worn for an hour, others through the night. Kits range in price from $300 to $500.

Bonding—a composite resin that is molded onto the teeth to change their color and to reshape them. The resin material can stain and chip over time. Bonding can usually be done in one office visit for $300-$700 per tooth.

Porcelain veneers— these shell-like facings can be bonded onto stained teeth. They are used to reshape and/or lengthen teeth as well as to whiten. Veneers require at least two office visits and cost $700 to $1,200 per tooth.

Whitening Toothpastes— While some whitening toothpastes effectively keep the teeth cleaner and, therefore, looking whiter, some are more abrasive than others. The stronger toothpastes rely on abrasion to remove external stains as opposed to actually changing the color of teeth. The key is to study a product's ingredients, look at your teeth to see if it changes their color, and consult your oral health care professional for customized advice.

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