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Whitening Information

Why do I have to see the dentist before I can have the treatment?

Whitening in this country and the European Union is governed by the Cosmetic Products (Safety) (Amendment) Regulations 2012. The legislation states that these products can only be provided when an appropriate clinical examination is carried out by a dental professional. This is to ensure that there are no risk factors and other oral pathology is ruled out.

Concentrations over 6% of hydrogen peroxide are prohibited from use.

Can I have the treatment if I’m under 18?

The same legislation states that products releasing between 0.1% and 6 % hydrogen peroxide cannot be used on under 18’s except where they are intended wholly for the purpose of treating or preventing disease.

Why are my teeth discoloured/stained?

There are two types of tooth staining; extrinsic and intrinsic

Extrinsic staining is the surface staining that occurs when the coloured components found in food and fluids (chromogens) are deposited and accumulate on the surface of the tooth or in the cracks, pits and flaws of the enamel. Certain substances produce more staining, examples of these are tobacco, red wine, strong tea, coffee, grapes, spices, dark coloured vegetables/fruits etc. Some chemicals can combine with the above staining elements to produce more adherent discolouration, these include chlorhexidine and iron supplements.

Intrinsic staining is the internal discolouration of the tooth caused by dark pigmented molecules being incorporated into the substructure of the tooth. There are multiple causes for this including genetics, drugs, aging, trauma and metabolic 

What are the different methods of whitening?

There are two methods of whitening, either mechanical or chemical:

Mechanical whitening is the easiest and most effective way to remove extrinsic stains. Mechanical whitening includes a hygienist scale and polish and use of whitening toothpastes.

Chemical whitening (vital bleaching) involves using a peroxide, either hydrogen or carbamide, which breaks down into water and free radicals. These free radicals then diffuse into the tooth and alter the pigmented molecules so they reflect the light more so the tooth is perceived to be whiter.

Due to the fact that only dental professionals can prescribe the peroxide whitening, you may find different methods of whitening on voucher sites, beauticians and internet selling sites. These usually use derivatives of Sodium Borate. These substances have been classified as carcinogenic, mutagenic or toxic for reproduction (CMR) and as such any substance classified as such, independent of its concentration, is prohibited for use in cosmetic products.

You may also find stronger concentration of peroxides on some internet selling sites from Non-Europe Union countries. These are highly dangerous especially as they do not come with a custom made tray.

Is there any reason I can’t have my teeth whitened?

Most people can have vital bleaching but there are a few contra-indications.

Medical: If you are undergoing radio or chemotherapy for melanoma, using photosensitive drugs or photosynthesis herbal remedies.

Age: As previously mentioned, the legislation prohibits vital bleaching to under 18’s. 8-13year olds have larger pulpal chambers and dental tubules so it may cause severe pain.

Allergy: If you are aware of previous allergies in relation to the ingredients in the bleaching materials.

Dental: Whitening is inadvisable if the enamel is compromised. Therefore any cavities, micro-cracks or thinned enamel, seen in some systemic disease or in some older people, will need to be treated. It is also unsuitable for patients with untreated periodontal disease, severe recession, dry mouth or previous severe hypersensitivity. If you already have extensive restorations in your front teeth it may also not be appropriate as these may also require replacement following the whitening treatment as they will not whiten, only natural teeth will respond to the whitening.

Patient Habits: It is contra-indicated for patients with habits that can lead to rapid recurrence of the discolouration e.g. heavy smoking.

Do whitening toothpastes work?

A whitening toothpaste will not whiten your teeth significantly. They will only mechanically remove staining by means of a more abrasive paste, enzymes (that can breakdown the extrinsic staining) or a very low dose of peroxide. The more abrasive paste may eventually wear some of the enamel away. However, they may be a good way to maintain your white smile after having vital bleaching carried out.

Does Home Bleaching work?

Yes, Home whitening/bleaching does work but you must be realistic in what can be achieved. Home bleaching will only work on organic tissue so crowns, veneers and fillings will not whiten. In fact, there is some evidence that tooth coloured fillings may actually get darker. We would recommend these are replaced a few weeks after the completion of treatment. The Hollywood smile as seen with some minor celebrities is not attainable by the majority people without additional invasive treatment i.e. crowns and veneer which will damage the teeth irreversibly. Aesthetic and cosmetic experts say that teeth should be no whiter than the whites of your eyes.

How do you whiten the teeth?

The most appropriate way is to place the peroxide gel into custom made trays either for a few hours during the day or for about 8 hours overnight. (See separate sheet for instructions). There are 4 concentrations of peroxide:

6% hydrogen peroxide, usually used during the day

10%, 15%, 16% carbamide peroxide, used for the overnight bleaching.

How long does Whitening take?

When will I know when to stop treatment?

Eventually your teeth will not change or change very little, this is the saturation point. This is the end point of treatment.

How long will the whitening last after treatment?

You may get some immediate relapse; some of the oxygen incorporated into the teeth that makes them whiter will be released from the teeth for about 2-3 weeks after treatment. This will be very minor and may not be noticeable. In the long term, studies have shown that teeth will return to their pre-bleached shade in about 3-4 years. Consumption of staining foods, poor oral hygiene and smoking could reduce the longevity of the treatment.

You can maintain your bright smile by regularly visiting the hygienist and using a recommended whiting toothpaste. There is the possibility of topping up the whitening at a later stage by purchasing additional individual syringes. These are at a cost of £27.50 per syringe. 

If I cannot wear a tray or cannot afford the tray therapy are there any alternatives?

Yes, there are whitening strips. You will still need to see the dentist to assess if it is an appropriate treatment and there are no contraindications. These strips contain 6% hydrogen peroxide and are attached to the front of the teeth. They will not bleach your teeth as much as the tray- based treatments. Research has shown these can whiten teeth up to around 4 shades whereas the gel/ tray method by around 6-7 shades.

Are there any problems in using the bleaching agents?

When used properly and as instructed, the risks and concerns of bleaching are minimal. The associated problems are tooth sensitivity, gingival irritation, sore throat, altered taste sensation and caffeine /tobacco withdrawal symptoms. All these are minor and are easily repaired. The most common complaint is sensitivity. In up to 85% of patients this can be managed by the placement of soothers in the newer generation of whitening products and pre-treatment of existing sensitive areas. Gingival irritation is reduced with correctly designed and fitted trays. Sore throats can be eliminated by removing any excess gel as soon as possible.

What are the associated costs with whitening treatment?

The Beeches Dental Practice has joined up with a leading dental cosmetic company.

Whitewash Laboratories is British company whose products have been developed by UK dentists and all comply with the European Cosmetic directive and legislation.

Whitewash Whitening toothpaste - £7.99 per tube (Dental exclusive)

Home whitening with trays/ gel - £275   (£199 for Beeches Smile Plan Patients)

Additional Top-Up Whitening syringes - £25.00 per syringe

Teeth Whitening Strips - £59.99 following a Routine Dental Examination

Please ask a member of the team for any further information or to arrange an appointment to discuss your whitening requirements.