Sunday, April 12, 2009

Laser whitening: safe or not?

The traditional whitening procedure is immersion of the enamel in a teeth whitening tray of peroxide solution, which has the effect of oxidizing chemical stains caused by coffee, tobacco etc. A new idea introduced to this old procedure is "laser teeth whitening". The procedure is simply described as follows: after application of the peroxide solution to the teeth, laser light is shone upon the enamel surface to provide focused, intense energy to increase the effect of the peroxide solution. The idea is that the combination of the peroxide cleansing action with the energy of the laser results in a brighter, whiter teeth. Does this work?
Actually, the jury is still out on this question. Although the idea sounds good in principle, in clinical tests the answer has never been clear-cut. Patients may in fact be signing up for a useless procedure. For example, in 2008, in the International Journal of Prosthodontics, Lin and Coluzzi reported that they tried a laser whitening procedure on 91 patients. They used an objective "Shade matcher" to assess whether the procedure improved dental whiteness, and found surprisingly that a subset of the patients responded to the treatment but another less so. They concluded that there is variable efficacy of the procedure depending on the patients.
Similarly, in a 2009 publication of Lasers Medical Sciences, Coutinho and co-workers found that depending on the laser light wavelength, there may be some to no whitening at all.
Ask your dentist whether objectively the laser treatment in his or her office is doing any good. Older laser-generating machines may not to have the correct wavelength to give the right results. Worse still, in all recent studies, pulp (the soft tissue at the root of the tooth) heating and sensitivity was a reported problem in many patients treated by laser-assisted whitening.

Sunday, April 5, 2009

Teeth whitening gum

One of the ways advertised for whitening teeth is a product called teeth whitening gum. The idea is that the dental patient chews the gum and as he or she does so the ingredients in the gum is slowly released which has the effect of removing the stain on the teeth. For example, the company Supersmile created an attractive can of gum called Supersmile Professional Whitening gum with CALPROX. What is CALPROX? It's a fancy name for the chemical carbamide peroxide! And carbamide peroxide is the main active chemical in teeth whitening trays. So teeth whitening gum really follow the same principles as teeth whitening trays except it's in gum form. Now one question we would ask is whether this will actually work? There are two really serious problems with the idea of whitening teeth by chewing gum. I mean, if it really worked, then why do dentists still get patients who want to use the custom treatments? Everyone would be going onto Amazon and just getting the gum instead of spending hours at the dentist sitting still getting those tray fitted. Well, here are the two problems with teeth whitening gum.
1) Chewing the gum moves it around the mouth, but never evenly immerses the enamel surface of your teeth in the CALPROX ingredient at all times. If it's not evenly covering it for extended periods of time, then the CALPROX can't possibly work.
2) The amount of CALPROX in the gum is just way too weak to have any effect on the teeth! This is the most serious issue. If there were a prescription dose of peroxide in each piece of gum, then maybe we'd expect a little bit of an effect. But the truth is that these OTC products can never have enough peroxide to have the right effect of whitening the teeth.

Here is what one product description says on Amazon:
"NEW All natural Sugar-free Supersmile Professional Whitening Gum with CALPROX® quickly and effectively whitens teeth, freshens breath, promotes healthier gums and removes superficial surface stains with every use. And Supersmile Professional Whitening Gum is sweetened with XYLITOL® the natural cavity inhibitor preferred by dental professionals."

Friday, April 3, 2009

Tooth trays in kits

Custom-fitted tooth trays are expensive, since they involve the expertise of a dentist. For those who cannot afford to be attended by a dental professional, there is the possibility of getting self-whitening kits from a brick-and-mortar or online store like Amazon. Each kit contains a small plastic mold that is to be fitted to your teeth. The plastic mold must be heated via boiling to a high temperature so that they can be pliable. Once heated, the tooth trays are to be fitted over one's teeth to provide a snug fit for the trays. Finally, a whitening agent needs to be used along with the trays. One may buy over the counter the peroxide agents that fill the trays. Thinking of using over-the-counter peroxide agents? Better to ask your dentist for a prescription peroxide, since these are usually given at higher concentration or stronger strength for improved whitening action.

Thursday, April 2, 2009

The whitening agent

The whitening agent
Instead of "bleach", usually an agent such as a peroxide is used for teeth whitening. The peroxide is a mildly oxidizing agent, which chemically "scrubs" discolorizing material from the surface of the teeth when exposed for extended periods of time. Unfortunately, the duration required for effective whitening stretches past two or more hours. Patients who are non compliant on duration may have less effective cleansing action and end up wearing the teeth trays for even longer.

Custom trays made by your dentist

Custom teeth trays by your dentist

To make the tooth tray, a dentist must first take a plaster cast impression of the teeth. Although this step is quick, the dentist must now create a custom tray of the patient's teeth using the plaster cast, which can take more than a week. The tooth tray should fit snugly over the teeth but stop short of irritating the gums. After the patient receives the teeth tray, he or she must be instructed in usage. This is generally a simple procedure, involving application of small amounts of teeth whitening agent to the tooth tray, and then wearing the teeth tray for an extended period of time.

Tuesday, March 17, 2009

All the information you need about teeth trays
Teeth trays or tooth trays are for used for teeth whitening, a process commonly known as "bleaching" even though no real bleaching agents are used. Unlike other whitening procedures which involve simply application of a gel or an adhesive strip coated with bleaching material, teeth trays cover much more surface of each tooth and increase the chances that the tooth is evenly whitened. A patient may elect to whiten both the upper and lower teeth (called arches), or just a single arch in the face of cost considerations. Although focusing on only one can exacerbate the contrast in whiteness between the lower and upper arches. On the other hand, the procedure for teeth trays is expensive and patients may wish to save some money.

Effects of "bleaching" on dental work
The colloquial term "bleach" actually refers to a peroxide compound that reacts mildly with coloring to reduce them on the surface of the teeth. Before whitening with bleach and tooth trays, you should know the effects on dental work. For enamel work, such as caps, crowns and bridges, there is minimal effect from the whitening agent. This means you may have to expect some color mismatch between your natural teeth and the artificial work. Of course, this mismatch may have already been there prior to whitening. Artificial work in the form of silver or mercury amalgams (mixtures of metals) is affected differently by the peroxide agents: they may become slightly discolored from oxidation, turning darker or becoming tinged.

Sunday, March 1, 2009

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