The most requested procedure we see in our practice is tooth lightening/whitening. It’s easy to understand why - who doesn’t want a brighter smile? It’s especially popular this time of year when people want to look best for their holiday party. There are several different options how you can achieve a brighter smile and it doesn’t necessarily mean you have to go to the dentist to get one.
Most oral bleaching gels use a form of peroxide as the active ingredient to lighten the teeth. Teeth whitening peroxides come in come in two forms - Hydrogen Peroxide and Carbamide Peroxide. These are the only two active ingredients which are approved by the FDA for teeth lightening so the consumer must be vigilant and make certain that the product they are considering uses one of these options. There have been instances of well-marketed products essentially selling acid etch and white paint to lighten teeth (which is not approved in case you’re wondering).
Hydrogen Peroxide gels tend to work a little faster but tend to have more side effects associated with it. Carbamide Peroxide has an agent in the peroxide that controls the release of the peroxide so it works a little slower but has fewer side effects. A solution strength 10% Carbamide Peroxide is equal to about 3.5% Hydrogen Peroxide. In other words, you need less concentration of Hydrogen Peroxide to work have similar results.
The most common side effect is extreme cold sensitivity and throbbing of the teeth. Other than concentration levels, what differentiates brands of solutions from one another is how they address limiting these side effects. Some don’t address it at all and will have a high likelihood of causing side effects. Others add ingredients such as Potassium Nitrate or Fluoride to help reduce side effects.
The peroxides work through an oxidation process. They penetrate through the porosities in the enamel and react with compounds which cause teeth to stain and break them apart lifting the stain from the tooth. Sensitivity occurs when the pores of the enamel are exposed allowing the cold to penetrate through the enamel layer and irritate the nerve.
There are over the counter solutions that can work pretty well for many people. Most of the major brands of toothpaste manufacturers have some sort of lightening system. They are usually of lower concentrations to prevent major side effects from occurring. I would advise you against buying lightening solutions off the internet or from radio commercials only because there is very little accountability with companies like these.
If these over the counter systems prove not to work effectively enough, you should probably pursue the professional lightening systems. These are not the systems you see at the mall, but rather systems that your dentist can distribute and closely monitor for you. A cosmetic dentist can also prescribe treatments to help completely eliminate any side effects that you may encounter.
One other quick note - systems with light activated solutions have been not been proven to work better or faster than traditional lightening treatments.