Everyone wants beautiful, white teeth. A great smile makes you approachable and confident. There are several whitening treatments now available to consumers, many of which have been in the news. But remember, only a Board of Dentistry-licensed dentist or the consumer is legally allowed to physically apply oral whitening agents.

Whitening options include:

In-office Bleaching

If you are a candidate for bleaching, your dentist may suggest a procedure that can be done in his or her office.

Chairside bleaching may require more than one office visit. Each visit may take from 30 minutes to one hour. During chairside bleaching, the dentist will apply either a protective gel to your gums or a rubber shield to protect the oral soft tissues. A bleaching agent then is applied to the teeth, and a special light may be used to enhance the action of the agent. Lasers have been used during tooth-whitening procedures to enhance the action of the whitening agent.

At-home Procedures and Products

There are several types of products available for use at home, which either can be dispensed by your dentist or purchased over-the-counter.

Bleaching Solutions

These products contain peroxide(s), which actually bleach the tooth enamel. These products typically rely on a percentage of carbamide peroxide as the bleaching agent. Carbamide peroxide comes in several different concentrations (10 percent, 16 percent, 22 percent). Peroxide-containing whiteners typically come in a gel and are placed in a mouthguard. Usage regimens vary. Some products are used for about twice a day for two weeks, and others are intended for overnight use for one to two weeks. If you obtain the bleaching solution from your dentist, he or she can make a custom-fitted mouthguard for you that will fit your teeth precisely. Currently, only dentist-dispensed home-use 10 percent carbamide peroxide tray-applied gels carry the American Dental Association (ADA) Seal. Be sure to follow the manufacturer's instructions carefully to minimize risk of damage to soft tissue.

Toothpastes

All toothpastes help remove surface stain through the action of mild abrasives. “Whitening” toothpastes in the ADA Seal of Acceptance program have special chemical or polishing agents that provide additional stain removal effectiveness. Unlike bleaches, these ADA accepted products do not alter the internal structure of the tooth.

Side Effects

You also may want to speak with your dentist if any side effects become bothersome. For example, teeth can become sensitive during the period when you are using the bleaching product. In many cases, this sensitivity is temporary and should lessen once the treatment is finished. Some people also experience soft tissue irritation – from a tray that doesn’t fit properly or from solution that may come in contact with the tissues. If you have concerns about side effects, you should discuss them with your dentist.

Patient Safety

The ADA advises patients to consult with their dentists to determine the most appropriate tooth whitening treatment. This is especially important for patients with many fillings, crowns, and extremely dark stains. A thorough oral examination, performed by a licensed dentist, is essential to determine if bleaching is an appropriate course of treatment. The dentist should supervise the use of bleaching agents within the context of a comprehensive, appropriately sequenced treatment plan. The ADA has recently provided a FAQ sheet which addresses common concerns regarding tooth whitening safety.