Dental Whitening
For some time, there has been consistent consumer demand for whiter, brighter teeth and an attractive smile. Professionally administered (in-office) tooth whitening, also known as dental bleaching, remains a popular esthetic procedure and can be performed using a wide range of techniques and application protocols. Another common approach is at-home whitening with custom-fitted trays, which patients use to apply professional-strength bleaching gel (for use at night or during the day).
Whitening Agents
The bleaching action in chemically induced whitening is due primarily to the effects of carbamide peroxide, which releases about one-third of its content as hydrogen peroxide, a strong oxidizing agent. Hydrogen peroxide diffuses easily through interprismatic spaces in the enamel, allowing for passage from enamel and dentin to pulp within 15 minutes of exposure. The bleaching process is generally believed to occur when reactive oxygen molecules (generated from hydrogen peroxide) interact with organic chromophores (colored compounds) within enamel and dentin through a chemical oxidation process, which is influenced by various environmental factors.
Tooth whitening is a common elective procedure and a popular, less-invasive aesthetic treatment for patients seeking to enhance their smile and appearance. A clinical exam prior to the start of tooth bleaching procedures, with radiographs and other screening and diagnostic tests as appropriate, can help diagnose various factors contributing to the patient’s tooth discoloration. A standard dental exam, beginning with a health and dental history, may include questions about the patient’s perception of the cause of the dental discoloration, as well as allergies (which may include ingredients in bleaching materials), and any past or recent history of tooth sensitivity.
Do-It-Yourself Whitening
Several activated charcoal product types (e.g., toothpaste, powder, mouthwash, tablets) are available in the consumer marketplace, but to date there is insufficient evidence demonstrating that charcoal-based oral care products or modalities provide measurable benefit in whitening vital teeth with adequate safety and effectiveness.