At-Home Teeth Whitening

When contemporary peroxide-based teeth whitening gained popularity in the early 1990s, it was limited to custom-made bleaching tray treatments that were available only at dental offices.

These whiteners set off what has become known as the “smile revolution,” and now dozens of whitening options are available for every budget and temperament – whether professionally dispensed, store-bought or sold on the Internet. Many teeth-whiteners are pre-mixed and ready to use; others require mixing at home.

The consensus is that dentist-dispensed whitening trays and whitening strips, when used as directed, can be even more successful than in-office bleaching over the long haul.

A key reason is their ongoing use, combined with the fact that small amounts of bleach remain within the tooth structure for up to 36 hours. When a new dose of bleach is applied to a tooth retaining the previous day's peroxide, its effect is greater.

Advantages of At-Home Teeth Whitening

• Long-term results: Dental professionals agree that the only way to maintain your whitened teeth is with at-home bleaching products, repeated regularly – preferably every four to six months. But lately, many dentists are advising people with very dark-stained or tetracycline-affected teeth to continue home bleaching over a period of months (or up to a year) for optimal results. What's interesting is, the newest teeth whitening strips on the consumer market are intended for five-minute use every day, like brushing or flossing.
• Variety: You have a choice of whitening trays, strips or paint-on products, as well as numerous whitening accessories.
• Convenience: You can do home whitening at any time of the day or night, for short or extended periods.
• Portability: You can also use at-home whitening strips while on the go or at the office.

Must-Knows About At-Home Whitening

Although you can get over-the-counter whiteners without a dentist's recommendation, if you over-use them or use them incorrectly, they can harm your tooth enamel and irritate your gum tissue. Also, over-bleaching can produce an undesirable bluish hue, chalky whiteness or uneven results (otherwise known as “the technicolor effect”).

Supervision by a dentist can prevent these problems. To ensure the health of your smile, see your dentist before choosing an over-the-counter tooth whitener and beginning the bleaching process. Dentists know a lot about these products and can help you choose the right one and use it correctly.

Also keep in mind:

• The stronger the peroxide formula, the more rapid its effect; the weaker the formula, the longer it can remain on the teeth safely. A low-percentage bleach used overnight every night of the week will produce about the same results as a high-percentage "day-bleach" that stays on the teeth one hour per day for seven days.
• The best time to begin at-home whitening is soon after a dental hygienist's prophylactic cleaning. This procedure removes the surface layer of plaque and grime that can interfere with bleaching.
• Dentists and oral care companies urge brushing and flossing the teeth just prior to any kind of at-home or on-the-go whitening.
• For best results, don't consume food or beverages (excluding water) for a couple of hours after whitening.

Dentist-Dispensed Take-Home Whitening Trays

According to dental professionals, the best bleaching results come from dentist-dispensed take-home kits – particularly those that are used over extended periods. These kits contain higher percentages of bleach than over-the-counter kits and typically consist of:

• Custom-fitted application trays made of a flexible plastic material. Custom trays offer several benefits:
  • They help ensure that the bleach stays in contact with the teeth, for maximum whitening.
  • They help prevent saliva from coming into contact with the bleaching agent (which can dilute its strength).
  • They minimize the amount of bleach that can dribble onto (and potentially irritate) the gums.
• Bleaching compounds are either pre-loaded into the trays or stored in syringes and added to the trays just before use. In many cases, your dentist can fine-tune the bleach concentration and add a desensitizing agent to use before or after application. Generally the kits provide enough gel for one two-week treatment per year, plus one- or two-day touch-ups every four to six months.

The following tray-bleaching systems are what most dentists dispense:

Discus Dental Nite White and Day White ACP: These are the only take-home whiteners with amorphous calcium phosphate (ACP), a proven enamel re-builder, and sensitivity-reducing potassium nitrate and fluoride.

Nite White is available in various hydrogen peroxide concentrations, for either overnight or twice-daily use. Ask your dentist which concentration and application are best for you.

Discus Dental Nite White Turbo: This is the fastest Nite White system, containing a mint-flavored, chemically accelerated 6 percent hydrogen peroxide formulation. It is intended for overnight use, two to four hours twice a day, or one to two hours a day if you are sensitive to bleach.

Discus Dental Zoom! Weekender Kit: This fast-acting whitening system has a 6 percent hydrogen peroxide gel and a time-release booster agent that enhances bleach penetration. The Weekender Kit is intended for overnight use, two to four hours twice a day, or one to two hours a day if you are sensitive to bleach.

Opalescence by Ultradent: Incorporating a viscous carbamide peroxide whitening agent known for its staying power over extended periods of time, the Opalescence gel also contains a patented mix of sensitivity-reducing potassium nitrate and fluoride. Pre-packaged in syringes, the gel is inserted into the custom-made trays before each use. Four concentrations of carbamide peroxide are available for use during the day or overnight.

Opalescence kits come in mint, melon and flavor-free formulas. Best results will likely appear after 10 days of directed use.

Opalescence Trèswhite Supreme: This innovative, one-size-fits-all system is designed for those who want a quick, convenient and relatively inexpensive whitener, with no wait for custom-made trays. Many people use this system while traveling or just before a major business meeting or social event.

Trèswhite has a two-layer tray system that guarantees automatic alignment. The delivery trays are pre-loaded with a membrane-like inner tray coated with a 10 percent hydrogen peroxide whitener containing the same sensitivity-reducing mix of potassium nitrate and fluoride as is found in Opalescence systems with custom-made trays.

The wear time for Trèswhite is 30 to 60 minutes, once a day. Packs of Trèswhite Supreme (10 uppers and 10 lowers), for use over the course of five to 10 days, are available in mint, peach and melon flavors.

Whitening Strips

Coated with a whitening gel, these thin, flexible membranes are designed to conform to the shape of the teeth. They are very convenient and easy to use – no mixing or molding is required. What's more, they are unobtrusive enough to be worn on the job or while commuting or shopping.

However, whitening strips are less effective than trays for removing between-the-teeth stains and are not suitable for crooked teeth. In addition, saliva can more easily find its way beneath whitening strips, diluting their potency. Some whitening strips aren't long enough to cover a wide smile, and they tend to slip and slide.

Crest Whitestrips Supreme, containing 14 percent hydrogen peroxide – the highest dose currently available in whitening strips – are dispensed at dentists' offices. These strips are wide enough to cover up to six teeth.

Brush-On Whiteners

Pens with brush-on or foam-tip applicators provide what has been billed as fuss-free instant whitening. Used directly after meals or in daily regimens, as alternatives to whitening trays and strips, these whiteners are often considered instant "antidotes" to new stains from food, especially just-consumed red wine.

But dental professionals are divided as to the effectiveness of paint-on whiteners. Some consider them useful adjuncts to in-office or tray bleaching. Others have yet to see any meaningful results with these whiteners.

Whitening Toothpaste

Technically speaking, all toothpastes are whitening toothpastes, since they remove surface plaque and debris. But only a few contain key whitening ingredients: chemical bleaching agents and abrasives in high concentrations.

When used regularly, these toothpastes may offer backup support for tooth whitening. Of course, given that brushing time is limited to a minute or two, that support is minimal. But since we all brush every day, some consider whitening toothpastes to be potential whitening enhancers.

Toothpastes with Peroxide

Because toothpaste foams all over the mouth and is swallowed, the percentage of any bleach it contains is low, to avoid irritation.

Toothpastes with Abrasives

Most toothpastes clean the teeth with finely ground abrasives such as silica, aluminum oxide, calcium carbonate and baking soda. Whitening toothpastes contain more of these abrasives – though the paradox here is that overuse can cause more stains and can also dull the surface of dental crowns and veneers.

Whitening Floss

Floss may seem like an unlikely part of the tooth-whitening regimen, particularly as it is in contact with the teeth for only a second or two. But over the long haul, using whitening floss daily may assist with stain removal in the narrow space between the teeth, an area that even in-office bleaching has a hard time reaching.

Whitening floss differs from standard dental floss in its use of mild abrasives, typically silica.