Your Step-by-Step Guide to Teeth Whitening at the Dentist

woman having her teeth whitened at the dentistThe professional teeth whitening process starts with a consultation with your dentist. Not everyone is a good candidate for teeth whitening, which is why you want to talk to a dentist before you have it done. If you have large fillings or crowns (caps) on your front teeth, teeth bleaching is not a good idea. The chemicals will bleach your natural teeth but not your dental restorations (which are made from ceramic, porcelain or composite material), resulting in your teeth being different colors.

Teeth whitening is most effective on yellow discoloration, and can be less effective on brown or gray discolored teeth, especially when the discoloration is the result of exposure to tetracycline antibiotics while teeth are still developing (before age 8).

Next comes the actual whitening appointment. Once you’re comfortable in the chair, the dentist will insert a lip retractor into your mouth, which is just a plastic guide that moves your lips out of the way so your teeth are easy to access.
The dentist will then cover your gums around your front teeth with a gel and then harden it with a high-powered light. This is called a gingival barrier, and it protects your gums from the teeth bleaching chemicals during the whitening process. The dentist may also apply a compound to your teeth that will help prevent tooth sensitivity.

The actual whitening process involves the dentist applying a gel made of 15% to 35% hydrogen peroxide to your front teeth. Hydrogen peroxide can penetrate the porous outer layer of your teeth and break apart stain compounds using a chemical reaction called oxidation. Depending on the whitening system being used, the application of the whitening gel may be followed by applying a high-powered light that speeds up the whitening process.

Most systems involve multiple applications of the gel throughout the whitening session. The dentist will rinse off the gel and reapply a fresh coat as many times as necessary within the space of about 40 minutes. Once complete, the whitening procedure can achieve four to six shades of whitening after only one session. Some patients experience tooth or gum sensitivity after whitening, but this usually goes away within a day or two.

While the effects of whitening can last quite a while (months to years), depending on diet and other habits (like smoking!), the stains on teeth will eventually return. Some dentists may recommend maintaining a freshly whitened smile with a professional home whitening kit. These kits include custom made trays to fit your teeth and tubes of whitening gel that has a lower concentration of bleaching agents than the in-office variety. The patient lines the trays with the gel and wears them for a few hours at a time each day or while sleeping.

When it comes to teeth whitening, you get what you pay for. While over-the-counter kits from the drugstore are cheap and offer the convenience of at-home bleaching without a visit to the dentist, they are slower and less effective than professional whitenings. And of course, without the supervision of a dentist, you don’t have the guidance you need to get the best results. If you want truly Hollywood-white teeth, invest in a professional teeth whitening administered by your dentist.

The Facts & Mysteries of Bruxism

woman with bruxism grinding her teethBruxism is what dentists call teeth clenching and teeth grinding. The symptoms of bruxism are fairly easy to spot, as are the complications that can result from it. The causes of bruxism, however, a more varied and mysterious.

Teeth grinding involves the moving of teeth back and forth across each other. Most teeth grinding is unconscious and happens during sleep. Grinding is more common in children and they usually grow out of it once they’ve finished losing their baby teeth. Most adults who grind their teeth are unaware of it until a partner tells them they can hear the grinding sound while they are sleeping or their dentist spots signs of wear on the teeth (more on this later).

Teeth clenching involves tightly pressing your top and bottom teeth together. While normal eating and chewing only exerts 20 to 40 pounds of force on your teeth, the clenching that occurs in bruxism can exert hundreds of pounds force on your teeth. Clenching is also unconscious, but it can occur both while someone is awake and while they’re asleep.

Most studies and indicators tie daytime bruxism to stress. As a result, daytime clenching can often be relieved with stress reduction techniques, massage or physical therapy. Sometimes just being made aware of the clenching problem helps sufferers change their habits.

Nighttime bruxism is trickier. Because it occurs while a person is asleep, it is impossible to treat with behavioral changes. As a result, nighttime bruxism is usually treated by your dentist, often with a dental appliance referred to as a splint or a mouthguard. This is usually a custom made rubber or plastic piece that fits over your top or bottom teeth to protect them from the forces of clenching and grinding.

In the past, bruxism was linked to misaligned teeth and was sometimes treated using orthodontics (braces). However, the link between bruxism and misaligned teeth (called malocclusion by dentists) has been somewhat disproven, so orthodontic treatment for the disorder has become more rare.

Recent studies have started to link bruxism to sleep apnea, and while more study is needed on this topic, it is possible that undergoing treatment for sleep apnea by your dentist (which often involves an oral appliance of some kind) could help alleviate nighttime bruxism.

As mentioned before, while the causes of bruxism aren’t totally clear, the symptoms are. Patients usually experience one or more of these symptoms:

  • Headaches, especially in the morning
  • Ear pain (because of the jaw joint’s proximity to the inner ear)
  • Trouble sleeping (insomnia)
  • Sore jaw or full-blown TMJ disorder
  • Tooth sensitivity (to hot, cold or sweet)
  • Anxiety & tension

If you are experiencing any of these symptoms, you should start a discussion with your dentist about whether you have bruxism.

In addition to uncomfortable symptoms, bruxism can have consequences for the health of your teeth. Some people with bruxism don’t have any of the symptoms listed above. They are diagnosed instead by the pattern of wear that the dentist sees on their teeth during an examination. Teeth worn down from grinding or clenching can eventually crack. Bruxism can also wear away the protective outer enamel layer of the teeth, making the exposed softer dentin more susceptible to cavities. Damage or decay in your teeth could lead to pain or even tooth loss. This is why it’s important to get treated for your bruxism once you’ve been diagnosed.

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