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CELEBRATING **25** YEARS OF DENTAL EXCELLENCE
DR. KHOSLA'S DENTAL CENTRE
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A2 AASHIRWAD, II CROSS LANE, LOKHANDWALA COMPLEX, ANDHERI (WEST), MUMBAI 400053, INDIA

TEL: 2636 3215 / 2633 5631
2632 8682 / 3082 7053 / 98193 63215

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BLEACHING / WHITENING OF TEETH

It is said that the face is the mirror of the human mind. A beautiful face achieves results or good first impressions easily while the opposite provides an uphill struggle. Not surprisingly, our teeth draw in a great deal of attention and are a significant factor in judging attractiveness, so a clean, white smile can play a crucial role in how you are first perceived by many. Lustrous teeth portray our confidence and eventually help us to win the hearts of those we interact with.

The current emphasis has shifted from cars & couture; the new must-have accessory is a set of gleaming, pearly-white teeth. One of the easiest ways to improve your overall appearance, tooth whitening has rapidly become the hottest new makeover trick. Because white teeth are commonly associated with youth, health and Bollywood or celebrities, it's no surprise that the Indian Academy of Aesthetic & Cosmetic Dentistry reports that the number of whitening procedures has increased more than 300 percent in the last five years.

Your genes, just like the colour of your hair or your eyes, determine the colour of your teeth. As we get older, the dentine - the soft substance below the enamel that protects the nerves and the blood supply to the tooth - changes colour, becoming more yellow. Drinking too much tea or coffee, smoking or even eating strongly coloured foods can stain and discolour them. Everyday life will take its toll on our teeth, anyway. Many individuals who have discoloured enamel are not satisfied with the appearance of their teeth and go to great lengths to achieve the perfect smile. The answer lies in Tooth bleaching.

Tooth whitening, also referred to as tooth bleaching, is an aesthetic dentistry technique designed to remove stains and discoloration, as well as lighten pigmentation within the teeth. While many dental offices now offer services such as in-office teeth whitening, at-home tooth whitening gel is another product that can be used to this end. By applying a bleaching agent to the teeth, teeth can be whitened, giving you a sparkly white smile. This procedure is simple, harmless and practically painless.

It is important, though, to do it under the dentist's supervision. OTC purchases are attractive but are not without inherent failures and sometimes damaging to the purpose. Don't be tempted to buy kits over the counter unless the reputation of product has proven locus standi. Not only are they not made to fit everybody’s mouth exactly; it may be that bleaching isn't suitable for prospective user especially with gum disease or crowns.

How is bleaching done?

There are two types of whitening systems available from your dentist:

1. IN-OFFICE WHITENING: Whitening done in the dental office that uses whitening gels that are activated by special, hight intensity lights. This takes about 1 hour.

2. AT-HOME WHITENING: Whitening system you use at home by placing the whitening gel in a custom made tray that fits over your teeth. This takes about 1 to 2 weeks.

There is no final difference in how bright teeth can become whether you use the IN-OFFICE 1 hour system or the AT-HOME 2 week system.

What people like best about whitening in the dental office is that the results are immediate. You do not have to wait 1 or 2 weeks, sleeping every night wearing a whitening tray in your mouth.

After IN-OFFICE Whitening, you should use an AT-HOME whitening system for quick touching up of future staining. If you are a busy person and want an instant, bright smile for a special occasion, like a wedding, a meeting or a special photograph, then you will love the in-office whitening.

Home whitening kits are convenient because you can touch up your smile whenever you want. You need to wear a custom designed whitening tray to hold the gel against your teeth for at least 4-6 hours a day for up to 2 weeks to achieve optimum brightning. The custom tray is invisible, very easy to wear, and lasts for years. Home whitening is the most economical way of making your smile brighter.

Advantages & Disadvantages of Teeth Whitening

Advantages

People typically have their teeth whitened to improve their appearance. Whiter teeth are associated with beauty and a healthier lifestyle. When people have a brighter smile, they tend to smile more often and are less self-conscious.

In addition, a whiter smile tends to minimize the appearance of facial wrinkles, giving way to a more youthful and energetic appearance.

Finally, a whiter smile gives people to whom you are speaking a place to focus on and gives you a friendlier appearance.

Disadvantages

Although bleaching is very effective, there can be short-term disadvantages, such as sore gums or teeth from the bleach. This disappears when bleach use is discontinued. Some individuals are more chemically sensitive. If you are one of them, inform us so that you can be tested for sensitivity to the solution.

Research indicates that bleaching is completely effective in nearly 80% of people. In cases of serious teeth discoloration, bleaching may not be the best choice. Veneers or crowns may be the superior choice. Bleaching is usually the first solution to try due to its lower cost.

Some people experience discomfort from wearing the mouth tray. This typically goes away in short order, but if you suspect that there is a problem with the fit of your mouth tray, call us. We can often make small adjustments that will minimize or eliminate the problem.

TYPES OF STAINS

There are two types of tooth stains:

INTRINSIC STAIN (Internal stain)

This means the stain occurs from within the tooth. This type of stain cannot be removed by brushing and flossing and sometimes bleaching may not be effective. Some causes of intrinsic staining are injury to the tooth, certain medications (such as tetracycline) taken during tooth formation or an excess fluoride ingested during the formation of teeth.

Tetracycline stains

EXTRINSIC STAIN (External stain)

This is staining of the tooth surface. Some sources of extrinsic stains are cigarettes, cigars, paan,paan masala , coffee, tea, or foods that contain a lot of spices. This type of staining can sometimes be removed by good tooth brushing habits or by professional prophylaxis (cleaning).

Different stains require different solutions, therefore it is important to have a consultation with a dentist.

Before

After

Aging Stains

Smoking Stains

Stains aquired
Genetically

Tetracycline Stains

IN OFFICE (CHAIRSIDE) BLEACHING

If you are the type of person that likes instant results, you might consider chairside teeth whitening which can be performed directly at our centre. While several cosmetic dentistry options are available for teeth whitening, chair side bleaching can dramatically lighten your teeth (around 4 to 6 shades) in about an hour.

How Does It Work?

During bleaching hydrogen peroxide is placed on the tooth. The hydrogen peroxide is unstable and reactive and breaks down very rapidly to water and oxygen. The oxygen searches for something to attach to because it is unstable. This oxygen enters the enamel where it is attracted to double bonds of stain molecules leaving shorter stain molecules that are more easily soluble and removed from the tooth structure. The peak of the whitening treatment occurs one to three days AFTER the treatment due to dehydration of the tooth! There is an end point to the bleaching process beyond which the teeth will not actively change colour. Whitening after this will not hurt the teeth but the colour will not noticeably change.

CONTRAST AM

How Is It Done?

1. An exam must be done to access the condition of your teeth and gums.
2. A dental polishing is done to remove any plaque or food buildup.
3. We will show you your present shade according to our shade guide and count down the shades to show you the approximately where you can anticipate the shade result you will receive. Your tooth colour will usually whiten 4-6 shades depending on your tooth enamel's ability to respond to the whitening process.
4. A rubber or plastic shield is placed on the upper arch to isolate the teeth and protect the gum tissue.
5. A super charged bleaching agent gel of hydrogen peroxide is used. It has a pH of 7.0 for maximum activation that is not likely to irritate your teeth or cause postoperative sensitivity.
6. To increase your comfort level we provide a fluoride treatment after the procedure.
7. We will recommend the use of an at home whitening process to maintain the colour change.

Home Care Instructions

1. How white your teeth get and how long the whiteness lasts relates to the character of your teeth so it can not be accurately predicated.
2. If you feel some sensitivity during and/or after the process but it only lasts a day or two. Ibuprofen or Paracetamol will help stop it. Here are some tips to help with sensitivity.
3. Teeth will continue to whiten for 48- 72 hours after treatment. Because of this it is not recommended to have any restorative work done for at least 1 week after the bleaching has been completed.
4. We will recommend a follow up program at home in order to prevent quick rebound and to enhance long term maintenance.
5. Dark foods will stain your teeth:
o Go easy on coffee, tea, cola, soy sauce, balsamic vinegar, blueberries, red wine, cranberry juice, grape juice and tomato sauce.Tea is the worse for staining, brush...brush...brush. If you do eat these foods brush teeth right away.
o Do not smoke after treatment.
o Drink liquids through a straw to prevent staining. o If you have sensitivity problems avoid high acid foods for 1-3 days after treatment.

Advantages / Disadvantages of in-office tooth bleaching / whitening

The advantages are:
** Fast and convenient
** Immediate Results
** Long lasting
** Less Fadeback
** Proven to be safe and effective
** Performed by a Dental Professional

The disadvantages are:
• Possible rebound of color if home care is not followed.
• May take more than one visit to meet expectations or to get "Bollywood White".
• Possible sensitivity, however we have bleached our office staff and no one experienced any problems with sensitivity.
• Restorative work needs to be done a week or more after this procedure into order to match dental work to a stabilized color.

AT HOME BLEACHING

The most common way a dentist will whiten or bleach your teeth is using a special plastic tray and some gel. First of all, the dentist will give your mouth a thorough check-up to make sure there are no other problems and that your gums are nice and healthy. Then he or she will take an impression of your teeth, upper and lower, using a special tray with dental putty. Using that impression, a plastic sleeve will be made which can fit snugly and exactly around your teeth.

The dentist will then show you how to put a small amount of the bleaching gel into the sleeve and then how to slide it over your teeth. Then you take the sleeve and the gel home and use it overnight, maybe every other or every third night, until your teeth are the desired colour. You may find that your teeth are more sensitive for about 24 hours after each application, but this is only temporary. The process takes from several days to a couple of weeks and will not harm fillings, bonding, caps, or other dental work.

NITEWHITE EXCEL 3 FROM DISCUS DENTAL

CONTRAST PM

COLGATE PLATINUM PROFESSIONAL WHITENING SYSTEM

Instructions For At Home Bleaching

Bleaching is used to enhance your smile by brightening your existing natural teeth. Bleaching will not make crowns, Veneers/Laminates, bonding or existing fillings lighter. If you bleach and have these type of restorations in your smile line you may want to have these changed after you bleach. When you start to bleach we typically have you bleach your top teeth first when you are bleaching both top and bottom teeth. This will provide you with a comparison so you know just how much your teeth are whitening. The first week just bleach the top teeth. We will check your results after the first week, then we will have you start bleaching the lowers. Bleaching usually takes several days to 2 weeks for the complete result. We cannot predict the exact level of shade changes you will have with bleaching, but it will always make your teeth lighter.

GEL PLACEMENT IN TRAY

TRAYS PLACED IN MOUTH

1. Brush and floss teeth thoroughly prior to placing the tray in your mouth.
2. Place small drop of gel in tray at each tooth site where whitening is desired.
3. Seat tray completely and firmly onto teeth.
4. Wipe off excess gel with toothbrush or clean finger.
5. Trays are to be worn overnight.
6. When trays are removed, rinse with cool water and remove residual material and store in case. Keep your trays out of the sunlight and heat. Excessive heat can melt the trays. Do not store them in your car during the warm summer months.
7. Brush and rinse remaining gel from teeth after Bleaching.
8. Remove tray prior to eating.
9. You will have enough material to bleach both upper and lower teeth for 2 weeks.

If yours gums or teeth become overly sensitive, please call our office at 2636 3215/2633 5631/2632 8682 / 3082 7053.

HAPPY BLEACHING!

BLEACHING - FREQUENTLY ASKED QUESTIONS

How can you brighten your smile?

Your wedding is coming up and you want your smile to be its brightest. Or maybe you have an important speaking engagement. Whatever the reason, tooth bleaching isn't just for the movie stars, and it isn't just for one day. Many people have had their teeth bleached, and probably millions more are thinking about it. The desire for a brighter smile with whiter teeth is very strong, and tooth bleaching safely lightens the colour of the teeth, lasting for up to five years. The most effective and safest method of tooth bleaching is dentist-supervised.

Is bleaching for you?

Generally, bleaching is successful in at least 90 percent of patients, though it may not be an option for everyone. Consider tooth bleaching if your teeth are darkened from age, coffee, tea or smoking. Teeth darkened with the colour of yellow, brown or orange respond better to lightening. Other types of gray stains caused by fluorosis or tetracycline are lightened, but results are not as dramatic. If you have very sensitive teeth, periodontal disease, or teeth with worn enamel, your dentist may discourage bleaching.

What's involved?

First, the dentist will determine whether you are a candidate for tooth bleaching and what type of bleaching system would provide the best results. If you're in a hurry for whiter teeth, you may decide to have your teeth lightened immediately. Your dentist will use either an in-office bleaching system. The dentist will make impressions of your teeth to fabricate a custom-fitted tray for you. The tray is custom made for your mouth and is lightweight so that it can be worn comfortably while you are awake or sleeping. It is so thin that you should even be able to talk and work while wearing it. Along with the custom-fitted tray, you'll receive the bleaching materials. You'll be given instructions on how to wear the tray.

Some bleaching systems recommend bleaching your teeth from two to four hours a day. Generally this type of system requires three to six weeks to complete, and works best on patients with sensitive teeth. Other systems recommend bleaching at night while you sleep. This type of system usually requires only 10-14 days to complete.

How long does it last?

Lightness should last from one to five years, depending on your personal habits such as smoking and drinking coffee and tea. At this point you may choose to get a touch up. This procedure may not be as costly because you can probably still use the same trays. The retreatment time also is much shorter than the original treatment time.

How does it work?

The active ingredient in most of the whitening agents is 10 percent carbamide peroxide (CH4N2O2), also known as urea peroxide. As the active ingredient in the gel, carbamide peroxide, is broken down, oxygen enters the enamel and dentine and bleaches the coloured substances. The structure of the tooth is not changed, only the tooth colour is made lighter.

Why Aren't My Teeth Whitening Evenly?

Sometimes the biting edges and the sides of the teeth whiten more quickly than the rest of the teeth. This occurs because your enamel is thicker in these areas and responds faster to the whitening process. As you continue to use the tooth-whitening system, the rest of your teeth will catch up and the colour will even out.

Is it safe? Any side effects?

Several studies, during the past ten years, have proven bleaching under the supervision of a dentist to be safe and effective. Some patients may experience slight gum irritation or tooth sensitivity, which will resolve when the treatment ends. To date, there has been no testing done on the effects of using a professional tooth-whitening system during pregnancy. Therefore, we do not recommend that you use it if you are pregnant or lactating.

How white can your teeth become?

How white your teeth can become from bleaching and whitening is a common question with a very subjective answer. Some whitening procedures claim they can whiten your teeth by up to nine shades, but that is highly unlikely. Just a change of two or three shades will make a significant difference in just about anyone's smile. There is no one standard system in the dental field to measure and determine tooth color. The most often heard about, however, is the Vita shade guide. This guide divides tooth color into four basic shade ranges:
A (reddish brown)
B (reddish yellow)
C (gray)
D (reddish gray)

In the A range there are five levels of darkness. Ranges B, C and D, each have four levels. Not all of your teeth are the same natural colour.

Usually your eyeteeth tend to be darker than the others, your front teeth are typically the whitest, and molars tend to be a shade between the two. The goal for everyone is to achieve his or her individual optimum whiteness while still looking natural. During your first consultation for tooth whitening, your dentist will go over what you personally can expect for your specific smile. How white teeth will become from a given procedure will vary from person to person. The structure of your teeth and the type of procedure implemented will affect the outcome.

What are realistic expectations?

No one can really predict how much lighter your teeth will become. Every case is different. Typically, there is a two-shade improvement as seen on a dentist's shade guide. The success rate depends upon the type of stain involved and your compliance. Bleaching can only provide a shift in colour from gray to a lighter shade of gray, for example. Bleaching does not lighten artificial materials such as resins, silicates, or porcelains.

RELATED NEWS ITEMS

Dentists advise checkup before teeth whitener use - Jul 24, 2001 (HealthCentral)
Do-it-yourself tooth bleaching kits cause problems - Aug 21, 2001 (E-Dental)
Whitening Smiles Sparkle After Quitting Smoking - Nov 21, 2002 (DentalReach)
Weigh the pros and cons - choosing whitening - Jul 08, 2003 (Kansas Star)
Say Cheese! - Jun 15, 2007 (Mumbai Mirror)
Are You A Bleach-A-Holic? - Jul 11, 2007 (NBC5)

Antibiotics | Baby Teeth | Bad Breath | Bleaching | Bonding | Brushing | Bruxism | Caries (Decay) | Cosmetic Dentistry | Crowns & Bridges | Dentures | Dry Mouth | Emergencies | Endodontics | Extraction | Flossing | Gum Disease | Implants | Migraine | NTI | Oral Cancer | Orthodontia | Pregnancy | Preventive | Sealants | Silver fillings | Tobacco | Toothpastes | Veneers | Wisdom Teeth | XRays | Dental Tourism

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