DDS Lister

Everyone wants a whiter, brighter smile. These days, there are many ways people seek to achieve this goal, from a whitening procedure in the dental office to strips sold over-the-counter to whitening toothpaste. Recently, tooth whitening kiosks have been popping up in places such as local malls. This trend raises the question, is it safe?

The Pennsylvania Dental Association (PDA) encourages the public to consult with and have a thorough examination performed by a licensed and registered dentist prior to having any tooth whitening procedure.

PDA reminds the public that tooth whitening procedures, outside of those readily available for over-the-counter purchase by the consumer for self-use, should be performed only by a licensed dentist within a registered dental office or branch thereof. The Pennsylvania State Board of Dentistry also is developing a policy statement that will help provide more guidance by clearly defining tooth whitening as the practice of dentistry. This approach will ensure that the patient’s specific dental needs are being properly addressed by an individual who is trained and licensed to diagnose and identify possible complications that could occur due to inadequately performed procedures.

Since not all tooth discoloration is the same, patients should first be examined by a licensed dentist to see what type of bleaching is best. After an examination and cleaning to remove simple stains, your dentist may recommend one of the following treatment options:

• Over-the-counter whitening products, such as whitening strips. These typically yield a very subtle lightening of the teeth. The American Dental Association only approves dentist-dispensed home-use whitening products, to ensure appropriate application and follow-up.

• Prescription bleaching kits, dispensed by a licensed dentist, contain peroxide(s) that will bleach the tooth enamel. Prescription bleaching kits contain higher levels of carbamide or hydrogen peroxide than their non-prescription counterparts. Peroxide whiteners typically come in a gel and are placed in a tray similar to a mouthguard. By obtaining the bleaching solution from your dentist, he or she can make a custom-fitted tray specifically designed to fit your teeth. Poorly fitting trays can cause gingival irritation and tissue burning.

• Zoom whitening (power whitening) is a high concentration of hydrogen peroxide gel coupled with a high intensity light used to whiten the teeth. This in-office procedure takes approximately one hour. Costing around $600, the results typically last about three years.

• Whitening toothpaste. While these will not change the natural color of teeth, some contain a special chemical or polishing agent to help more effectively remove stains from the tooth’s surface.

Keep in mind that bonded teeth, tooth-colored fillings, crowns and veneers cannot be whitened. Discolored teeth that have a brown, yellow or grayish hue may not yield a full whitening effect.

“Since patients should be cautious when seeking tooth whitening procedures, the first stop should be with their licensed family dentist,” said Dr. Joseph Ross, a PDA member and general dentist from New Castle. “Their dentist can inform them of the appropriate options available. Tooth whitening kiosks in malls and shopping centers may not be operated by licensed dentists. Although tooth whitening is cosmetic in nature, there are biological effects. Only a trained licensed dentist can properly diagnose and treat tooth discolorations.”

Source:

• Pennsylvania Dental Association

Nowadays, many people bleach their teeth, with the hope of enhancing the color of the enamel of their teeth. However this method of whitening the teeth is said to have its share of side effects. Now, a new study has demonstrated that the application of several products at home for this purpose, results in the loss of the hardness of tooth enamel. This discovery could further lead to the development of new re-formulated products in order to reduce the occurrence of such side effects. This study was conducted by the College of Dentistry, Ohio State.

Enamel is suitable for the protection of teeth as it is believed to be the hardest structure in the human body. But certain products and even vigorous brushing can cause abrasions in the enamel. Therefore it is important to find ways to ensure that the damage to this part of the tooth is reduced. Enamel is said to almost be completely inorganic and translucent. It appears yellow in most set of teeth, as it reflects the color of the dentin underneath, which is stated to be naturally yellow in color.

It has been noted that if the amount of lost enamel calcification is small, then the teeth can usually restore its previous hardness. But this is the first study to reveal on a nanometer scale, the process of how human teeth are affected by the usage of popular home whiteners.

Shereen Azer, assistant professor of restorative and prosthetic dentistry at Ohio State University and lead author of the study, says that, ?There is some significant reduction in nano-hardness of enamel, but we are talking on a very minute scale. So even though it may not be visible to the human eye, it?s important for research because that?s how we improve products.?

The study investigators were said to have applied the recommended treatments of five name-brand home whiteners to samples of human teeth. This set of teeth was said to have been tallied with the tooth samples which did not receive any treatment. It was discovered that in all the cases, the products reduced the hardness of the enamel. The products also seemed to reduce the elastic modulus or stiffness of the enamel as well. Elastic modulus is said to be the ability of the tooth surface to bounce back in response to an applied force.

Many previously conducted studies have tried to determine how whitening of the teeth may affect the hardness of the enamel. However their results apparently didn?t seem to prove much. It is assumed that this was probably because the previous studies measured the loss of enamel hardness in microns, in contrast to the nanometer scale used in the present study. The study investigators stated that various widespread evaluations have pointed out that fluoride treatments, including the use of fluoride toothpaste, may be able to promote enamel re-mineralization.

Source:

• Journal of Dentistry