If you’ve not gone beyond whitening-promising toothpaste in your efforts to brighten your smile, it can be intimidating to pursue heavier duty options. Dental work of any kind is a common fear, and when you don’t know what to expect out of a process, you’re likely to avoid it. Like many cosmetic dental procedures, teeth whitening can give a person a boost of confidence, and fortunately for consumers, there’s a range of options and prices to make the process fit your time, comfort, and budget. Whether you’re preparing for a big event or just looking to reverse the effects of a lifelong love of coffee, knowing the basics of teeth whitening will help you chart your path forward.
Exactly like it sounds, teeth whitening is a cosmetic dental treatment that lightens the color of natural tooth enamel, removing stains and discoloration. Natural tooth enamel is important to remember—the treatment does not work on crowns, veneers, or fillings, so according to dentists, you’ll need to consider this when attempting a uniform result. The treatment is primarily cosmetic, but there can be some indirect health benefits.
“A lot of times, I see my patients starting to take better care of their teeth after teeth whitening treatments,” said Sarah Bienes, DDS, owner of SB Dentistry. “This can mean more frequent brushing and flossing to maintain their whitening results. So, in a way, teeth whitening can lead to overall healthier habits.”
There are three types of treatments to consider: over-the-counter products (like Crest 3D Whitestrips), at-home whitening kits from your dentist, and in-office professional whitening treatments. According to Dr. Bienes, in-office procedures are recommended for more complex or severe stains (due to the higher concentration of whitening agent), while mild or maintenance cases typically call for at-home treatments.
“In-office professional whitening treatments are usually a one-time treatment initially,” she said. “At-home and over-the-counter treatments take several sessions to reach the desired result. Touch-up treatments are usually needed every six to twelve months depending on your habits like drinking coffee, red wine and tea or smoking. These things increase your need for touch-up treatments.”
Dr. Hunter Charvet, Jr. helps detail the differences of these options at Charvet Dental Center. There, premium in-office bleaching uses a solution of around 40 percent whitening agent and is a one-hour appointment with three sets of 20-minute treatments.
“The higher the solution, the faster the whitening,” said Dr. Charvet. “In-office treatments are more or less the same as at-home treatments, but they get you from A to Z with a faster approach.”
At-home treatments at Charvet Dental Center include pre-filled, form-fitting Opalescence Go trays and, alternatively, custom-made bleaching trays and whitening agent in a variety of percentages (10-45%) that are worn typically for a few hours. Higher percentages allow for quicker results but come with a higher risk of sensitivity. With at-home treatments, patients wear the flexible, retainer-like tray for four to six hours—or sleep in it—but depending on their sensitivity and the solution’s concentration, they may need to limit the hours of treatment.
“I always caution patients to be wary of products promising instant or dramatic results or those not approved by dental associations like the ADA Seal of Acceptance in the U.S.”
-Dr. Bienes.
“During a whitening treatment some people feel ‘zingers,’ which are short, sharp nerve responses of the teeth,” said Dr. Bienes. After a whitening treatment, your teeth may be sensitive to hot and cold temperatures, and your gums may be slightly irritated if the gel makes contact.”
She recommends that her patients avoid acidic or super-hot/cold foods and use a sensitivity toothpaste for one to two weeks before a whitening treatment to reduce the post-treatment sensitivity. Additionally, there are desensitizing gels dentists can apply after in-office whitening treatments to reduce this side effect.
Is there a way to test your sensitivity ahead of time? Dr. Charvet said there’s no “test” to help you know your sensitivity levels, but if you have pain with tart or sour candy, that could be a good indicator of sensitivity. He recommends reducing your first treatment to half the time to see how you feel before continuing. Besides wearing your tray for shorter periods, a person could spread subsequent treatments out over more time.
According to both dentists, one big takeaway is that if you’re considering whitening, a dental exam is recommended.
“That way, your dentist can check for cavities, gum issues, and whether you’re a good candidate for a specific whitening treatment,” said Dr. Bienes.
Dr. Charvet adds that whitening treatments can aggravate any active decay or gum disease. Gum recession can be problematic since you don’t want bleaching solution to reach exposed roots. A dentist can help identify any of these issues in advance and provide guidance on the best whitening method. Additionally, patients who were treated with tetracycline as children may have tooth staining that does not respond to traditional treatments, and a dentist should be consulted for options.
While sensitivity can be an after-effect of whitening treatments, there is no “downtime” after a treatment.
“You are able to go about your day right after,” said Dr. Bienes. “The only restriction after a whitening treatment is to stick to a ‘white diet,” which means for 24–72 hours after treatment, avoid staining foods/drinks such as coffee, tea, red wine, curry, tomato sauce, etc.”
Teeth are more susceptible to staining immediately after a whitening treatment—whether in office or at home—because the active ingredients used to whiten teeth open the microscopic pores in the enamel and make them more porous for the first 24-72 hours after treatment.
“During this window, our teeth can easily absorb pigments from foods, drinks and even mouthwash or lipstick,” she said. “That’s why it’s the most important time to be careful with these things. Sticking to the ‘white diet’ is key during this timeframe.”
After one to three days, you can return to your normal habits, knowing that some habits may cause the need for touch-ups sooner than others. Whitening isn’t a permanent treatment—it lightens the enamel and dentin, but exterior factors will continue over time to cause darkening. The good news is that, despite briefly porous enamel, whitening doesn’t affect the integrity of the tooth or make it more susceptible to weakening, according to Dr. Charvet.
When asked about the effectiveness of over-the-counter products, both dentists acknowledge that they can serve as an affordable option and noticeably brighten teeth over time. However, they note that these products are less powerful, lead to slower results, and are less precise than professional whitening from a dentist.
“I always caution patients to be wary of products promising instant or dramatic results or those not approved by dental associations like the ADA Seal of Acceptance in the U.S.,” said Dr. Bienes.
She notes that the cost of teeth whitening can vary a lot, depending on where you go, the method you choose, and how dramatic your results need to be. To budget for whitening, consider that some over-the-counter treatments are under $50 while others can run several hundred dollars. Take-home trays from a dentist will be more affordable than an in-office treatment and can vary in price depending on whether they are pre-filled or custom-made.
Is it possible to avoid staining altogether?
Unfortunately not, according to Drs. Charvet and Bienes. The darker substances that we consume are going to be absorbed. Professional teeth cleanings remove some exterior stain but do not remove deep staining, which requires whitening treatments.
“Teeth staining is something almost everyone will deal with at some point,” said Dr. Bienes. “There are extrinsic stains and intrinsic stains. The most common causes of extrinsic stains are food and drinks, tobacco use, poor oral hygiene, certain mouthwashes, and medications.”
An interesting fact, she adds, is that some antihistamines can cause surface stains on the teeth. Intrinsic stains, meanwhile, can be caused from trauma or tooth injury, medications, or aging. Having healthy daily habits can help prevent tooth staining. These habits include brushing two times per day, flossing daily, using a straw when drinking staining foods, and rinsing your mouth with water after eating or drinking staining substances.
What should you know about whitening ahead of a special event or professional photographs? Dentists recommend your whitening treatment begin two to four weeks before your event. You may need additional time if your teeth are sensitive, and some people may need touch-ups. This time frame allows for both treatment time and time for the sensitivity to fade.
“Not everyone’s teeth can be whitened to a paper-white Hollywood level—and that’s totally normal,” said Dr. Bienes. “Our genetics determine the baseline shade of our dentin—the layer beneath enamel—and how responsive our enamel is to the active whitening ingredients.”
Dr. Charvet agrees and said no two people are the same. Some people will require more touch-ups than others, and at-home treatments can be good for maintenance over time.
As a final note, Dr. Charvet adds that parents sometimes ask about whitening for their children following braces or for other reasons. Whitening can begin as soon as a person has their adult dentition. To be sure of your child’s readiness for whitening, consult a dentist.
