In Office Whitening Treatments

In-office tooth whitening is the fastest, most dramatic way to whiten your teeth. There are many different brands of bleaching agent used for this procedure and the concentrations of peroxide range from 16-44%. All of these procedures must be done in a dental office and overseen by a  dentist. These products tend to cause more sensitivity due to the high concentrations of peroxide and may require further treatment to decrease the sensitivity (ie. fluoride treatment, MI Paste or other desensitizing agents) [1]. 

 

There are 3 ways to activate these products: 1.) by mixing the peroxide (hydrogen or carbamide) and activator in two tubes; 2.) Light Activation and; 3.) Laser activation [2]. Any of these methods produce dramatic results and none are better than any other. The lights and lasers do not produce any better or faster results than the mixed products and are generally much more expensive. Do not be fooled into thinking that they do. Many research articles refute these claims although many dentists stand by them. There is significant evidence in the research suggesting that the lights and lasers may cause greater sensitivity than mixed products alone, due to the over heating of the teeth from the lights [3]. There has been efforts to produce lights and lasers that give off less heat but to date, none of these methods of activation produce more dramatic or quicker results than peroxide alone. 

 

We have found, though, that patients are more likely to follow through with treatment and agree to pay more money if a light is involved. Marketing is everything, and this is where the research supports the use of lights. Currently, in our office we have both systems but we use a mixed peroxide system instead of the light because it is a more patient friendly procedure; quicker set-up, dramatic results and produces less sensitivity.

 

One rule of thumb when considering a treatment that is being presented to you is to consider why that treatment is being pushed. Whitening lights cost a significant amount of money as does the continuing education for the ones providing the service. So whether or not the research supports the claims presented to you may be irrelevant to your dental provider when they are trying to cover their costs! Please be mindful of this as you are considering any treatment. Your provider should be able to give you sources for their claims and explain why they believe it is a better course of action.

 

Finally, whitening does not last forever. Dependent on your habits (smoking, drinking dark liquids or eating heavily pigmented foods) the results could be short lived. Without some sort of continued treatment (OTC or take home treatments) results generally last 6-12 months [4]. Meticulous home care and home treatments are highly recommended.

 

1.) Changes in surface morphology and mineralization level of human enamel following in-office bleaching with 35% hydrogen peroxide and light irradiation. Gen Dent. 2010 Mar-Apr;58(2):e74-9.

2.) Argon laser: a light source alternative for photopolymerization and in-office tooth bleaching. Gen Dent. 2007 Sep-Oct;55(5):416-9.

3.) Effect of light energy on peroxide tooth bleaching. J Am Dent Assoc. 2004 Feb;135(2):194-201

4.) The effect of in-office vital bleaching and patient perception of the shade change. SADJ. 2011 Mar;66(2):70, 72-6.