Whitening 101, part 1

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In this multi blog about whitening, I’m going to discuss a little bit about a lot.  For any more questions, or to find out more information in detail, visit my site at www.koppelmandental.com

and if you’d like to view just how beautiful whitening results can be, follow this link https://www.koppelmandental.com/before-and-after/ to see just how beautiful of results can be obtained.



I guess let’s talk about what whitening is, and answer some of the most common questions I get asked.



In the past week alone I had two emergencies who presented with pain due to unforeseen consequences of using over the counter whitening products.  Luckily, we were able to help, but sometimes the only remedy is time. But why these emergencies? Isn’t whitening your teeth supposed to be safe? I will discuss the why’s, and more importantly, the hows, to get the best whitening results with least discomfort and adverse effects.



Routinely, I’m asked:
Is Whitening bad for me?  
Does it harm my teeth?
Which whitening should I use?
Will whitening work on me


If any of these are questions you’ve had, then keep on reading



For best results I am a big proponent of professional, customized whitening trays with whitening gels, accompanied by a desensitizing, reminerlization gel after use.  For this first article, I will be discussing this technique.  If interested in understanding or learning other techniques, or have questions, follow this link www.koppelmandental.com, and I will try to answer

The reason I like professional, customized trays is that I can help my patients obtain the level (key word being level) of whitening they like, and help minimize and avoid potential side effects.


So, lets tackle the first question, “is whitening bad for my teeth”?  The short answer is that it does not remove the enamel off your tooth. Enamel being the outer layer of the tooth, (and fun fact- the strongest, most mineralized structure of the human body!!). So Enamel is not being removed, so the tooth structure remains relatively intact. That said, the way whitening gels work is by penetrating through the enamel of the tooth to clean it out the pores.

So, to better and more thoroughly answer this question, first you should understand a little about what whitening is.  For now, I’m only going to be addressing traditional whitening gels, which are either hydrogen or carbamide peroxide. Kind of like the liquid in a brown bottle you pour on your knee if you scraped it.  Yup, thats hydrogen peroxide. In a later blog I will discuss alternative whitening techniques.

Whitening gel works by a chemical process called oxidation. It gets in to the microscopic pores in your teeth and removes the stains.  It leaves the enamel (the outer layer of your tooth) intact. Whitening opens these tiny, microscopic pores in your teeth, and once they’re open, they may initially be susceptible to cold things. The degree varies with every person (from none at all, to mild, to I never want to do this again).  But there are way to help prevent that too! Through the use of special desensitizing gels, and prescription toothpastes, I have made custom protocols based on patient to patient that can virtually eliminate these side effects.

This is why at my office, Koppelman Dental, we can create a custom whitening protocol to each specific patient, to optimize your results and minimize discomfort (often starting before you actually whiten your teeth).



OK, so maybe I skirted around the question a little. So, its not bad for my teeth, but does whitening harm my teeth??
Although traditional whitening gels will not weaken your tooth, that does not mean there are not potential side effects.  In fact, the reason I saw those two aforementioned emergencies, are because there can be unforeseen consequences. Like most things in life, the phrase handle with care should always be in the back of your mind. Done professionally, unintended side effects can be reduced and minimized to almost nothing. Buying something online or over the counter, without a Dentist to guide you, and you may cause mild burns on your gums, sensitive teeth, electrical “zings”, etc. You do not know what you’re buying online, and what percentage will work best. Higher percentage gels do not necessarily work better, and can be worse if used improperly.

The gel itself can irritate and burn the gingiva (your pink gums) if left on and and not removed, so be careful not to put on too much gel, and be sure the tray fits in such a way that you can remove any excess gel. Custom trays are an excellent way to make sure the excess gel can be easily removed. This is why those over the counter 1 size fits all mouth guards should not be your go to for whitening. Remember, you pay for what you get. This is what happened to those two patients I saw last week. They used store bought trays and gel, and the gel wound up irritating their gums so much they couldn’t continue whitening, let alone eating or drinking, without being in pain.
Whitening gels should not make your teeth brittle but that’s not to say there are not other dental products that can be abrasive and remove tooth structure, your toothbrush being one of them! What?! Did I just say your toohtbrush? I’ll talk more about that later.  Whitening toothpastes and even your very own tooth brush can wear your tooth structure away!


In general, if you have sensitive teeth, meaning that you routinely have discomfort when you drink or eat something cold, breathe cold air in, brush or floss in certain areas, I would advise talking to us or another professional prior to using any whitening 




Lastly, will whitening work on me?  Not all people are candidates for whitening.  Basically, what you need to know is that there are two types of stains your teeth can have, extrinsic, and intrinsic, staining.  Extrinsic staining you get from drinking or eating.  Simple rule of thumb, if it can stain your shirt, it can stain your teeth.  Smoking is one of the worst, coffee too.  Tea is a hidden stainer as well that a lot of people don’t realize.  Extrinsic staining is the one that whitening can help the best with.  The other type of staining is called intrinsic staining, and this can happen sometimes from antibiotics taken at young age (tetracycline stains for example), or very high fevers during tooth bud development.  Intrinsic staining are the ones that whitening will work least on.   If you’re not sure, ask your dentist.

In the next blog I ‘m going to talk about alternatives, and some other fun facts

Hope you learned a thing or two!




— 
Dr. Adam Koppelman 



Koppelman Dental
7 W. 45th St
2nd Fl
NY NY 10036



212.382.3782