Whitening doesn’t affect function; it is purely a cosmetic procedure. Babies and children really do have pearly whites, but as people age, their teeth can become stained or yellowed. Coffee, tea, and red wine are particularly likely to cause severe stains, as they contain chemical compounds called chromogens that leave pigments in the tooth enamel. Enamel tends to wear down and become thinner with age, which allows the yellowish underlayer, or dentin, to show through. Tobacco, whether smoked or chewed, leaves yellow or brownish stains on the teeth. Radiation therapy, chemotherapy, and some medications may also stain the teeth.
Chair-side whitening is much more effective as the dentist can use a stronger concentration of the bleaching agent, although teeth whitening products are available over-the-counter. At-home products contain hydrogen peroxide in the form of gels or strips. Carbamide peroxide is the material used in chair-side whitening. A dental dam (rubber shield) or special gel is used to protect the gums from the bleaching agent, which is brushed onto all surfaces of the teeth. A special light or laser treatment can increase the bleaching effect. In many cases, a single treatment is all that is required, but additional treatments are possible. A treatment usually takes about 45 minutes and does not cause discomfort.
If the enamel is thin enough to allow the whitening product to reach the dentin layer, tooth sensitivity can result. Any sensitivity is usually temporary. At-home whiteners can damage the tooth enamel or gums if used too frequently. Yellowed teeth usually respond well to bleaching products, but if the teeth have a grayish tone, bleaching is likely to be less successful. Deep stains from medications or injuries may not respond to bleaching, and teeth with a brownish discoloration may not bleach successfully. Bleaching can’t be used for crowns or veneers, only on natural teeth.
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