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Do-it-yourself whitening: for many but not for all 

Everyone would like to have a beautiful smile, that’s why there are an increasing number of products for so called “home whitening”. What are the solutions, how safe are they, who are they suitable for and who are they not.

Even though many people are satisfied with the way their smile looks thanks to constant care at home, and at the dentist, many others would like to go beyond and render their smile extremely white and luminous.  Generally speaking, when they are utilised following the instructions carefully and on healthy teeth, whiteners are safe and effective, and the side effects are few and temporary (sensitivity of the teeth and irritation of the gums).

Whiter & healthier
Soon there could be available whiteners that not only make the teeth whiter, but at the  same time care for them.  The new formula would in fact contain re-mineralizing agents for the teeth.  To date the two agents - whitening and re-mineralizing – are separate and are mixed only during application (on the strips and the gel) but experts are putting to the fore a product that contains both components in a single solution. Whitening can often open up the pores which are naturally present on the teeth and this is what causes temporary sensibility to air, heat and cold – a very common side effect after whitening. Saliva contains the minerals that the teeth need to close these pores, but this process is very slow; hence, the new formula supplies the teeth with essential minerals, guaranteeing equally efficient whitening but almost devoid of the unpleasant side effects.

By “tooth whitening” you refer to any procedure that renders the teeth whiter, be it by means of direct lightening, or thanks to the elimination of marks and discolouring.  There are two methods of home whitening:

  • Whitening toothpastes.  All toothpastes contain a gentle abrasive that helps to  remove superficial marks on the teeth, but the “whitening” toothpastes have in addition chemical   abrasive agents that perform this chore more keenly, but they are not capable of altering the natural colour of the teeth;

  • Whitening agents containing peroxide or whiteners (bleaching agents), including gels and whitening strips.  Unlike toothpastes, they are capable of altering the natural colour of the teeth, apart from helping, naturally, with the elimination of superficial marks and ingrained marks.  In general they contain a whitening agent in concentrations lower than those used by the dentist, and hence require prolonged use before the desired effects are achieved.  The whitening agent is typically carbamide peroxide (or urea) guaranteeing differing concentrations (10%, 16%, 22%). In simple terms, higher the concentration of peroxide, more significant the whitening effect, it’s the strength of the whitening agent at play, peroxide acts of the surface of the tooth but also on the layer beneath, the dentine.  Some products are used twice a day for two weeks, others are used at night for 1-2 weeks. They are not capable of changing the colour of the teeth in the same way as professional  treatments – based on hydrogen peroxide that can reach 9 tones less in colour.  The concentration of the active ingredient of the whitening treatment used by the dentist is higher because the product is used by a professional who knows its application perfectly, understands the action mechanism of the product and can explain to the patient how to use it safely at home and can intervene immediately in the event of unwanted reactions.

In exactly the same way as the treatment performed by the dentist, home whitening does not guarantee permanent effects and to maintain the results the treatment has to be repeated periodically.  The minimum interval between one treatment and the next should not be less than 6 months and the application period not superior to 14 consecutive days without the supervision of a dentist. Clinical studies show that home whitening products are not dangerous if they are used in conformity with the instructions, and according to recent studies, possible unwanted side effects of the products on the tooth structure and the solidity of the enamel do not pose any threats.

Instructions for use

  • read the instructions in the package insert carefully, and follow them to the letter;

  • in the presence of existing problems (for example, known sensibility of teeth) or of infections, or if you are about to undergo orthodontic work discuss the wisdom of the treatment with the dentist before you begin the whitening;

  • In the presence of increased sensibility of the teeth you can adopt one of the following solutions, starting with the first:

    • halve the recommended duration of use, for example apply the product for 30 minutes instead of 60;

    • discontinue the use of the product for two or three days and then recommence the treatment;

    • discontinue treatment and refer the problem to the dentist;

  • do not subject the teeth to a whitening treatment in the presence of oral or gum disease, or if the teeth have changed colour after pharmacological treatment.

The effects of do-it-yourself treatments last for six months in general, but, the duration of the results can be influenced by:

  • the difference in the actual colour and the desired colour;
  • the food and drinks that we consume;
  • the quality of our oral hygiene.

Products for home whitening are not indicated for:

  • pregnant or lactating women;
  • children younger than 16 years;
  • subjects with sensitive teeth or allergic to peroxide>
  • subjects with gum disease or with consumed dental enamel.

Naturally, home or professional treatment have no results on crowns, veneers, fillings, dentures and exposed roots.

published: 21 January 2008

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