Learn the facts about teeth whitening with Dr. Lara



Dr. Lara Coseo (DDS, FAGD) – Author –  Dr. Lara is a 2004 graduate of Baylor College of Dentistry in Dallas, Texas. Having practiced general dentistry for 13 years, Dr. Lara currently serves as an Associate Professor at Texas A&M College of Dentistry.

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Q. How do celebrities get their teeth so white?

A. For each individual celeb, we don’t know the exact answer. However, it is likely that many famous people have invested large sums of money in porcelain veneers. Veneers recreate the outer visible surface of the teeth with a certain shade of porcelain. And that porcelain cannot change color. So if the celebrity chooses to cover their teeth with opaque white porcelain, then they will have a dazzlingly white smile with no obvious imperfections in color. They will have a smile that we sometimes refer to as a Hollywood smile. Some celebrities do have their natural teeth and those celebrities have probably undergone some form of professional teeth whitening, whether that’s in the dentist’s office or a technique that they can use at home.

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Q. In order of effectiveness, what are the five best ways to whiten your teeth?

A. In order of effectiveness –
1. My personal opinion is that the best and most effective way to whiten your teeth is the professional-at-home method, using a professional-strength peroxide whitening gel in a custom-fitted tray provided by your dentist. This method tends to produce the most consistent and predictable results in teeth whitening.
2. Next, would be using a generically shaped tray or strip or application method with a professional-strength peroxide gel.
3. The third most effective will be an in-office whitening procedure. You may have heard of Zoom whitening or Boost or Sapphire. These are all procedures performed in the dental office. You may be surprised to hear that these are not number one. The reason they’re not is that you only get a single session of the whitening ingredient applied to your teeth. Whereas with anything you can do at home on your own, you can continue to use the method until you reach your desired Shade.
4. The fourth best option would be over-the-counter teeth whitening pens. With these types of products, you are applying the whitening gel directly onto the teeth. The disadvantage of this type of option is that the gel may not adhere to the teeth long enough to be as effective as some of the other methods.
5. The fifth most effective would be whitening toothpaste. Whitening toothpaste doesn’t actually change the underlying color of the teeth, but it does help to give a brighter appearance.

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Q. How can I get white teeth in one day?

A. The only teeth whitening method proven to deliver visible results in a single day is the professional in-office whitening method. The way that this method works so fast is because it uses a very high concentration of the peroxide whitening ingredient. Because it’s such a high concentration, it’s not safe for people to randomly apply it to the teeth. It has to be applied professionally after the patient has had a protective gum barrier applied and a lip and cheek retractor fitted. The high concentration gel is great for whitening the teeth quickly, but it also is so highly concentrated that it can burn the soft tissues of your mouth. So it must be applied by a professional.

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Q. Is teeth whitening done with peroxide chemicals safe?

A. Yes. Peroxide chemicals are perfectly safe when you use them according to the manufacturer’s instructions. However, if used incorrectly, peroxide chemicals can cause burns or irritation to the soft tissue inside the mouth. So you want to keep it away from the gums, lips, cheeks, and tongue. You also do not want to swallow amounts of peroxide chemicals. And so, from a safety perspective, our main concern with teeth whitening is the method of application. Is the peroxide chemical going to be kept safely in contact with your teeth, or is it going to mix with your saliva and allow you to swallow it or swish it around your mouth where it could irritate your gums, lips, and cheeks? So the method of application is actually more important than the chemical that it contains. Peroxide chemicals are the only chemicals proven to penetrate through tooth enamel and actually oxidize or break down darkly pigmented compounds causing the staining or yellowing of teeth. So you really do need peroxide chemicals to see a visible result, but they have to be used in a safe manner.

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Q. If I go to the dentist to get my teeth professionally whitened, will it hurt?

A. It could. There is a small risk that the teeth themselves can hurt. Sometimes a high concentration of gel can irritate the nerve inside the teeth, making them feel sensitive, or even causing something that we commonly refer to as zingers, which are sharp shooting pains you can feel inside a tooth when the whitening gel is applied. So there is a slight risk for some discomfort during the procedure. It should be stressed that teeth whitening using high concentrations of bleaching chemicals should only be performed by trained dental professionals. This is to ensure that a protective gum barrier is correctly applied, and the lips and cheeks are retracted away from the whitening agent. The great news is that any discomfort felt is temporary. And as soon as we remove the barrier and the gel, the symptoms will go away.

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Q. I suffer from sensitive teeth. Can I still safely whiten my teeth?

A. Yes, you can. There are certain products specifically aimed at preventing tooth sensitivity while you whiten your teeth. Your best bet will be to use a professional strength gel in a custom-fitted applicator tray made by your dentist. The reason for this is your dentist can custom shape the tray to keep the gel away from areas of sensitivity. You can also use a professional gel that doesn’t only contain the peroxide whitening chemical but also contains active ingredients that strengthen your enamel and fight sensitivity. One particular brand that does this is Opalescence. Their whitening gels contain both fluoride and potassium nitrate. So this strengthens the enamel and fights sensitivity in the nerve of the teeth. If you have sensitive teeth, you probably should not try teeth whitening on your own. You should talk to your dentist about it and find out your options.

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Q. How soon after having my teeth whitened, can I have a cigarette?

A. Well, that just depends on how much you value your whitening results. The sooner you smoke after whitening your teeth, the more likely you are to rebuild those tobacco stains. The longer you can wait, the less staining will occur, and the more you’ll protect that whitening result. In general, a good idea would be to wait at least 24 to 48 hours after your last whitening treatment. So if you’re performing at-home treatment where you’re whitening every day for seven to 10 days, you’re going to need to take that amount of time off of smoking so that you can get your best results.

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Q. I wear braces. Can I still get a teeth whitening treatment?

A. In general, the answer to this question is no. Teeth whitening with braces is difficult because the methods that we apply the whitening gel to the teeth typically will not fit over traditional brackets and wires. There’s one product from Opalescence that I am aware of that was designed for people with braces. And it was a generic fitting tray that had a little bump across the outer side, facing your lip, where you smile, that would go around the brackets and allow the whitening and gel to penetrate into the teeth. There are studies showing that peroxide chemicals can penetrate underneath braces brackets. So you should not have to worry that you’re going to whiten everything, except where the bracket is. However, because of the lack of ease of application, it’s not easy to do. You shouldn’t really try to whiten your teeth while you have braces, just plan on doing it as soon as you get the braces off. While you’re wearing braces, though, you should commit to keeping your teeth as clean as possible and avoiding the foods and drinks and habits like tobacco that will stain the teeth during your orthodontic treatment, and then you’ll have fewer stains that you’ll need to remove when your treatment is complete.

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Q. How long do the effects of teeth whitening last?

A. In general, we can’t accurately predict how long someone’s whitening results will be maintained. But we can tell you that your habits and your intake of certain foods, drinks, and tobacco products will have a direct effect on how long your teeth stay white. Someone who performs teeth whitening, whether it’s an in-office procedure or at home on their own and then refrains from consuming dark-colored foods and beverages like coffee, red wine, berries, and sauces will typically see much longer-lasting whitening results We know that what we put on the outside of our teeth causes stains to build up. So whenever you are whitening, if you are concerned about maintaining that whitening result, you have choices. Either you avoid the things that are causing the staining, or you just commit to maintaining teeth whitening on a more frequent basis than someone who does not use those products.

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Q. Once my teeth have been whitened how can I stop them from turning yellow again?

A. There are a couple of ways to do this. You can try to avoid the foods, drinks, or smoking habits that have caused your teeth to stain or yellow overtime in the past. Cigarette smoking, chewing tobacco, and consuming darkly pigmented foods can really accelerate the yellowing process. Another way to maintain a nice white smile is to use a good whitening toothpaste combined with an electric toothbrush. The vibration of an electric toothbrush combined with the minor abrasiveness of a whitening toothpaste will polish away the superficial stains that gradually buildup on your teeth.

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Q. How much does a professional teeth whitening treatment cost?

A. This cost will vary pretty widely in different areas. In the United States the whitening professional in-house can range anywhere from five hundred dollars to two hundred dollars. What we typically see is actually more expensive in rural areas where there is less competition among dentists and it actually can be a lot less expensive in a metropolitan area where you have a higher density of dentists and a little bit higher level of competition. Dentists will run specials on teeth whitening, bringing the cost down in order to attract patients. In general an average cost in a metropolitan area for an in office teeth whitening treatment would be between five and seven hundred and fifty dollars.

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Q. What are the best over-the-counter teeth whitening products to use?

A. My personal opinion is the very best over-the-counter product for good teeth whitening results are Crest Whitestrips. Crest Whitestrips have an easy method of application, they adhere to the teeth, and they will hold the whitening ingredient on the teeth very well for the prescribed amount of time. They do contain Peroxide chemicals that are proven to whiten the teeth, they are simple to use, they have very low risk of any kind of side effects or adverse effects from the whitening and they are relatively low cost. Crest makes many different lines of Crest Whitestrips and to be honest I don’t know the difference between them, I just tell people any Crest Whitestrips are likely to work. Most of them don’t show the concentration of the active ingredient on the packaging. So if you just read it, it says it has a hydrogen peroxide or carbamide peroxide chemical in it, you know that it’s going to work. 

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Q. Do teeth whitening toothpaste really whiten the teeth?

A. Teeth whitening toothpastes will not technically whiten teeth. They do not contain an ingredient that is going to penetrate the tooth enamel and oxidize those darkly pigmented compounds that cause staining or darkening of the teeth. Whitening toothpaste work by using abrasive ingredients to polish away superficial staining. Technically speaking, whitening toothpaste will not alter the natural color of the teeth but can help restore the underlying color. So if you have a lot of surface staining on that outermost layer of enamel a whitening toothpaste will give a brighter appearance. So it’s a great idea to begin using a whitening toothpaste and then once you’ve used it consistently for a couple of weeks you can assume you’ve polished away any superficial stains and then if you still are unhappy with the underlying color of your enamel you move on to a true teeth whitening product.

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Q. I have seen lots of charcoal teeth whitening products online, do they really work?

A. So the method of action of a charcoal whitening product is typically going to be about the same as those whitening toothpaste. It’s going to have a slight abrasive characteristic that helps to polish away surface stains. Now that’s not what most charcoal products claim to do. They claim that the therapeutic properties of charcoal will help adsorb the stains and unfortunately that’s not true. With charcoal products because we don’t really know how abrasive these particle sizes are, if it has not been approved by American Dental Association that means that we can’t guarantee that it is safe, we can’t guarantee that it will damage your enamel. So there are some charcoal products that have that ADA seal of approval or that have been tested for the abrasivity index, if you can find one that it approved and safe it’s okay to use, just expect it to give about the same result as a whitening toothpaste not more than, it’s not going to actually absorb stains out of the tooth.

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Q. I have seen blue teeth whitening lights on Instagram, do they really whiten teeth?

A. So I’m going to break this question down into two parts, first of all does the light whiten teeth? The answer to that is no, a blue light will not change the color of your teeth, what it may do is give a whiter appearance to the teeth because it can cause a little bit of a dehydration effect if you leave your mouth open for a long time and let your teeth dry out, they will appear whiter, and so some lights have a little of a heat effect and they can dehydrate the teeth making them look whiter. This is a temporary effect only because as soon as your saliva rehydrates the teeth they go back to their original color. But the second part of this question I’ll answer is there are some products that use the blue light in addition to a peroxide whitening gel, do these products work? And the answer is yes, what the light does is it heats the gel and when the peroxide gel is heated it actually has a little bit quicker effect and so it doesn’t increase the effect it just speeds it up and so you can whiten for a shorter period of time and achieve the same result with a light as you can without a light, so the light addition is only going to speed up your teeth whitening result.

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Q. Will an electric toothbrush help whiten my teeth?

A. An electric toothbrush can increase the effectiveness of a whitening toothpaste and help to remove more plaque and surface teeth stains. So from a dental health perspective, it’s a wonderful investment, not only is it going to give you the appearance of whiter teeth it’s actually going to make your teeth healthier.

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Q. Does oil pulling whiten teeth?

A. Oil pulling is a wonderful oral hygiene practice that many people choose to do. Although there is some scientific research that suggests that oil pulling will help reduce plaque and gum inflammation, there is no evidence to support the claims that it will whiten teeth. Peroxide chemical-based bleaching techniques are the only scientifically proven way to penetrate the enamel and physically change the color of the teeth.

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Q. I have heard that brushing your teeth with common natural ingredients like lemon juice, apple cider vinegar will whiten teeth, is that true?

A. I’m so glad you asked this question! You need to know that these home remedies that are suggested as DIY whitening hacks are very dangerous. Lemon juice, apple cider vinegar, and strawberries are all very acidic. Lemon juice has a pH of about 2 on the pH scale, this is very dangerous to tooth enamel. These ingredients will cause the acid erosion of your tooth enamel and although they may initially remove some superficial stains as you continue using them your enamel layer will become thinner. As the enamel becomes thinner, your teeth will actually begin to look more yellow because the underlying core structure of the tooth dentine is yellow and as the enamel gets thinner and thinner you see more dentine, so it looks more yellow. This is a really terrible idea, do not use lemon juice or apple cider vinegar on your teeth, it will actually remove enamel which we cannot replace without dental treatment.

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Q. You are a dentist, what teeth whitening method would you choose to whiten your own teeth?

A. I use custom-fitted whitening carrier trays made from an exact replica of my teeth along with professional-strength whitening gel. The specific gel that I choose to use is an Obsolescence brand that contains fluoride and a desensitizing ingredient called potassium nitrate. This type of gel is safe, effective and it comes in different strengths. My husband uses 10% because his teeth are sensitive, I use 35% because I’m impatient and I want it done as fast as possible! I place the professional gel in my trays, put them in my mouth, do my shower, dry my hair, put on makeup, and then by the time I’m done with that I can pull them out, brush my teeth and I’m ready to go. I typically whiten my teeth every three to four months as maintenance. I have reached a shade that I want to maintain so I just monitor the way that they look when I look in the mirror or when I see photos and if I determine that I need to whiten them a little bit more then I’ll do a two or three days in a row of maintenance whitening. The whitening trays will last for many years, I think mine are about fourteen years old and you can purchase the refill gel in syringe kits from your dentist. So that’s the type of whitening that I use on my own teeth. It’s the type of whitening that I recommend for my patients because I think it gives the best long-term results. it’s very simple to use and people are typically happy with what they see out of the take-home professional whitening gel in custom-fitted trays.

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Teeth Whitening FactsTeeth Whitening Facts

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Teeth Whitening Facts

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Learn the teeth whitening facts from Dr. Lara.

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Dr. Lara Coseo

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Mouthpower.org

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