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                                                        DR. DAN PETERSON

                                                                      1415 SAGE STREET ~ GERING, NEBRASKA 69341 
                                                             
      Call: 308-436-3491       www.dentalgentlecare.com           

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TOOTH WHITENING FOR A BRIGHTER SMILE!

IS IT FOR YOU?

Tooth Whitening Video

     Now you can have whiter teeth in the ease of your own home.

How Does Tooth Whitening Work?

Teeth come in many colors. Some have a yellowish tone, some orange, some brown and some gray. The outside of your teeth, the enamel, is clear. The color that you see show through from the tooth structure under the enamel called the dentin.

To whiten teeth a peroxide-type chemical is applied and it goes through the enamel into the dentin. There are different ways this chemical can be applied. Both the character of your teeth and the whitening technique used determines how long it will take for your teeth to whiten, how white your teeth will get, and how long the whiter color will last.

Individual's Teeth

It is important for you to understand that every individual's teeth responds in a unique way to bleaching and whitening products.  Some people will see dramatic results in a short time, others will see little results or need lengthier treatment to achieve desired results.  This is why it is very important to seek the advice and supervision of a dentist for your safety and favorable results.

      Over the years you may have experienced a natural build up of stains on your teeth from coffee, tea, colas, smoking, antibiotics, food, deposits of calculus and tartar, certain minerals, old fillings, tooth nerve damage or trauma to teeth that have darkened the natural whiteness of your teeth. These factors will effect the bleaching procedure you should choice.  These factors also determine when the teeth will need a bleaching touch-up.

     But yellowing (aging) of your teeth can be easily reversed to boost your self confidence, appearance and self esteem.

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"Bleach is bleach is bleach, it's effectiveness is time and dose related"*

There is actually no bleach involved at all in this process. A clear flavored gel  base bleaching produce made up of carbamide peroxide is applied in the "bleach" tray that is worn over the teeth for several hours each day or overnight.. This systems works well for moderate staining or discoloration

Aside from Crest, the only approved whiteners are given out by dentists.
Whitening effect is entirely
dependent on peroxide concentration x time in contact with teeth

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Professional Tooth Whitening vs. Over-The-Counter Kits

     Whitening is safe when supervised by Dr. Peterson and his staff as opposed to over the counter treatments. 

     Be careful of over the counter home bleaching kit: 

  1. They can vary in quality of materials.

  2. The gel may be of low viscosity allowing the gel to leak onto your gums and cause irritation.

  3. Whitening gel may be swallowed due to poor fitting one size fits all bleaching trays.

  4. Lack of dental supervision. 

  5. If you have an abscessed tooth, the tooth may get traumatized through the use of an over-the-counter product and all of a sudden, they will just start dissolving,  Tooth discoloration could be due to decay, older fillings or leaking fillings.  Your dentist is the best advisor to tell you what methods of whitening is best for your individualized needs and conditions.#

  6. The boil-and bite" trays used by over-the-counter products:
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    Dramatically overlap soft tissue (gums) producing more irritation.

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    They also feel bulky in your mouth which can result in discomfort and possible TMJ problems

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    Whitening results are more unpredictable

          Dentist supervised whitening ensures that you are the right candidate for the procedure, monitor the progress of bleaching and address problems if they arise.   

     Without this guidance, people sometimes try to bleach teeth discolored from nerve damage, trauma or cavitiesBleaching these teeth only causes additional damage,  People with tooth sensitivity or gum disease also creates more problems such as... bleaching sensitive teeth causes intense pain and discomfort. 

     We suggest dentist supervised take home bleaching kits. or In Office Power Bleaching:

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These kits use high quality materials 

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 Individualized designed trays that are less bulky and conforms more closely to the natural contours of your teeth making it more comfortable and safe to produce better whitening results.  

Only your dentist can provide you with a well constructed whitening tray
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The custom-fitted tray helps protect your gums from leaking peroxide.

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More importantly your dentist can can perform a check-up before you use the kit which allows problems to be identified before they cause pain or are worsened as a result of unsupervised bleaching.  

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Follow-up visits allow the dentist to monitor progress and address problems that may arise.

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It is a safer method that provides betters results.

    For your safety we use only Whitening products that have the ADA Seal of Approval. 

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Tooth Whitening vs. Toothpaste That Promotes Whitening

    It would take up to a year and half longer to whiten your teeth one shade lighter through daily use of a toothpaste whitening product as compared to using a whitening gel.  

    The reasons for this is that the toothpaste is diluted by saliva and is only in your mouth for a few minutes or less.  Also whitening toothpastes do not lighten the color of tooth structure, they simply remove surface stains with mild abrasives or special chemical or polishing agents. 

     With the whitening kit you will be able to see results within three days of starting the whitening process and usually takes only 4-5 applications to see one color shade change.  

Remember: Whitening toothpaste can only remove stains, they do not change the color of the teeth.

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What Is Involved?

     Tooth whitening can be done in your home around your schedule after only two visits to our office:

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At your first visit we will check your teeth and gums to be sure that you begin the treatment in good dental health. We will than take an impression of your teeth in order to provide you with a custom-fit soft plastic tray that is fabricated by us. This tray is designed to hold the whitening gel next to your teeth. 

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At the second visit, this custom made mouth tray will be tried in, adjusted and trimmed to channel the active whitening agent to your teeth and not your gums to prevent irritation. You will be given your kit which contains the custom mouth piece, syringe delivered whitening gel and samples of products to help you maintain your smile along with instructions and supervision by Dr. Peterson. You decide when and how often to bleach your teeth!

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We suggest you return for a third visit to review your progress and determine the response of your teeth to whitening and any side effects.

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A great smile can last for a lifetime

Side Effects

     The main ingredients in most whitening products is hydrogen peroxide or carbamide peroxide. One in two people experience temporary tooth sensitivity to cold, heat, or pressure as a result of home whitening treatment.  Individuals with receding gums appear most likely to experience tooth sensitivity. This sensitivity is short lived and tends to decrease as whitening treatment progresses and usually ends a day or two after the treatment is completed. Remember that home use whitening systems are safe and effective and result in only mild, temporary changes in gum and dental pulp tissues.^

    If you have persistent discomfort please contact Dr. Peterson. If this uncommon case of sensitivity develops he can adjust your treatment regimen to help you attain the best results while ensuring your safety.

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Contra-Indications For Tooth Whitening

  1. We do not recommend bleaching for smokers or alcohol users. Smokers should stop smoking before having their teeth bleached. The smoking not only defeats the effect of whitening but there is concern about the mixture of hydrogen peroxide with smoking having a potentiating effect on tissue damage already known to be caused by smoking. 

  2. If you have pre-existing cosmetic restoration (bonding, porcelain crowns or veneers) you may need to replace them after the whitening treatment in order to match your new, whiter smile.

  3. Stains in the gray family (such as from tetracycline) can be harder to remove, if not impossible. These stains can take up to six months or longer to whiten. 

  4. The best candidates for whitening are those with stains caused by coffee, tobacco or aging. 

Contraindications/limitations of home bleaching: Comments
Extensive composite (white) & porcelain restorations Restorations will NOT bleach and you need to be informed about the cost of replacement
Pre-existing sensitivity 2/3 of these people will experience some sensitivity for 1-4 days; usually reversible upon termination of bleaching
Severe gray/blue banded tetracycline staining Guarded prognosis, may reduce amount of
"masking: required for future
Discoloration in gingival third or exposed yellow Guarded prognosis for whitening
Pregnant or lactating  No know adverse effects but avoid use as a precautionary measure
TMJ Consider bleaching one arch and monitor comfort
Translucent teeth May appear darker after bleaching
Amalgam restoration in front teeth Replace amalgams to avoid "greening effect"
Noncompliance or unrealistic expectation Determine realistic whitening results****

***An Update on Tooth Whitening, Woman Dentist Journal, pg 10-22, Jan/Feb 2003

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CAUTIONS

    If restorations are planned for the anterior (front) part of your mouth it is advisable to accomplish the whitening first, then match the new restorations to the now whitened teeth. You will need to plan to wait three weeks after bleaching before starting these restorative procedures. 

     We cannot predict the effectiveness of the whitening agent, so it is recommended that whitening be tried first to see what degree of shade change is obtainable because each person’s reaction to whitening is so individual.  

    The results for people who don’t smoke, drink coffee/ tea/red wine and have good dental health habits see little to no change in their whitening effect for up to five years after treatment. 

    You can easily "touch-up" the results at home within a few days once or twice a year. And don’t forget to keep your regular dental visits twice a year.

For permanent change, you should consider the placement of Veneers.

One study concluded that both surface roughness and adhesion of S. mutans to the enamel surface increase after bleaching.  
Journal of Dentistry Volume 31, Issue 8 , N. Hosoya, , K. Honda, F. Iino and T. AraiNovember 2003, Pages 543-548

Is Teeth Whitening Addictive?

Are you addicted to tooth whitening?WebMD.com raises the question of “whitening addiction,” citing those who have a narcissistic compulsion to maintain their youth by overuse of tooth whitening products, both OTC and professional. Signs of whitening abuse include people who seek to get their teeth to a "Clorox white” shade until their teeth are almost transparent, yet do not seem to realize their teeth are already white. It is unlikely that damage to the surface of the tooth will be caused before the sensitivity occurs. He cautions against bleaching for people under age 18 as there is greater opportunity for hypersensitivity. Dentists need to partner with patients to set realistic expectations and avoid overuse of whitening products.

For instructions on how to whiten your teeth: How To Whiten 

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September 28, 2008

Resource: Whitening Systems, Stacie Crozier, ADA News April 16, 2001, pg 11.
* Whiteners put shine on dental care, Stacie Crozier, ADA News April 16, 2001 pg 8-10 stated by Dr. Heymann.
^Incidence of Tooth Sensitivity After Home Whitening Treatment; Dr. Jorgensen, Dr. Carroll; JADA, Vol 133; pgs 1076-1082; Aug 2002.
Dentistry Today pg 34-36, September 2002
#Nightguard Vital Bleaching; Dr. Haywood; Dental Products Report pg 82-86,96; Oct 2002.

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          If you have any questions please e-mail me at: drdpeterson@scottsbluff.net
                                                                                 308-436-3491 Office number

PLEASE NOTE: The information contained herein is intended for educational purposes only.  It is not intended and should not be construed as the delivery of dental/medical care and is not a substitute for personal hands on dental/medical attention, diagnosis or treatment.  Persons requiring diagnosis, treatment, or with specific questions are urged to contact your family dental/health care provider for appropriate care.
This site is privately and personally sponsored, funded and supported by Dr. Peterson.  We have no outside funding.
Confidentiality of data including your identity, is respected  by this Web site. We undertake to honor or exceed the legal requirements of medical/health information privacy that apply in Nebraska.

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