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Tooth Whitening by Elaine Halley - Principal of Cherrybank

Dental Spa

By: Elaine Halley - Principal of Cherrybank Dental Spa

Dentists in Perth

Author: Dr. Elaine Halley is the principal of Cherrybank Dental Spa, a private practice in Perth. Her main interests are cosmetic and advanced restorative dentistry and she has studied extensively in the United States and the UK. She is the CEO of Jameson UK, a practice management consulting firm. She can be contacted on Elaine@jmiuk.com.

Elaine is also vice-president of The British Academy of Cosmetic Dentistry (BACD) is a non-profit making organisation established to provide training for dentists , Technicians and all members of the dental team seeking to respond to the burgeoning demand for cosmetic dental treatments.

For further information about becoming a member of the BACD call Suzy Rowlands on 020 8241 8526 or visit www.bacd.com and join on-line.

� �Tooth Whitening�

There are currently many techniques available within the field of conservative and restorative dentistry, which allow for greater conservation of tooth tissue than with conventional indirect techniques.

Aesthetic improvement may be desired by patients for a number of reasons, for instance, the colour, position, or shape of teeth. Tooth whitening or dental bleaching can be an effective technique for the treatment of discoloured teeth.

The problem with these treatments occurs due to continuing negotiations between the BACD/GDC and Europe as to what is legal or illegal in the practice of tooth whitening. This controversy has been ongoing for many years, and is still going on now � leaving many of the profession uncertain as to what they are allowed to offer their patients under European regulations.

Despite some areas still being unclear, the GDC is certain that tooth whitening is the practice of dentistry and should only be carried out under the supervision of a dentist. In future, this may restrict the beauty industry from participating in the tooth whitening market.

The cost of over the counter products is considerably less than in-surgery, hence why many patients are beginning to question why they should spend more with the professionals for apparently similar results? There are a variety of over the counter products available for our patients to purchase for self-whitening. Many of these contain very low levels of active ingredients. Some, such as Crest Strips available in the US, have been shown through clinical trials to be effective. Others, such as those obtained over the internet, may contain unsafe levels of hydrogen peroxide.

The main concern with over the counter products is that tooth whitening can be an effective treatment, however, without a thorough pre-treatment examination by a dental professional, it may not be an appropriate one. The presence of caries, periodontal disease, and defective restorations are of particular importance and ought to be corrected prior to any whitening procedures.

In terms of a service to our patients, there is no doubt that tooth whitening responds to a need in the population. It is well known that good oral health will have a direct positive consequence on an individual�s overall health. With whiter teeth, an individual can look younger and healthier.

Whitening can remove the extrinsic stains that have built up over time through consumption, e.g. tea, coffee, red wine and by smoking. Whitening can also be used to improve the discolouration caused by tetracycline staining of teeth, which have discoloured due to loss of vitality.

All agents for tooth whitening function through the action of hydrogen peroxide, which is a powerful oxidising agent. The time taken for the desired whitening depends on a number of factors including the aetiology, severity of staining, materials, and techniques used for whitening. Higher concentrations of hydrogen peroxide will have more rapid results, but may also have a greater incidence of adverse effects e.g. sensitivity, shade regression and gingival irritation.

For the whitening of individual teeth, methods such as walking bleach technique, inside-outside or home whitening with a reservoir for a single tooth, may be used under professional supervision.

For vital bleaching of multiple teeth, home whitening using custom made trays, power bleaching e.g. Zoom (Discus Dental), Britesmile or a combination of both have all been shown to provide good results.

According to the BACD, there are two main methods of �properly� undertaking tooth whitening:

Tray based. The gel is placed in a custom-made night-guard, which is worn from one hour to overnight for 7-10 nights (depending on the gel), which is provided by the dentist.

Surgery based - otherwise known as laser or power bleaching. Here, gels that are more concentrated are applied directly to the teeth and accelerated with heat or light (laser/power). Usually a one-hour appointment is needed, with maintenance provided through top-up trays.

The BACD published the following guidelines for patients on its website:

No whitening is permanent. Maintenance is needed to keep that bright smile.

Only a dentist can get your teeth to the maximum whiteness.

See a dentist first to check teeth are healthy before starting. Teeth and gums can become permanently sensitive if they are not healthy first.

There is no evidence that whitening toothpastes can actually whiten your teeth.

Whitening kits can at best do nothing and at worse, some of those bought abroad or over the internet can actually harm your teeth, as they contain acids/abrasives that can cause permanent damage.

Whitening is a safe procedure when carried out properly, and non-invasive. The alternatives, including veneers or even full coverage restorations, are non-reversible and potentially much more destructive.

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