Table of Contents
INTRODUCTION
Everyone wants their teeth to be white and bright. Right! But how much white and bright is the question? Unnecessary teeth whitening is harmful.
Teeth whitening can damage your teeth.
Teeth whitening is a widely preferred and adopted procedure by a lot of young individuals. Many commercial home-based bleaching kits are available in the market. These bleaching kits carry 3-20% carbamide or hydrogen peroxide in them.
Office bleaching is a standard teeth whitening procedure recommended by many dentists, as a part of teeth cleaning. In-office bleaching kits contain 15 to 45% of carbamide peroxide. Few products include hydrogen peroxide also.
People tend to opt for cosmetic treatments more than regular dental procedures. In a survey published in the American journal of orthodontics and dentofacial orthopaedics, 89% of patients chose to have dental teeth whitening process when compared to other treatments.
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HISTORY OF BLEACHING
In the late nineteenth century, many chemicals came into use to bleach non-vital or dead teeth. Out of them, few materials like Oxalic acid, sulphurous acid, aluminium chloride, pyrozone and sodium peroxide gained popularity.
In 1868 oxalic acid is used for the first time to bleach vital teeth. Later fisher popularised using hydrogen peroxide for active bleach. Now it has developed into IN-OFFICE BLEACH containing various concentrations of hydrogen peroxide ranging from 15% to 40%.
In 1960 Dr.Bill klusmier introduced the FIRST HOME BLEACH KIT, for his patients. The kit consists of a custom fitting mouth tray and 10% carbamide peroxide [Gly-oxide] solution.
In 1990 the first OVER THE COUNTER BLEACHING KITS were made available in united states. The present-day commercially available bleaching agents contain variable concentrations of carbamide or hydrogen peroxide.
Along with the principal ingredient, they also include Carbapol [thickening agent], a glycerine carrier, a surfactant for surface-wetting, preservative [sodium benzoate, methyl paraben] and flavouring agents [peppermint, spearmint, saccharin].
HOW DOES TEETH BLEACHING WORK
The bleaching solution, which mainly constitutes hydrogen peroxide gets activation from light or laser of a specific wavelength. As a result, the activated hydrogen peroxide produces free radicals like hydroxyl, per hydroxyl and superoxide anions.
These free radicals attack the organic pigmented material of teeth. As a result, there is a shift in the absorption spectrum of these pigmented molecules making them less colourful.
IS TOOTH WHITENING SAFE?
The effect of teeth whitening on enamel is devastating. Bleaching causes porosity in enamel structure degrading the calcium-phosphate ratio. It results in more calcium loss and organic matrix destruction leading to brittle and weakened teeth.
Hegedus, in his study, found increased surface irregularities in enamel, 28 hours after the application of 10% carbamide peroxide and 30% hydrogen peroxide.
Azer et al., in his study reported that extensive use of dental bleach could make teeth more brittle and prone to fracture.
In recent years, HOME BLEACH TECHNIQUE gained popularity. Patients started ordering them online. But these materials do carry risks. Their applicability is questionable as many of them are not approved and regulated by FOOD AND DRUG ADMINISTRATION [FDA].
Many HOME BLEACH KITS are known to cause SOFT TISSUE BURNS AND TISSUE WHITENING. In addition to it, Howard, in his research article, reported patients with the burning palate, burning throat and stomach problems.
HOME BLEACH VS IN-OFFICE TEETH WHITENING. WHICH ONE IS BETTER?
Home bleach contains low concentrations of carbamide peroxide. But, researchers found HOME BLEACH KITS to produce more damage when compared to IN-OFFICE TEETH WHITENING.
The reasons for this:
- Bleaching is technique sensitive. You should exactly know when and where to apply. Inappropriate use of dental bleaching kits can lead to excessive wear and tear of enamel.
- There are a bunch of conditions where teeth whitening can produce impressive results. But, at the same time, there are more conditions where teeth whitening is harmful.
- People with enamel abnormalities like amelogenesis imperfecta and dentinogenesis imperfecta are not ideal for bleaching.
- Dental bleach is not suitable for patients who are susceptible to more caries and with excessive teeth wear. Untimely use of dental bleach can increase teeth sensitivity in these patients.
- Patients with cosmetic fillings in front teeth are not ideal for bleaching. It may impart colour changes in these restorations.
- Patients with crowns, veneers and chipped teeth should use dental bleach with caution.
Usually, a dental expert handles teeth whitening procedure in the dental clinic. He evaluates your teeth and decides whether you are apposite for Dental bleach or not. After a thorough examination, your dentist decides the treatment protocol (number of times the bleaching procedure has to repeat).
He may also stop the procedure in the middle if he thinks the desired result has attained. There are many sophisticated instruments (colourimeter & spectrophotometer) which come handy to the dentist, to evaluate the shades of teeth. These instruments will not be available at home. Moreover, your dentist can handle if any pre-operative or post-operative complications arise.
Besides, home bleach doesn’t include any pre-operative checkup. A common man usually lacks professional skills to judge the grade of teeth whitening, when compared to a dentist. It could lead to inappropriate and incorrect use of these materials resulting in severe damage to teeth.
CONCLUSION
Excess of anything is harmful. In recent days interest over teeth whitening has increased radically. This increased demand has driven the companies to develop and promote their dental bleaching products.
However, BLEACHING INVOLVES RISK. Unprofessional use of dental bleach can cause peril to teeth. Here are a few steps to consider before opting for dental bleach.
- Do not decide yourself, whether you are suitable for dental bleach or not.
- Have a dental visit first. Let your dentist evaluate your teeth and decide.
- In case of any doubt, get clear clarifications from your dentist. REMEMBER, NOT ALL PATIENTS ARE SUITABLE FOR DENTAL TEETH WHITENING PROCEDURE.
- After a thorough evaluation, if your dentist recommends dental teeth whitening procedure, it is up to you to follow your dentist or use a HOME BLEACH KIT.
- IN-OFFICE BLEACH is always safe, as it is performed under professional surveillance.
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