Basics Of Whitening
Teeth whitening is not permanent. With no intervention, the colour of your newly whitened teeth will begin to slowly fade back to your previous colour. The duration between topping up your teeth whitening depends mainly on lifestyle choices. People who smoke or consume food and beverages that stain teeth, such as red wine, coffee and curries, will find that they need teeth whitening at more regular intervals after their initial whitening treatment. If your lifestyle involves one or more of these factors then you may require top-ups every 3 to 4 months. In the absence of these habits, most people will require a top-up on their teeth whitening at 6 monthly or yearly intervals.
Age and habitual factors also play a role in how long your whitening treatment will last.
If you grind your teeth, the enamel can develop micro cracks. These will accumulate stains much more readily and mean you need whitening treatments more regularly. Your dentist will be able to help you determine how often you should top up your whitening.
Boutique Whitening by Day is a 6% hydrogen peroxide gel. Hydrogen peroxide is inherently unstable and will break down immediately once you place the whitening trays in your mouth The majority of the peroxide will be spent within the first 20 minutes of wear, but to experience the full effect of the gel, we recommend at least 1 to 1.5 hours of wear time.
Boutique by Night has several different protocols, all designed for a minimum of 4 hours’ wear time, but best results will manifest from keeping the trays in overnight, so you can whiten as you sleep. Wearing for 6 hours or more at night will typically yield better results.
We have a 10% carbamide peroxide gel, or a 16% carbamide peroxide gel – both designed to be worn overnight. These are the equivalent of 3.5% hydrogen peroxide and 5.7% hydrogen peroxide, respectively.
Both gels will give you a fantastic white smile, but the 16% will get you there a little faster. If you suffer from sensitivity, the 10% is a better option for whitening your teeth.
Boutique also manufactures a 4.25% Hybrid Pro teeth whitening gel. This is a blend of 4.25% hydrogen peroxide and 4.25% carbamide peroxide. This gel is designed to be worn overnight and delivers a gentle nudge with the hydrogen to get things started, whilst the carbamide slowly ramps up overnight. This is a powerful formula, delivered gently to ensure excellent whitening, whilst minimising side effects.
Teeth whitening is more effective on teeth that are on the yellow and white spectrum. Teeth that are shades of brown and grey are more difficult to whiten and may require a longer treatment, or stronger whitening agents.
If you have local discoloration that does not respond very well to whitening, then your dentist may discuss whitening in conjunction with more in-depth procedures, such as micro-abrasion, ICON resin infiltration treatment, composite bonding, crowns or veneers.
With all types of teeth whitening products, the results will vary from person to person, and depend largely on the original colour of the teeth, the condition of the teeth, the type of staining present and compliance with the teeth whitening regime.
The most difficult staining to remove is deep, intrinsic staining from factors such as tetracycline use. This type of staining can take many months of whitening to achieve a good result.
The success of tooth whitening depends largely on the type of staining present. Intrinsic staining is discoloration that is incorporated into the structure of the tooth, either while the tooth is developing, or after it has erupted – this stain cannot be removed by prophylaxis (professional cleaning) and whitening is often the treatment of choice.
Fluorosis:
Some of the main causes of intrinsic staining are excessive fluoride intake over the period that the tooth develops. The resulting fluorosis manifests itself as either white and chalky enamel, or brown staining. Either way, bleaching can be used in most cases, to reduce the contrast of the mottled enamel and improve the appearance. In more extreme cases, these will still require either ICON resin infiltration, or more extensive restorative work.
Antibiotics:
Another major cause of intrinsic staining is the use of antibiotics, particularly tetracycline and minocycline. These impart a blue-grey banding on the teeth. The severity of staining will differ, depending on the type and duration of use. In both cases the staining is similar. However, minocycline can stain teeth both during development and after eruption. Prolonged whitening is usually required in these cases, but more often than not, it must be used in combination with bonding or veneers to achieve a satisfactory result.
Trauma:
The most common cause of intrinsic staining is trauma, which manifests itself in a two-fold process. Firstly, inflammation of the pulp causes haemorrhage into the dentinal tubules to give the tooth a pinkish tinge. The haemoglobin in the blood then breaks down to iron sulfide, leaving the tooth a grey, or dark black colour. This type of staining responds well to prolonged whitening. Likewise, if a tooth becomes necrotic secondary to trauma, a similar process occurs. However, treatment in this case must include root canal treatment to remove the necrotic material. This can then be followed by a course of internal whitening.
Hereditary:
Other common causes of intrinsic staining are hereditary. Imperfections in the formation of either enamel or dentin can cause discoloured teeth. Both amelogenesis and dentinogenesis imperfecta, along with enamel hypoplasia, are examples of hereditary causes of intrinsic staining. Diseases like porphyria can also cause discoloured teeth owing to excess porphyrins in the blood during mineralization of the teeth. Affected teeth are usually pinkish brown.
Age:
Age also causes intrinsic discoloration of teeth. This is a result of changes in the physical composition of the tooth. Over time, layers of enamel are lost, exposing the darker underlying dentine. Sclerosis and secondary dentine can often take on a darker hue, which also contributes to age related discoloration
A man named Louis Jacques Thenard discovered hydrogen peroxide in 1818. Hydrogen peroxide is a potent oxidising agent. The whitening action is a result of peroxide breaking down to form oxygen free radicals. These then oxidise, or break up, larger pigment molecules into smaller, less visible molecules that can be absorbed by the body – this is whitening!
By the European Directive on teeth whitening, dental professionals are only permitted to sell products that contain a maximum of 6% hydrogen peroxide.
Over-the-counter products that do not require the supervision of a dental professional may contain only 0.1% hydrogen peroxide by law. These products are ineffective in whitening the teeth as the concentration of peroxide is simply too low.
Carbamide peroxide is hydrogen peroxide compounded with urea. Urea helps stabilise the formula, giving carbamide peroxide a more predictable, and longer shelf life, than hydrogen peroxide alone.
The European Directive allows dental professionals to prescribe up to 16% carbamide peroxide. In the presence of water, carbamide peroxide degrades into urea and hydrogen peroxide. Any given volume of carbamide peroxide will yield 35% volume of hydrogen peroxide when it breaks down.
A notable difference between hydrogen peroxide and carbamide peroxide is the rate of breakdown, and therefore, the rate of release of oxygen ions. Carbamide peroxide is a more stable molecule and breaks down much more slowly than hydrogen peroxide. Carbamides release about 50% of their available peroxide in the first 2 to 4 hours, then the remainder over the next 2 to 6 hours.
Hydrogen peroxide breaks down almost immediately, releasing active oxygen ions entirely within the first hour. It is thought that because of this relatively concentrated bombardment of peroxides on the pulp, hydrogen peroxide produces more sensitivity than carbamide peroxide of a comparable concentration.
A man named Louis Jacques Thenard discovered hydrogen peroxide in 1818. Hydrogen peroxide is a potent oxidising agent. The whitening action is a result of peroxide breaking down to form oxygen free radicals. These then oxidise, or break up, larger pigment molecules into smaller, less visible molecules that can be absorbed by the body – this is whitening!
By the European Directive on teeth whitening, dental professionals are only permitted to sell products that contain a maximum of 6% hydrogen peroxide.
Over-the-counter products that do not require the supervision of a dental professional may contain only 0.1% hydrogen peroxide by law. These products are ineffective in whitening the teeth as the concentration of peroxide is simply too low.
Carbamide peroxide is hydrogen peroxide compounded with urea. Urea helps stabilise the formula, giving carbamide peroxide a more predictable, and longer shelf life, than hydrogen peroxide alone.
The European Directive allows dental professionals to prescribe up to 16% carbamide peroxide. In the presence of water, carbamide peroxide degrades into urea and hydrogen peroxide. Any given volume of carbamide peroxide will yield 35% volume of hydrogen peroxide when it breaks down.
A notable difference between hydrogen peroxide and carbamide peroxide is the rate of breakdown, and therefore, the rate of release of oxygen ions. Carbamide peroxide is a more stable molecule and breaks down much more slowly than hydrogen peroxide. Carbamides release about 50% of their available peroxide in the first 2 to 4 hours, then the remainder over the next 2 to 6 hours.
Hydrogen peroxide breaks down almost immediately, releasing active oxygen ions entirely within the first hour. It is thought that because of this relatively concentrated bombardment of peroxides on the pulp, hydrogen peroxide produces more sensitivity than carbamide peroxide of a comparable concentration.