HOW ARE TEETH WHITENED?

The active ingredient used for whitening teeth is the peroxide. When peroxide is applied onto teeth, the hydrogen peroxide eliminates stains and whitens them. The best way to describe teeth whitening is a deep cleaning of the tooth’s enamel.

WHAT ARE THE CAUSES OF TEETH DISCOLORATION?

The extrinsic discoloration of the teeth is caused by deposits on the surface of the enamel. The main culprits are: plaque, tartar, coffee, tea, soft drink, wine, fruit juice, and tobacco.
The intrinsic discoloration of the teeth appears inside the enamel or the dentin. The main causes are: aging (principal cause), medication (antibiotics), fluoride, and some forms of trauma.

ARE THE RESULTS CONSISTENT FOR ALL PATIENTS? 

The results vary from one person to another because enamel is comparable to skin color (dark to light). Like skin, enamel has different colors. Consequently, excellent results can be obtained when the enamel is a little yellow or orange. However, teeth whitening is more difficult and requires regular follow-ups when the enamel is grey or blue tinted.

Finally, the discoloration caused by antibiotics such as tetracycline is more difficult to treat. The dosage length ofnorm the course of antibiotics has an impact on the discoloration. Cosmetic procedures such as the fitting of porcelain veneers are sometimes necessary to produce the desired effect.

HOW LONG LAST THE WHITENING TREATMENT?

The length of a whitening treatment that will yield the best results possible is linked with the type of discoloration selected. Consult the sub rubrics below in order to choose the best whitening treatment suited for you.

For average discoloration

At-home treatment: 1 to 6 weeks.
Laser combined with at-home treatment: 1 session at the dentist followed by approximately 1 week at home.

For discoloration caused by nicotine

At-home treatment: 1 to 3 months.
Laser combined with at-home treatment: 1 session at the dentist followed by approximately 2 weeks at home.

For discoloration caused by tetracycline

At-home treatment: 1 to 6 months (sometimes more).
Laser combined with at-home treatment: 1 session at the dentist followed by approximately 3 weeks at home.

Note
A single laser treatment can be sufficient depending on the expectations of the patient. However, combining laser and at-home treatments will yield better results and increase long-term stability.

ARE THERE SIDE EFFECTS CAUSED BY TEETH WHITENING?

Yes. Tooth sensitivity is the most uncomfortable side effect. This sensitivity (contact with air, hot and cold foods, etc.) can last up to two days at varying degrees during the treatment. For some, it will last throughout the treatment.

Irritation of the gums is another possible side effect of teeth whitening. You can avoid a potential minor irritation by using the right amount of whitening product and filling up the trays carefully.

CAN WHITENING TREATMENT ALTER THE SURFACE OF THE TEETH’S ENAMEL?

A slight deterioration of the enamel will occur, but is only perceptible with a microscope, and is not perceived by the naked eye. However, minerals in the saliva will make up for this loss by remineralising the surface of the enamel. There is a sudden loss of calcium, but it is comparable to the loss of calcium that occurs after drinking an orange juice.

Finally, there will be very little change to the texture of the teeth, except for them becoming more porous, having food stick to them more easily. This problem will only last for the duration of the whitening treatment.

WHAT IS THE SCIENCE BEHIND TEETH WHITENING?

There are two products used to whiten teeth: carbamide peroxide and hydrogen peroxide. The process involves oxidization whereby carbamide peroxide decomposes into hydrogen peroxide. Carbamide peroxide is a small molecule that rapidly penetrates the enamel and dentin, and it breaks apart the double carbon fragments that cause the yellowing and the dull appearance of the teeth.

Carbamide peroxide-based products have a concentration of 10% or 15%. Hydrogen peroxide-based usually has a concentration of 3% or 5%. The concentration of hydrogen peroxide is roughly a third of the concentration of carbamide peroxide.

DOES THE CONCENTRATION OF THE PRODUCT HAVE AN IMPACT ON THE RESULTS?

A higher concentration of peroxide will act faster, but it will increase sensitivity. A lower concentration, on the other hand, will not increase sensitivity as much, and it will produce the same effect at the end of the whitening treatment. Therefore, it is preferable to use a lower concentration of peroxide as it will cause less sensitivity related problems, and the outcome of the treatment will be the same as if you would have used a product with a higher concentration.

WHAT FACTORS WILL HAVE AN IMPACT ON THE EFFECTIVENESS OF THE TREATMENT?

It first depends on the type of discoloration, then, on the intensity of the discoloration, and finally, on the motivation of the patient to follow the protocol.

WILL THE RESULTS OF TEETH WHITENING BE LONG-LASTING?

Yes if the treatment plan is followed as prescribed, its effects will last from one to three years. However, a touch up treatment every six months is suggested. Note that your teeth will never return to their original color.

HOW MANY HOURS MUST THE PRODUCT BE APPLIED ON THE TEETH?

The gel is effective for a surprising length of time. Carbamide peroxide gel decomposes rapidly during the first few hours of usage, but after two hours, it is still 50% effective. After four hours, the gel is still 35% effective. With time, the gel loses its effectiveness, but it stabilizes. When the discoloration is important, we recommend that you wear the gel filled trays throughout the night to maximize the effectiveness of the gel on your teeth.

Dentists that sell at-home teeth whitening products often recommend that their patients wear the trays from half an hour to two hours a day. However, to obtain better results, you can wear the trays for longer periods than suggested. If this causes your teeth to become sensitive, you should consider reducing the time you wear the trays.

WHO CAN BENEFIT FROM A WHITENING TREATMENT?

Almost everyone at all ages! However, we suggest the whitening treatment only to patients whose enamel has reached complete maturity. Therefore, it is acceptable to whiten the fully mature teeth of teenagers. Women, however, should not get their teeth whitened during pregnancy or while breast-feeding. Smokers, on the other hand, will be pleased to know that there is no contraindication to whiten their teeth. However, they should be prepared for the results to not be as long-lasting, and they should understand that they may need to touch up their teeth regularly.

ARE THERE EFFECTIVE PRODUCTS SOLD IN DRUG STORES?

Whitening toothpastes

No: The concentration of peroxide is not sufficient to whiten teeth, and the active ingredient is not in contact with the teeth long enough. However, whitening toothpaste can be an excellent adjuvant following an at-home treatment. Consequently, it will work well in tandem with the whitening treatment as it will effectively prevent extrinsic stains from appearing on the enamel.

Whitening chewing gum

No: It simply removes stains.

Crest Whitestrips 

Yes: They are effective, reliable, and inexpensive on straight and equal teeth. However, there are disadvantages to their use that make them somewhat uncomfortable. This whitening system employs polyethylene strips that are applied to the teeth. The lower strip is difficult to install and to keep in place. People with teeth crowding or overlapping will have problems keeping a form contact between the strips and their teeth which will reduce the effectiveness of the product. Note that you have to protect your gums against irritation and burning caused by the product.

Colgate Simply White (or Crest Night Effects)

Yes and no: This is a new technology which involves applying a gel on the teeth using a small brush or applicator. This type of whitening works relatively well, but is never as effective as an at-home whitening treatment. lf you do use one of these gels, avoid swallowing it, and prevent it from touching your lips or your tongue. If you intend to use this product more than 14 days, a dentist must follow you.

APART FROM PRODUCTS SOLD IN DRUG STORES, WHAT ARE THE WHITENING OPTIONS?

There are three whitening treatment options

At-home teeth whitening 

The most popular method is the at-home teeth whitening which has to start when the patient’s teeth are clean. Teeth must be free of tartar, and be polished in order for the extrinsic stains and deposits to be removed.

At our dental office, we will take note of the color of your teeth at the beginning of your treatment so that we can compare the results. Also, the impression of your mouth will be taken to manufacture two small moulds, called trays, which will fit perfectly on your teeth. Following your dentist’s instructions, you will put the gel in the trays, and wear them at home.

Chairside whitening at the dentist’s

This popular method consists of activating the whitening product with a high intensity light (a curing light). To maximize the treatment effects, the procedure has to be repeated two to six times (60 to 90 minutes for each treatment). But, the disadvantage of this method is that the teeth become quite dehydrated immediately after the treatment, and appear whiter than they actually are.

The best way to take advantage of this method is by combining a light activated treatment which accelerates the whitening with an at-home treatment which uses trays for a few weeks. The advantage of this method is that instead of having to do the at-home treatment for the prescribed number of times, you have to wear the trays for less time because the gel effectiveness will have been increased while exposed to a curing light beforehand at the dentist.

Laser whitening at the dentist’s

This is the most innovative method at the moment, and it is done at the dentist’s office. The procedure consists in applying a gel to the teeth, and activating it with a laser instead of a curing light. The procedure takes about 60 minutes. The advantage of this method is the absence of dehydration of the teeth since the laser does not produce heat. After a single session using the laser, the results are quite satisfying, but they can be optimized when this treatment is combined with an at-home whitening treatment.

At Centre dentaire La Vallée, laser treatment is followed by an at-home treatment during a few days. Being the most effective of all, this type of treatment requires less touch ups. For some, the results are so positive following the session at the dentist’s that they do not need to extend the whitening treatment at home.

WHY SHOULD YOU SEE A PEDIATRIC DENTIST?

The pediatric expert treats children with a different psychological approach than a general dentist because he or she specialized at university and at a children’s hospital after the five years’ general dental program. Also, the pediatric dentist is more familiar with children’s more complex treatments.

WHY SHOULD A PRIMARY TOOTH BE FILLED IF IT IS GOING TO FALL OUT EVENTUALLY?

Some primary teeth (baby teeth) will be in your child’s mouth until he or she is 12 year old. Broken or infected teeth can affect your child’s health and self-confidence. A filling could be a cheap and easy way to fix the problem that could be painful and later cost more because it stops decay from spreading deeper into the tooth.

WHAT IS MALOCCLUSION?

As the permanent teeth of your child arise, your dentist can tell you if they are growing normally or not which can cause deeper problems such as malocclusion. A malocclusion is a biting problem that can occur when teeth are not straight and causes problems while eating, and teeth cleaning. This can also affect your child’s appearance, and it can make your child feel out of place. Your dentist can suggest ways to treat this condition.

WHAT SHOULD YOU DO IN CASE OF DENTAL TRAUMA?

In case of a dental trauma (fracture, tooth knocked out, mobility, etc.), whether it is a primary or a permanent tooth, it is very important to contact your dentist as soon as possible, or to bring your child to the nearest dentist available. The dentist will be able to proceed with the most appropriate treatment. If the delay between the trauma and the dental visit is too long, consequences of the trauma may be more significant.

WHAT ARE THE POSSIBLE WAYS TO TREAT AN ANXIOUS CHILD OR A VERY YOUNG CHILD?

For children of six years of age and older, your dentist can suggest performing the treatment under nitrous oxide, a very safe gas that has been used for more than twenty years. This gas has the effect of calming a child. For very small children who have many caries, your dentist may recommend treatment under general anesthesia in a private clinic to avoid the one year wait at the hospital. The advantages of general anesthesia are that all your child’s teeth can be repaired in one sitting while he or she is asleep.

WHEN SHOULD YOU START AN ORTHODONTIC TREATMENT?

The American Dental Association recommends evaluating children at 6-8 years of age to detect developmental problems. By this age, we can usually predict the necessity for treatment, and when to start it.

HOW ORTHODONTIC PROBLEMS ORIGINATE?

In an orthodontic case, the heredity is important. This is the case for size or space problems including missing or supernumerary teeth and jaw width or shape abnormalities. Other cases such as thumb-sucking, incorrect swallowing (tongue position), accidental tooth fracture or early loss of baby teeth may cause poor teeth alignment and can affect oral health.

WHAT IS MALOCCLUSION?

Malocclusion is an incorrect relationship between teeth and jaws. There are three main malocclusion classes:

Class I: Jaws are well positioned, but teeth are crooked or overlapping.

Class II: The upper jaw is too big and/or the lower jaw is too small, so teeth are in an incorrect relationship.

Class III: The upper jaw is too small and/or the lower jaw is too big, so teeth are in an incorrect relationship.

WHY ARE ORTHODONTIC TREATMENT SO IMPORTANT?

The main purpose of an orthodontic treatment is to improve oral health. Crooked teeth are more difficult to clean and decay more which can cause gum disease, tooth loss, joint problems, worn-down teeth, headaches, neck aches, and defective chewing.

WHY ARE ORTHODONTICS RECOMMANDED TO ADULTS?

There is no age limit to start an orthodontic treatment even if it is considered better to do it during the growth period. Nowadays, 35% of orthodontic patients are adults. New technologies enable us to use very discrete – “invisible” – appliances.

WHAT TYPE OF APPLIANCE SHOULD YOU USE?

There are two types of appliance: fixed and removable. Sometimes, we have to combine these two appliances for better results. It is during the consultation that your dentist will inform you about the best treatment for you.

HOW LONG DOES AN ORTHODONTIC TREATMENT LAST?

The length of an orthodontic treatment varies with each case. Sometimes, uncontrollable or late growth will change the treatment. Also, patient cooperation (wearing your appliance) is essential. We plan the treatment duration during consultation. However, a typical treatment will last about two years.

HOW MUCH DOES AN ORTHODONTIC TREATMENT COST?

The cost depends on the severity of the problem, the duration of the treatment, and the appliances required. Consequently, it is very hard to establish an average cost. During your evaluation, we will evaluate a cost. We offer different methods of payment, and an insurance policy usually covers part of the treatment cost. Most of the time this expense is tax-deductible.

ARE PERIODONTAL DISEASES ASSOCIATED TO A LACK OF HYGIENE OR TO A BAD BRUSHING TEETH HABIT?

Unlike the idea largely spread around, parodontosis are not diseases due to aging or a non-existing oral hygiene. Parodontosis can develop quickly on part of the tooth or on the entire tooth at different ages and different medical contexts

WHAT ARE THE MAIN SYMPTOMS OF PERIODONTAL DISEASES? 

• Abscess
• Accumulation of food between teeth gaps
• Apparition of teeth gaps
• Bad taste in the mouth
• Bleeding when brushing your teeth
• Gums retraction
• Sensitivity to cold
• Tooth mobility