Dental bleaching, also known as tooth whitening, is a common procedure in general dentistry. According to the FDA, whitening restores natural tooth color and bleaching whitens beyond the natural color. There are many methods available, such as brushing, bleaching strips, bleaching pen, bleaching gel, and laser bleaching.
The ADA recommends to have one’s teeth checked by a dentist before undergoing any whitening method. The dentist should examine the patient thoroughly: take a health and dental history (including allergies and sensitivities), observe hard and soft tissues, placement and conditions of restorations, and sometimes x-rays to determine the nature and depth of possible irregularities.
A recent study by Kugel et al. showed that nearly half the initial change in color provided by an intensive in-office treatment (i.e., 1 hour treatment in a dentist’s chair) may be lost in seven days. Rebound is experienced when a large proportion of the tooth whitening has come from tooth dehydration (also a significant factor in causing sensitivity).
Various chemical and physical agents can be used to whiten teeth. Toothpaste typically has small particles of silica, aluminum oxide, calcium carbonate, or calcium phosphate to grind off stains formed by colored molecules that have absorbed onto the teeth from food. Unlike bleaches, whitening toothpaste does not alter the intrinsic color of teeth.
Bleaching solutions contain peroxide, which bleaches the tooth enamel to change its color. Off-the-shelf products typically rely on a carbamide peroxide solution varying in concentration from 10% to 44%. Bleaching solutions may be applied directly to the teeth, embedded in a plastic strip that is placed on the teeth or use a gel held in place by a mouthguard.