Dr. Soll
Serving Ontario In Toronto, Hamilton, Mississauga, and Surrounding Areas
Having beautiful teeth is a guarantee that you'll smile at the world more often. Teeth, however, tend to darken with age due to exposure to coffee, tea and other agents that stain the enamel, but now your teeth can be restored to a sparkling pearly white.
In the past couple of years, a slew of new teeth-whitening products has flooded the market, promising to deliver a dazzling smile. Some whitening techniques are available only from dentists, either through an in-office procedure or a custom system you can use at home. Other whitening systems and toothpastes can be bought over the counter.
Why the demand? "There has always been a demand for teeth whitening, but now it is so much more accessible and easier to use," says dentist Dr. Daniel Daniel of the Centre for Laser Dentistry in Calgary. "When I ask my clients what their goals are for their teeth, whiter and brighter is the answer. People are discovering how easy it is to achieve and how relatively inexpensive it has become."
Dr. Jordan Soll, a Toronto dentist at Aesthetics in Dentistry, says, "Teeth yellow with age. Think of a white carpet. Over time, it yellows." Generally, smoking and food such as coffee, tea, red wine, even blueberry pie, are the typical extrinsic culprits. Intrinsic causes are certain drugs (for example, tetracycline taken as a child) and certain nutritional deficiencies (lack of calcium, for example).
The only way to actually lighten the color of your teeth is through chemical bleaching. The active ingredient in all bleaching or whitening systems is hydrogen peroxide. Though bleaching can do wonders for teeth yellowed by age, it's less successful for teeth that look grey, a side effect of some antibiotics.
"Years ago, doctors weren't aware that treating a baby with tetracycline would, in the child's later years, cause teeth to grey," Soll says. "Because the antibiotic combines with the cells that lay down the enamel for adult teeth, it's very difficult to liberate the greyness from within the teeth. Though in many cases it can be done, it does take much longer." In such cases, crowns or veneers are often the best solution.
Here's a look at the latest smile brightening options available.
What your dentist can do
The
main menu of teeth whitening procedures served up at the dentist's office
includes laser whitening, power whitening, the application of veneers,
and a custom whitening system to be used at home. Most dentists can provide
you with the at-home method or refer you to a clinic that specializes
in laser whitening and veneers. Regardless of which method you chose,
begin with a dental exam.
"It's best to visit your dentist prior to launching any whitening method to make sure there are no cavities or decay," says Dr. Daniel. "Cracks in teeth or fillings increase the likelihood of discomfort and sensitivity. Also, make sure there isn't a lot of recession of the gums because the root exposure can make teeth feel very sensitive to the process."
Take-home, dentist-supervised treatments
"The at-home system uses a low concentration of material over an extended period of time; the teeth gradually take up the whitening material, giving you a change that penetrates the tooth," says Dr. Soll.
What improvement can you expect? Dr. Soll advises: "Whoever guarantees you a specific result, I would run from. You cannot guarantee a result. This is the rule of thumb to go by: The more yellow your teeth, the greater the result. My findings have been that 25 percent of people get a satisfactory result; 50 percent get a good result and the last 25 percent get an outstanding result. The more yellow along the color spectrum your teeth are, the greater the results you're going to have. If your teeth or more along the grey end of the color spectrum, the more difficult it will be and the more prolonged your treatment will be.
It's also important to note that chemical bleaching does not work on porcelain crowns, composite fillings or veneers. "If, for example, you have one front tooth that's a crown and all the other teeth are natural, count on replacing that crown after you've whitened your teeth," says Dr. Soll.
Here's how the use-at-home method works: The dentist takes an impression of your teeth (many people just do the upper teeth). Next, plaster casts are made from the impressions and these are used to create custom flexible plastic molds. The molds, or trays, have a thin space built in to hold the whitening gel.
The tray fits snugly over your teeth. Most patients find it feels "just fine," a few say it feels like a mildly uncomfortable glove. The tray serves two purposes: it delivers the bleach to your teeth and protects your gums and the soft tissue of your mouth.
This
protection allows the dentist to give you a higher concentration of bleaching
agent (usually carbamide peroxide - a more viscous, easier-to-handle form
of hydrogen peroxide) than you would get in an over-the-counter kit. These
kits have a one-size-fits-all tray, and dentists usually advise against
them. Dr. Soll says the professional molds have the advantage of creating
an intimate contact between the material and your teeth. "If you are trying
to wear a one-size-fits-all tray, half the material is apt to run down
your throat."
At home, you simply brush you teeth (ideally, your dentist should polish your teeth first so the enamel is spotless), fill the plastic tray or mouth guard from the tube of whitener, and squish or ease this over your upper or lower teeth.
You keep the mouth guard on your teeth for a set amount of time each day, depending on the strength and concentration of the gel. Generally, you wear the trays for as little as a half hour per day to six to eight hours while you sleep, for a period of two or more weeks. The bleach penetrates the enamel slowly, and in the end your teeth should be a few shades lighter.
How frequently do you need to do this? "Use it initially for two weeks for the top, then two weeks for the bottom," says Soll. "Don't do the whole mouth at the same time because you may experience sensitivity during the process and you won't want to double up on this experience. Plus, it's a psychological game we play - watching one part whiten gives you something to compare it with. And that will really get you excited so that you can't wait to do the bottom."
The whitening treatments don't prevent future stains. To keep your teeth their whitest, it's recommended that you use a whitening toothpaste, and repeat the bleaching procedure (whether you use an at-home or professional process) every six months to a year. The touch ups only need to be done for one week, instead of the two weeks required for the initial procedure.
Teeth whiteners have not been found to cause any long-term side effects. "There have been exhaustive studies that show if you use professionally dispensed material, it is 100 percent safe," says Dr. Soll. But a common short-term side effect is tooth sensitivity.
"Fortunately, when you stop the treatment, the sensitivity disappears," says Dr. Daniel. If you do experience sensitivity, try brushing with toothpaste for sensitive teeth during the bleaching process.
The cost: Expect to pay anywhere between $300 to $700. The fee covers the initial evaluation, a custom-fitted mouth guard, a package of tubes of bleaching gel and routine care by the prescribing dentist.
Another product you can obtain through a dentist is Professional Whitestrips, new from Crest. They are thin, flexible strips coated with a professional strength tooth-whitening gel containing peroxide. This system produces noticeably whiter teeth. The package contains 84 whitening strips and Crest Dual Action Whitening 100mL toothpaste. The system costs around $100.
Laser whitening
The
quickest way to get whiter teeth is with laser whitening. All it takes
is one office procedure. The drawback: Laser is costly, and the results
may not be as good as those achieved with the at-home method.
"A good reason to have the in-office procedure is if you have a big event scheduled," says Dr. Soll. "A patient will call and say, 'I have a big wedding to go to and my teeth look horrible. What can you do?' The in-office treatment will get you a jumpstart on the whitening process. If you want a quick fix and you have the dollars and want to see an improvement right off the bat, then that's the way to go."
Here's how it's done: Teeth are isolated to protect the gums and the soft tissue in your mouth. The dentist applies peroxide to your teeth and then uses the laser to accelerate the whitening process. The laser does not do the whitening; it is "simply used as a catalyst to activate the gel," says Dr. Daniel. "The session can take one to two hours. Though it varies from individual to individual, most people find the procedure comfortable."
He says, "I have discontinued the laser service in my practice. I get better, longer-lasting results with the at-home whitening procedure and it's less expensive for my client."
How much does the laser route cost? About $1,000 to $2,000. Though this method gives you a quick transformation, and may be necessary in cases of severe discoloration, the difference in price leads many people to opt for the at-home kits.
How long does laser whitening last? "It's variable, but you cannot expect as good or as long-lasting a result as with the at-home system," says Dr. Soll. He suggests that after laser and power treatments, you continue on with the at-home whitening system "to make spending this much money count for you long term."
Power Whitening
In-office power whitening is similar to the at-home whitening in that a super strong concentration of bleaching material is applied to the teeth, but in this case the concentration is much higher than that used at home. It generally takes between two to four in-office procedures to get the equivalent whitening you would achieve with two to four weeks of the at-home treatment.
Veneers
Bleaching
is less successful for teeth that have a grey or bluish color caused by
taking antibiotics when very young. This is where veneers can help.
"Veneers are like false nails for your teeth," says Dr. Soll. "I can show you cases where we have taken people's smiles from 0 to 100, and we do it very quickly using veneers."
Veneers are individually shaped, made of ultra-thin porcelain and bonded to the front of the tooth (the sides and back of the teeth are left untouched). The procedure is quick: In only two weeks, you'll have a dazzling new smile. Veneers can rectify many problems such as chips and misshapen or crooked teeth; they can also close gaps and open up crowding.
But the method involves some alteration of the tooth surface. "The downside for some people is that the top .5 to 1 millimetre layer of tooth structure has to be removed," says Dr. Soll. "Some people are averse to having any part of their teeth removed."
The procedure is extremely costly, ranging from $600 to $1,500 per tooth. The resulting whiteness can last for years before you have to replace them, depending on your lifestyle. Routinely eating and drinking foods and liquids that cause staining can dull the veneer.
Over-The-Counter Methods
The do-it-yourself, over-the-counter systems are essentially peroxide bleaching kits. The main reason they may not be as effective as a dentist-supervised system is because the concentration of the chemicals is government controlled to protect health. However, that's not to say that eventually you won't achieve the same results.
By and large, the degree of satisfaction increases as the concentration of the agents used to bleach the teeth increases. If you are using a product prescribed by a dentist, it's more likely that your results will be quicker and more satisfactory.
But most people have satisfactory results with these kits, which can be purchased for approximately $20 to $50. If you decide to try an over-the-counter product, begin with a dental exam so cracks in teeth or fillings won't cause discomfort and sensitivity.
Keeping your teeth their whitest
Good dental hygiene, brushing, flossing and regular checkups invariably result in a nicer smile.
What about using baking soda? "Yes, it's nice for removing surface stains," says Dr. Soll. "You will get a slight color enhancement from the whitening toothpastes and baking soda, but only due to removing surface stains."
There are many new whitening toothpastes on the market.
To learn more about cosmetic dentistry in the Greater Toronto Area (GTA), including Markham, Thornhill, Richmond Hill, Newmarket, Ajax, Mississauga and Hamilton, Ontario, please email or call Aesthetics in Dentistry today to arrange your personal cosmetic dentistry consultation with Dr. Soll.
