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All you need to know about teeth whitening

What is teeth whitening?

Over time, your teeth can go from white to not-so-bright for a number of reasons, including bad habits, a medical condition, staining agents, dental plaque, or simply wear and tear.

A teeth whitening treatment may bring back the brightness of your teeth so you can look and feel younger and lot more confident.

Teeth whitening can be achieved by either changing the intrinsic color or by removing and controlling the formation of extrinsic stains.

Hydrogen peroxide (H2O2) is the active ingredient most commonly used in whitening products and is delivered as either hydrogen peroxide or carbamide peroxide.

When it diffuses into the tooth, hydrogen peroxide acts as an oxidizing agent that breaks down to produce unstable free radicals.

In the spaces between the inorganic salts in tooth enamel, these unstable free radicals attach to organic pigment molecules resulting in small, less heavily pigmented components.

Reflecting less light, these smaller molecules create a “whitening effect”.

There are different products available on the market to remove stains. Nevertheless, a professional teeth whitening performed by a skilled dentist has a higher and more stable success, because of a more precise diagnosis on the type, intensity, and location of the tooth discoloration.

What is teeth whitening?

It’s no secret that a mouth full of whiter teeth provides benefits, the most obvious being – a brighter more attractive smile.

Stains or overall discoloration tends to dull your smile, so regardless of how widely you smile or heartily you laugh, your expressiveness has missing something.


Whiter teeth restore this missing dimension to your self-esteem.

How does teeth change color?

Teeth discoloration and staining comes from two sources: intrinsic and extrinsic.

Intrinsic staining

Intrinsic staining primarily occurs during teeth development either before birth or at early childhood, which cannot be removed through mechanical measures such as debridement or prophylactic stain removal.

Some intrinsic teeth staining examples include:

  • Age yellowing

  • Decay

  • Orthodontic white spot lesion

  • Mild fluorosis

  • Amalgam restoration

  • Tetracycline stain

  • Genetic (amelogenesis imperfecta)

  • Non-vital coloring

Extrinsic staining

Extrinsic teeth staining comes from environmental factors including smoking, pigments in beverages and foods, antibiotics, and metals such as iron or copper.

Colored compounds from these sources are adsorbed into acquired dental pellicles or directly onto the surface of the tooth causing a stain to appear.

Some extrinsic teeth staining examples include:

  • Dental plaque

Although usually virtually invisible on the tooth surface, plaque may become stained.

Prolonged dental plaque accumulation on the tooth surface can lead to enamel demineralization and formation of white spot lesions which appear as an opaque milk-colored lesion.

  • Calculus

A neglected plaque will eventually calcify, and lead to the formation of a hard deposit on the teeth, especially around the gum line, called calculus.

The color of calculus varies and may be grey, yellow, black, or brown.

  • Tobacco

The nicotine and tar in tobacco, combined with oxygen, turns yellow and over time will absorb into the pores of the enamel and stain the teeth yellow.

  • Betel chewing

The extracted gel of betel leaf contains tannin, a chromogenic agent that causes discoloration of the tooth enamel.

  • Mouthwash

Chlorhexidine mouthwash has a natural liking for sulfate and acidic groups commonly found in areas where plaque accumulates such as along the gum line, on the dorsum of the tongue and cavities.

  • Metallic compounds

Exposure to such metallic compounds may be in the form of medication or occupational exposure. Examples include iron (black stain), iodine (black), copper (green), nickel (green), and cadmium (yellow-brown).

Metals can be penetrated into the tooth causing permanent discoloration or can bind to the pellicle causing surface stain.

Who performs teeth whitening?

An orthodontist or cosmetic dentist, and other dentists that are certified to perform professional teeth whitening procedure.

What are the benefits of teeth whitening?

Here is a comprehensive list of all the possible benefits of a professional teeth whitening procedure, equally if not more important than the bright smile itself.

  • Oral health


Stain removal during a professional whitening session can strengthen your teeth, which increases the overall health of your gums as well as that of your entire mouth.

  • Self-confidence


Either at home or if you are on the lookout, a white smile makes you more attractive. Your brighter smile becomes a magnet as it attracts people and makes bold positive first impressions, making your self-confidence shoot through the roof.

  • Minimize the look of wrinkles

A whiter smile shifts the focus on your face, “reducing” the appearance of any surrounding wrinkles like frown lines.

  • Speed and reliability


A professional teeth whitening procedure can give you whiter teeth in around an hour. That’s it. Hassle-free.

Plus, the results are reliable and with suggested home maintenance it’s long-lasting.

Professional whitening of your teeth is not only fast, but the results are also reliable. After a session with a professional dentist, you’ll have long-lasting home maintenance suggestions.

  • Customized treatments


Professional whitening is customized to give you the precise amount of whiteness that you’re looking for and in the areas that you need it most.

  • Safe, comfortable


Professional whitening treatment is much safer and more comfortable because you have an experienced expert performing the procedure and monitoring the progress every step of the way.


The amount and concentration of the whitening agent can be adjusted, and your gums and other parts of your mouth are covered for protection.

You’ll also receive tips on post-session care for your teeth and how to limit tooth sensitivity.

  • Good grooming


White teeth also convey the sense that you have good grooming and daily habits. It also proclaims that you take pride in your appearance and pay attention to keeping yourself well-groomed and attractive.

The key to your success?


Research indicates that others perceive you as being more successful financially and professionally if you have bright white teeth. You’re seen as trustworthy and dependable, which can help you at work, during interviews, and in business overall.

  • Expert approach and information

One of the most significant advantages of professional services is the wealth of knowledge you get.

A dentist will first determine the cause of the stains. He will be able to examine both extrinsic and intrinsic stains.

Extrinsic stains are mostly a result of food and beverage consumption, and lifestyle choices. Intrinsic stains emanate from within the teeth.


They may prove hard to get rid of, but a professional will always know the best approach to use. A dentist will first identify the causes of the stains and deal with the real problem.

  • Boosts mental health


If you concerned about your appearance and look after your teeth, the positive effects of teeth whitening will trickle over to your mental health.


As your smile shines, your brain will follow suit.



Oral health is one part of your general health that should be of utmost concern.

The benefits of teeth whitening go a long way in improving the general quality of your life.

Profession treatments are reliable, long-lasting and safe for your general health.

In general, teeth whitening gives you more reasons to smile. Even when you aren’t truly happy, smiling tricks your body into believing that you are.

Who is an ideal candidate for teeth whitening?

In theory, professional teeth whitening is suitable for the majority of people.

While whitening is effective, it cannot perform miracles.

It produces the best results for people with mild to moderate stains.

Your dentist should be able to advise you on whether or not this kind of treatment will give you a satisfactory outcome.

The ideal candidate for professional teeth whitening is the one who has healthy, unrestored teeth (no fillings) and healthy gums.

Patients with yellow tones to their teeth respond best.

Who is not an ideal candidate for teeth whitening?

Whitening is not recommended in the following circumstances:

  • Age and pregnancy issues

Bleaching is not recommended in children under the age of 16 and is also not recommended in pregnant or lactating women.

  • Sensitive teeth

Individuals with sensitive teeth and gums, receding gums, and/or defective restorations should consult with their dentist prior to using a tooth-whitening system.

  • Allergies

Anyone allergic to peroxide (the whitening agent) should not seek professional teeth whitening.

  • Gum disease, worn enamel, cavities, and exposed roots

Individuals with gum disease or teeth with worn enamel are generally discouraged from undergoing a tooth-whitening procedure.

Cavities need to be treated before undergoing any whitening procedure because the whitening solutions penetrate into any existing decay and the inner areas of the tooth, which can cause sensitivity.

Also, whitening procedures will not work on exposed tooth roots, because roots do not have an enamel layer.

  • Fillings, crowns, and other restorations

Tooth-colored fillings and resin composite materials used in dental restorations (crowns, veneers, bonding, bridges) do not whiten.

Any whitening procedure should be done prior to the placement of restorations.

People with numerous restorations that would result in uneven whitening may be better off considering bonding, veneers, or crowns rather than a tooth whitening system. Ask your dentist what strategy is best for you.

  • Unrealistic expectations

Individuals who expect their teeth to be a new “blinding white” may be disappointed with their results.

Smokers need to be aware that their results will be limited unless they refrain from continued smoking, particularly during the bleaching process.

  • Darkly stained teeth

Yellowish teeth respond well to bleaching, brownish-colored teeth respond less well and grayish-hue or purple-stained teeth may not respond to bleaching at all.

Blue-gray staining caused by the antibiotic tetracycline is more difficult to lighten and may require up to six months of home treatments or several in-office appointments to successfully lighten.

Teeth that have dark stains may be better candidates for another lightening option, such as veneers, bonding, or crowns. Talk to your dentist about which options are best suited for you.

What are the risks or possible side effects of teeth whitening?

Among those who receive professional in-office teeth whitening treatment, between 67–78% of the individuals experience some sort of sensitivity after the procedure where hydrogen peroxide and heat is utilized.

Although it varies from person to person, sensitivity after whitening treatment can last from 4 to 39 days.

Not to be scared, toothpaste containing potassium nitrate and sodium fluoride are used to ease discomfort following teeth whitening.

Some of the risks involved in teeth whitening are:

  • Increased sensitivity of the teeth

  • Gum irritation

  • Extrinsic teeth discoloration.

  • Exposure to cold, hot, or sweet stimuli may increase the intensity of the hypersensitive response.

  • Damage to the enamel. Teeth enamel can have an adverse negative effect on a whitening treatment.

Which ingredients are used for teeth whitening?

According to the American Dental Association, there are two main types of whiteners: bleaching products which contain peroxide to lift both deep and surface stains, and non-bleaching products to lighten surface stains only.

Bleaching products usually contain either hydrogen peroxide or carbamide peroxide.

Hydrogen peroxide is mostly used in professional teeth whitening procedures performed by qualified dentist, to help you achieve a brighter smile.

Is teeth whitening painful?

Achieving a beautiful smile can really help boost your self-confidence and make you feel great.

If you’ve ever experienced discomfort after a professional teeth whitening procedure, it is most likely due to sensitivity.

The teeth whitening procedure itself is not painful.

You must know that while it can be uncomfortable, it doesn’t cause any permanent damage to your teeth and typically doesn’t last for very long.

If you notice continued teehh whitening sensitivity, consult your dental professional.

How is the teeth whitening process?

Professional teeth whitening delivers optimum results in a relatively short amount of time.

Performed under the supervision of a dentist, this method of whitening has gained popularity among those who either are dissatisfied with over-the-counter (OTC) products or don’t want all of the fuss and bother of a professional at-home kit.

In-office teeth whitening is not an altogether complicated procedure, but it does require skill to avoid injury to the gingival (gum) area.

All told, you can achieve significant whitening results in a single 1-2 hour appointment. The procedure itself can take anywhere from 60 to 90 minutes to complete.

Here is a breakdown of the standard steps to perform an in-office whitening:

Before starting, the dentist will make a record of the current shade of your teeth.

Your teeth would then be polished with pumice, a grainy material used to remove any plaque on the surface.

Your mouth will be isolated with gauze to keep your teeth dry.

A cheek retractor is inserted to your cheeks, lips, and tongue well away from the whitening solution, exposing all the aesthetic zone teeth, which is teeth that are visible when you smile).

A liquid rubber dam or hardening resin is placed along the gum line to protect against any irritation caused by the bleaching gel.

A bleaching gel containing hydrogen peroxide or carbamide peroxide is applied to the targeted teeth and kept on for approximately 15 to 30 minutes.

Many whitening products require a curing light or laser to activate the peroxide. Once applied, the solution would be left on the teeth for the time stated or reapplied occasionally, depending on the brand.

The bleaching gel is suctioned or washed off, and fresh gel is applied for one or more additional periods of 15 to 30 minutes.

Once the optimum shade has been reached (or the maximum time has passed), the teeth would be rinsed. A fluoride application may be used to help ease any tooth sensitivity.

The teeth may whiten by as few as two to three shades or as many as eight (out of a total of 16).

After the final gel application, the cheek retractor is removed, the patient rinses and the immediate post-treatment shade change is measured.

Additional visits may be scheduled by the dentist, depending on the level of teeth staining or until the desired shade is reached.

Part of the whitening effect is due to dehydration during the bleaching process, which makes the teeth look whiter than their true new color. That color will emerge after a couple of days.

Upon completion, you would be advised to avoid foods or beverages with a high level of pigment for at least 24 hours.

Is teeth whitening safe?

Professional teeth whitening procedure performed by a board-certified dentist is a safe and effective method.

Some people may experience tooth sensitivity.

However, in most cases the sensitivity is temporary. If so, you have the option to delay treatment, then try again.

The International Agency of Research on Cancer (IARC) has concluded that there is insufficient evidence to prove that hydrogen peroxide is a carcinogen to humans.

Recently, the genotoxic potential of hydrogen peroxide, used for teeth whitening, was evaluated.

The results indicated that the oral health products that contain or release hydrogen peroxide up to 3.6% will not increase the cancerous risk of an individual.

How long do teeth whitening results lasts?

Well, it really depends on your aftercare.

The degree of whiteness will vary from individual to individual depending on the condition of the teeth, the level of staining, and the type of bleaching system used.

The effects of teeth whitening can last up to 2-3 years or as little as 1 month and it varies from person to person, meaning that it depends mainly on you and your lifestyle.

There are plenty of staining agents in foods, habits, and medications that can interfere with the results of your teeth whitening experience.

You’ll want to avoid these as much as possible during whitening in order to maintain your white smile.

Here are some habits, drinks, and foods that stain your teeth quickly:

  • Smoking

  • Chewing tobacco

  • Dark liquids like red wine, coffee, and tea

  • Staining foods like beetroot and berries

Brushing your teeth at least twice a day and avoiding these staining foods and drinks will help keep your teeth whitening noticeable for as long as possible.

Nevertheless, keep in mind that teeth whitening is not permanent.

People who highly expose their teeth to foods and beverages (on a daily basis) that cause staining may see the whiteness start to fade in as little as one month.

On the other hand, those who take proper care and avoid foods and beverages that stain may be able to wait one year or longer before another whitening treatment or touch-up is needed.

If you are concerned that your white smile is fading, ask your dentist about a touch-up treatment to retain your desired shade.

What is the recovery time for teeth whitening?

Teeth may become temporarily sensitive to cold drinks or foods after treatment.

Other symptoms like gum discomfort or sore throat may also appear, but they are temporary and fade shortly.

The aftercare is vital to maintain your results, and for the following 24 hours after treatment you may try to:

  • Avoid any dark staining drinks like tea, coffee, red wine, colored soft or alcoholic drinks and fruit juice.

  • Avoid all dark staining foods like bolognese, soy sauce, red meat, chocolate and all fruit except bananas.

  • Avoid any foods or drinks that would leave a stain on a white shirt.

  • No smoking

  • Avoid colored toothpaste (red or blue) or mouthwash for 24 hours.

You are able to consume the following:

  • Plain chicken

  • Skinless turkey

  • Whitefish

  • White rice

  • Potatoes

  • Plain pasta and white sauces

  • Cereals

  • Skimmed milk

  • Water

  • White lemonade

  • White cheese

  • Cauliflower

  • White onion

  • Egg whites

  • Crustless white bread

  • Rice Crispie

  • Clear coconut water

  • Bananas

  • White low-fat yogurt

  • Clear alcohol mixed with clear mixers (gin and tonic, vodka and white etc)

What should I expect after teeth whitening?

Despite achieving the results, stains can return within an initial couple of months.

Take special care during the first 24–48 hours after the whitening procedure is seen as the most crucial period to protect your teeth.

Hence, it is key that you eat non-staining drinks and foods during this time as enamel is prone to adhere to stains.

Various methods may be employed to prolong teeth whitening results, such as:

  • Brush or flush out mouth with water after eating and drinking

  • Floss to remove plaque and biofilms between the teeth

  • Drink fluids that may cause staining through a straw

  • Depending on the method used to whiten the teeth, re-treatment every six months or after a year may be required.

  • If an individual is a smoker or they consume beverages with the capacity to stain, regular re-treatments would be required.

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