Teeth whitening

Restoring your smile has never been easier

“I truly believe my job is to help people smile”.Dr David Treherne

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At Melbourne Dentist we have many ways to improve your smile including Porcelain veneers, dental crowns and dental implants. However, the easiest and least invasive treatment we offer is teeth whitening, also known as bleaching. The procedure’s simplicity and affordability has made it extremely popular.

Smile Makeovers

Watch how we blend art and science to design ideal smiles.
This process can be used to address a wide range of aesthetic issues and often involves teeth whitening procedures..

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Describe your issues, upload one or more photos and we will outline some treatment options that will help you achieve the smile you’re after.

In-Chair Whitening

This new protocol involves two visits, but the second is short, easy and can happen anytime from 1 week to 6 months after the in-chair procedure. The visits progress as follows:

The causes of teeth staining  are as wide and varied as the techniques developed to restore brightness. Many of these techniques are useless, or outright dangerous. Here at Melbourne Dentist, we value service and results.

To predictably give our patients the smile they desire, we have developed two simple and safe protocols. A few extra steps with newly developed materials have made all the difference. We offer a no-obligation consultation at no charge to assess if tooth whitening is right for you.

Visit 1

  • A comprehensive professional assessment is performed. The suitability of teeth to be bleached is determined.
  • Impressions of your teeth are taken to create perfectly fitted, custom trays.
  • Your teeth are polished.
  • A paint-on isolation barrier is carefully placed over your gums to protect them.
  • At least 2 x 20 minute applications of Opalescence Boost! Are carried out. This new formulation does not require a harsh light or laser (that can dehydrate the teeth and necessitate safety eyewear).

Visit 2

  • You return at your discretion anywhere from 1 week to 6 months later where you will be given the custom trays. We will demonstrate the use of these trays with a fantastic new product, Opalescence Quick PF 45%. This gel can only be administered under a dentist’s supervision. A 30 minute application usually leaves the teeth noticeably whiter again.
  • You leave our practice with a stock of lower concentration gel that you can use for “touch-ups” as you require them.

Expect a follow-up phone call from us. We’d like to address any unanswered questions you may have and ensure you know how to get the best possible results from the products provided to you.

If you participate in our hygiene program, store the trays at our practice and have a 30 minute application of Opalescence Quick PF 45% after every hygiene visit for an even brighter smile! Maintenance of your perfect colour has never been more hassle-free.

Professional Take-Home Whitening Kits

You can skip the In-Chair process all together and just get the kit to use at home. These kits by themselves are cheaper but may take 2-4 weeks of wearing to achieve your desired result. These visits progress as follows:

Visit 1

  • A comprehensive professional assessment. The suitability of teeth to be bleached is determined.
  • Impressions of your teeth are taken to create a perfectly fitted, custom tray.

Visit 2

  • You return at your discretion anywhere from 1 week to 6 months later where you will be given the custom trays. We will demonstrate the use of these trays with a fantastic new product, Opalescence Quick PF 45%. This gel can only be administered under a dentist’s supervision. A 30 minute application usually leaves the teeth noticeably whiter again.
  • You leave our practice with a stock of lower concentration gel that you can use for “touch-ups” as you require them.
  • You leave our practice with a stock of lower concentration gel that you can use for “touch-ups” as you require them.

Expect a follow-up phone call from us. We’d like to address any unanswered questions you may have and ensure you know how to get the best possible results from the products provided to you.

If you participate in our hygiene program, store the trays at our practice and have a 30 minute application of Opalescence Quick after every hygiene visit for an even brighter smile!

FAQ

What is Teeth Whitening?

Teeth whitening is exactly as it sounds – applying a substance to the tooth surface to restore your teeth to the natural bright white colour they were before the ravages of everyday life stained them. There are many products that claim to complete this aim but the only effective techniques work on the same basic principle: the application of a peroxide to the surface to dissolve any organic strains on and within the tooth.

The peroxide is found in one of two forms, as either Hydrogen Peroxide (HP) or Carbamide Peroxide (CP). Click here for a more technical explanation of the process.

The most commonly dispensed material dispensed by dentists is 10% and 16% CP. These products have long-term data supporting their effectiveness and, most importantly, their safety. Concentrations above this are not considered safe to be used on a regular basis without direct dental supervision.

How long does it last?

We will always provide you with custom fitted trays that will allow you to “touch up” the colour as you wish. Alternatively, you can have our hygienist place Opalescence Quick PF 45% in your tray after each of your regular hygiene visits for the most hassle-free maintenance of your smile. How often you need to touch up your smile will vary from person to person and depends on the porosity of your teeth and your own personal habits. See below for the causes of teeth staining and how to prevent it.

What do we assess before bleaching?

Not everyone is a good candidate for teeth whitening. Before progressing, we need to check the following:

  • Dental disease – there should be no decay, leaking fillings, or fractured teeth as these may allow access and thus damage to the nerve.
  • Tooth sensitivity – every day sensitivity to hot/cold should be assessed particularly where sensitive root surfaces are exposed.
  • Pregnancy or breast feeding – the procedure should not be carried out under these circumstances.
  • Level of discolouration – some teeth are extremely dark and this is related to antibiotic taken in early life. Such teeth may be very resistant to bleaching and be better covered with veneers or even crowns.
  • Relationship of darkness to trauma, or previous root canal treatment. These teeth may need to be treated with an internal bleaching procedure before an overall result is achieved by bleaching all teeth. Teeth that are discoloured due to poor placement of root canal fillings may not be able to be bleached at all and again may only be corrected with a dental veneer or dental crown.

Why have a dentist perform teeth whitening?

It’s always safer to have a dentist complete teeth whitening – particularly the In-Chair Whitening process. People who claim to provide this treatment who are not dental professionals can cause serious damage – there have been multiple cases of burns related to not protecting the gums, lips or cheeks properly.

Low cost alternatives also have very low concentrations of active ingredients. The literature suggests the use of 10% Carbamide peroxide as a minimum for effective teeth bleaching – only dental professionals are licenced to hold these substances. Low cost alternatives are also often inactive when you get around to using them. We keep all bleach refrigerated as per manufacturers instructions. Retail stores have products sitting on shelves after sitting in warehouses or on a trucks for indeterminable times.

Are there different types of bleach?

Most of the bleaching gels available from dentists are very similar.

We have chosen Opalessence for two reasons:

  1. Its viscosity. It thickens nicely when coming into contact with saliva on your teeth so it wont readily leak out from under the trays.
  2. It has been shown by independent studues to have the longest effective usefullness – all bleach breaks down to become ineffective fairly quickly.

The other difference is the concentration of the gels.

The higher the concentration of the gel the faster the bleaching process. However, the downside is there is greater potential for sensitivity of your teeth using the higher concentrations.

What are the risks of teeth whitening treatments?

With adequate assessment before the process begins, risks are extremely low. However, teeth bleaching can result in:

Mismatched colours.
Filling materials are not affected by the bleach so if large restorations (including crowns or veneers) exist and they match the current tooth shade, they will not lighten and may require replacement after the desired whitening result is achieved.

Teeth sensitivity.
This is generally temporary and rare with the Opalescence formulations. It sometimes can put an end to an In-Chair whitening session and required protocol modification if it occurs with custom tray use – we will discuss this modified tray use if such sensitivity arises. People under the age of 18 may be more susceptible to sensitivity. Root surfaces may not lighten and are susceptible to becoming sensitive.

Gum irritation.
Again, this is generally temporary. At Melbourne Dentist we have not had this occur with the In-Chair whitening treatment as we take great care to isolate all gums and never rush this part of the process. Irritation associated with custom trays may suggest a minor adjustment is needed for the tray.

Bleachorexia.
Some people can become obsessed with trying to obtain extremely white teeth. There are some reports that transparency in the enamel has arisen with some of these people.

Bleach Resistance
Teeth with deeper “intrinsic” staining (particularly those resulting from antibiotic use causing a gray discoloration) may be very resistant to bleaching and may be better treated with porcelain veneers or even dental crowns.

Irritation or bleeding
Irritation and possibly bleeding in the oesophagus and stomach if some of the bleaching agent is ingested.

What are the causes of darkened teeth and how can I prevent it?

Over time, many elements take their toll on teeth to cause discoloration. Some factors involved are:

“Lifestyle” dyes.
The main culprits are sugary, acidic and highly pigmented foods such as coffee, teas, red wine, cola and soft drinks. The other non-food culprit is smoking.

Dental factors.
Tooth decay, old, stained or leaking fillings, tartar and thin enamel can discolour teeth and will not be removed by teeth whitening procedures.

Age.
With time, the quality and thickness of enamel changes and the underlying dentine will become a deeper yellow. Grinding and decay are common causes of deeper discoloration, while excessive brushing with harsh brushes and pastes can make the overlying enamel thinner – the underlying dentine then becoming more visible.

Medications.
The most common culprit is Tetracycline. This causes a banding effect during tooth formation and can be very difficult to remove with standard whitening techniques.

Excessive fluoride at a young age.
Mild cases will cause irregular white spots, while more severe cases can result in darker brown or black areas with an associated roughened surface. Mild cases may improve with bleaching (although sometimes there can be an initial worsening), while the darker areas may require other services such as Microabrasion or Porcelain Veneers.

For a more complete list of things to avoid, click here. (See “Teeth Stainers” below)

Teeth Whitening kit: Instructions for use

Teeth Whitening KitExpress a match-head size amount of Opalescence gel syringe into the tray where the tray will meet the outside surfaces of the teeth.

Teeth Whitening MelbourneMake sure your teeth are brushed before you place the loaded tray on to your teeth.

Best Teeth WhiteningGently press the tray edges against the teeth (near the gumline) on the inside and outside surfaces. Take care not to push the gel out.

Teeth CleaningRemove any excess gel with a soft dry toothbrush or clean finger. You may see “bubbling” within your trays while wearing them, which is part of the whitening process

White TeethWith the tray in place, gently rinse your mouth with cold water twice. Treatment time begins now. Note: If significant sensitivity occurs, take the trays out immediately and call us.

Teeth Cleaning MelbourneAt the end of treatment, brush your teeth and use the soft toothbrush and cold water to clean the tray (hot water may damage the trays). Store the tray in the tray case after each use and when treatment is completed.

Natural Whitening

Chairman of the ADA Oral Health Committee, Dr. Peter Alldritt, says the best way to keep a healty white smile is to maintain good oral health.

“Practicing good oral hygiene is a basic way to assist in making your teeth look whiter naturally.”

“Brushing and flossing your teeth daily assist in removing surface stains on your teeth,” Dr. Alldritt says.

The ADA advocates “Natural Whitening”. Their website on whitening states:

For healthier and better looking teeth, you should:

  • Brush your teeth twice a day for 2 minutes using a fluoride toothpaste
  • Floss your teeth daily
  • Chew sugar free gum if advised by your dentist
  • Drink water throughout the day
  • Consume a sensible diet
  • Visit your dentist regularly for a professional clean

Referrences:

http://www.toothwhiteningfacts.com.au/index.htm

Teeth Stainers: The Un-Usual suspects

The causes of stained or darkened teeth are many and varied. To know how to solve the problem, we need to first understand how the discoloration occurred.

There are two basic categories of staining, namely:

  • Superficial, or “extrinsic” staining
  • Deep, or “intrinsic” staining
Superficial stainers:
  • Food and drink

Tea and coffee are the most obvious culprits but other highly pigmented stainers include beetroot, curries and dark sauces such as soya sauce.

Acidic foods erode the outer enamel which makes the underlying yellow dentine more visible. Couple acidity with heavy pigments and you have very effective stainers. Examples of this are berries (blueberries, cranberries, cherries, pomegrantes), balsamic vinegar, colas, red wine and tomato sauce.

  • Tobacco.

This causes the teeth to stain on the surfaces closer to the tongue and discoloration can range from light brown to black. Poor oral hygiene will only add to the deposits.

  • Poor Oral Hygiene

Yellow stains. Dyes in foodstuffs can cause generalised dull staining of dental plaque.

  • Green stains.

These stains are caused by certain bacteria and fungi, breakdown products of blood and inorganic elements.

  • Black stains.

This is usually seen as a black line next to the gums and is made up of a certain type of bacteria (grain positive rods and actinomycetes).

  • Mouthrinses.

Chlorhexidine containing mouthrinses can cause brown to black stains on the teeth after only 2 weeks.

Deep staining
  • Antibiotics.

Tetracycline use while the teeth are forming can result in grey/blue/black banding of the teeth. The discoloration is evenly dispersed through the enamel and dentine.

  • Trauma.

A severe knock to a tooth can cause such a build-up in pressure within the central portion of the tooth that blood products are forced into the surrounding tooth structure. As those break down, the tooth will darken – generally with a red/brown hue. A knock to a baby tooth (usually one of the front four teeth) can force it upwards so that the tip of its root strikes the developing tooth above it. It usually results in an isolated white to yellow spot on one tooth.

  • Dental decay. 

This usually presents as a brown-to-black shadowing or stain of the surface.

  • Dental restorations. 

Dental amalgam may show through thin remaining tooth walls and have a grey/ blue appearance. Leakage or decay at the junction of filling with tooth will show up as a dark line or shadow. White filling material (particularly the older generation) becomes more porous with time and becomes infused with food and bacterial dyes.

  • Fluorosis. 

If too much fluoride is ingested during the formation of the teeth, they can become stained. The staining is found on multiple teeth and is often spotted or mottled in appearance. Mild forms will be white to yellow. More severe causes can be grey to black and the surface can be rough or pitted.

  • Age changes. 

The structure of the enamel and dentine can change over time and these changes affect the way light is transmitted through them. Enamel undergoes thinning and textural changes. The pulp (central nerves and blood vessels) becomes infilled with more darkly coloured dentine that shines through to the outer surface.

  • Inherited causes
    • Dentinogenesis imperfecta. In this condition, the dentine is incompletely formed and will result in an amber, grey or blue-purple discoloration.
    • Amelogenesis imperfecta. In this condition, the enamel is defective and the enamel layer is yellow to brown and does not cover the yellow colour of the dentine below it.