key2 This document is to provide information on Infant Oral Mutilation and has been produced from a review of the literature, and research gained as part of an elective project in Tanzania.
What is tooth whitening?
Tooth whitening can be a very effective way of lightening the natural colour of your teeth without removing any of the tooth surface. It cannot make a complete colour change, but it may lighten the existing shade.
Why would I need my teeth whitened?
There are a number of reasons why you might get your teeth whitened. Everyone is different; and just as our hair and skin colour vary, so do our teeth. Very few people have brilliant-white teeth, and our teeth can also become more discoloured as we get older.
Your teeth can also be stained on the surface by food and drinks such as tea, coffee, red wine and blackcurrant. Smoking can also stain teeth.
‘Calculus’ or tartar can also affect the colour of your teeth. Some people may have staining under the surface, which can be caused by certain antibiotics or by tiny cracks in the teeth which take up stains.
What does tooth whitening involve?
Professional bleaching is the most usual method of tooth whitening. Your dental team will be able to tell you if you are suitable for the treatment, and will supervise it if you are. A professionally supplied whitening product is applied to your teeth using a specially made tray which fits into your mouth like a mouthguard.
The ‘active ingredient’ in the product is usually hydrogen peroxide or carbamide peroxide. As the active ingredient is broken down, it permeates in to the tooth, lightening the inner layer of dentine. As we get older dentine gets thicker so naturally teeth get darker. Whitening changes this and lifts the shade value of the teeth and improves the aesthetics and ‘youthfulness’ of the smile.
How long does this take?
The total treatment can usually be done within two weeks. We will need to make a mouthguard and will take impressions at the first appointment. Once we have started the treatment, you will need to continue the treatment at home. This means applying the whitening gel once a day. We like to start things off with a slower release gel to be worn at night and then move on to a gel that can be applied for up to 2 hours each session.
What other Treatments are there?
There is now laser whitening or ‘power whitening’. During this procedure the teeth are isolated to protect the gums, and a bleaching product is painted onto your teeth. Then a light or laser is shone on the teeth to activate the chemical. The light speeds up the reaction of the whitening product and the colour change can be achieved more quickly. Laser whitening is said to make teeth up to five or six shades lighter. It takes about an hour as an in-surgery procedure. As a ‘gold standard’, we only ever recommend this in conjunction with tray whitening.
How much does tooth whitening cost?
Tray tooth whitening – £320
Combined with in chair whitening session – £550
How long will my teeth stay whiter?
The effects of whitening are thought to last up to three years. However, this will vary from person to person. The effect is less likely to last as long if you smoke, or eat or drink products that can stain your teeth. Ask your dental team for their opinion before you start the treatment.
What are the side effects?
Some people may find that their teeth become sensitive to cold during or after the treatment. Others may have discomfort in the gums, a sore throat or white patches on the gum line. These symptoms are usually temporary and should disappear within a few days of the treatment finishing. Our current tooth whitening product has a special ingredient to reduce such side-effects and commonly we don’t find issues of sensitivity to be a factor anymore.
Information assisted by British dental health foundation.
Tooth Whitening is a procedure that can only legally be carried out by a dentist. Tooth whitening kits bought on the internet or over the counter can only legally contain 0.1%hydrogen peroxide. This is not a concentration that will have any noticeable effect on the colour of teeth.
On 31 October 2012, the EU Council Directive 2011/84/EU (amending EU Council Directive 76/768/EEC) came into force in the UK. It sets out who can use what strength of product when carrying out tooth whitening. In the UK, the changes were brought into force by the European Communities (Cosmetic Products) Regulations 2004 to 2013 (‘the Regulations’).
The Regulations say that products containing or releasing up to 6 per cent hydrogen peroxide can be used, as long as:
- Products of this strength are sold only to dental practitioners.
- A dentist has first examined the patient to make sure there are no risks or any other concern about their oral condition.
- The patient is over 18 years old.
- For each cycle of use, first use is by a dental practitioner or under their direct supervision by a dental hygienist or dental therapist.
key2 New Chair
key2 My dentist he has a new chair,
Tilting and swinging and taking care
Of every toothy emergency.
It can’t take away the threatening noise
Of drills and bits from dental boys
However sweetly maskly smiling.
I want a chair with a tilting hand
Sliding to a never never land
Where fairies gently stroke my brow,
Where ‘there now, that’s al done,’
Is all I hear, and can feel I’ve won
With my knights of the ivory castles.
Written by a patient whom took inspiration from her recent visit and ride on the ‘new chair’.
Below is an update from the work we support in Kenya:
‘Hello sir, We are doing well in the project. Have had dental camps organized and our school oral health program is doing well. Our recent dental camp saw 2350 mouths screened and over 200 extractions done. Colgate supports our programme by donating toothbrushes, toothpaste and educational materials on oral health.’
key2 TEXT ‘SMILE’ to 70020 and DONATE £3 to DENTAID
September is ‘National Oral Health Month’ and to help raise awareness and support for dentaid, Jonathan walked the Jurassic Coast from Durdle Door to Swanage in a day. Please give a small donation of £3 to support the work of dentaid. We are so grateful for you support.
key SEPTEMBER SPECIAL OFFER
key2 20% OFF PROFESSIONAL GUMSHIELDS
This is big news that has been released by media circles and I am sure our patients will be wanting to know more.
Academics from Kings College, London, have discovered that introducing an electric current to teeth pushes minerals into the decay site, essentially allowing the tooth to repair the site naturaly. This process is known as Electrically Accelerated and Enhanced Remineralisation (EAER).
To see the article on this click here.
key2 My Professional Opinion:
– We are yet to see all the evidence from clinical trials and it is likely that it’s application will be limited to ‘small’ decay areas, and I can’t see how it will change existing treatment modalities for secondary decay (decay under existing restorations), and interproximal decay (decay that is not contained within the walls of the teeth).
– We already know that the topical application of the correct minerals (namely calcium, phosphate and fluoride) help prevent early decay that is on enamel. It will be far more cost effective to use already existing products such as duraphat and tooth mouse to help prevent decay in the first instance.
– Be careful with media hype – lasers were the craze a few years back as we could promise patients fillings with no anaesthetic. I find they have limited use in dentistry when it comes to treatment of decay (it takes ages to drill a tooth with a laser). They are good for contouring soft tissues ie shaping gums, but for the limited times we need to do this, they were not worth the investment.
– There have been numerous studies on the use of ozone for treating decay, again promising patients no drill, but it’s application is very limited. I can see the new research on ‘EAER’ leaving us with the same result as that which ozone does. Not many dentists invested in ozone treatment for their patients as it was not cost effective.
– Anaesthetics have come on a long way. We can offer pain free treatment of teeth with local anaesthetic, in a predictable operative procedure by using a drill, so do we need another option?
– The treatment will doubtful improve the look of an area that is being treated for decay. When decay occurs in front teeth especially, it is unsightly. The ‘EAER’ may be able to halt the decay and ‘remineralise’ the lesion but this is likely to look like ‘arrested decay’ in which the patient will still want to have an ‘invisible / white filling’ for. Therefore this will likely be restricted for use on back teeth out of the aesthetic part of the mouth.
– Will it be a ‘one-off’ treatment? – I doubt it. People get tooth decay as specific bacteria feed on sugars in the mouth, and give off acids that attacks the teeth. It will be interesting to see how they recommend we dentists are to implement the treatment. I cannot comment any further until we know more.
CONCLUSION is that it is exciting research. When used it will definitely help dentists offer a minimally invasive treatment option as it allows nature to repair the disease process, rather than surgical intervention. However, unless it is cost effective it will have a difficulty getting in to the dental market. There will always be a need for a drill in dentistry. But, the more things we can do that require us not using a drill, the better, so I welcome new treatments.
Whitehall House dental practice is supporting and following the work of KingaAfrica in Kenya. Over the summer they will be doing outreach in local schools and communities. Here are a couple of pictures from their teacher training day in Yatta.
Oral Health Promotion carried out by the team plays a big part in the fight against dental diseases in rural communities.