Modern dentistry offers several types of tooth whitening. For normal vital(living, not root canaled) teeth, the options include (the least expensive and least effective over the counter (OTC, sold in the drugstore, etc) toothpastes, applicable strips or jells. These products for the short term(a few weeks), may be effective for mild colour changes, (one or two shades) and only for very young teeth( less than 30 years of age)).
The drawback with these products is because there is no professional supervision, damage to the teeth or surrounding tissues is likely to occur. Since the toothpastes contain a high percentage of abrasives(silica, pumice, sodium bicarbonate, tin oxide), it is quite easy to cause excessive wear, and irreversible damage of the tooth enamel with just normal brushing. The jells and strips themselves if applied excessively or incorrectly can cause gingival recession( gum shrinking), root exposure, and tooth sensitivity.
The professionally applied jells with custom trays, are the most effective. They will alter colours 3-6 shades and if professionally monitored, relatively safely with little sensitivity to the teeth or damage to the tissue.
The professional jells applied at home for several weeks, have the least sensitivity and the most control. Treatments may last from 30-60 minutes once or twice per day for two weeks with few side effects.
The in office professional jells (like”Zoom”) require a 90 minute office visit, with a carefully supervised application of a highly concentrated bleaching jel and a laser or UV light to activate them. This will also create the same 3-6 shade colour change but with some tooth sensitivity which can be reversed chair side with a 5 minute application of potassium nitrate jel.
Six months to a year later, touch ups can be preformed with a 30-60min. application of the bleaching jel in the custom trays for one or two days.
Non-vital(root canaled )teeth may only be bleached in the dental office by an application of a very concentrated bleaching jel applied internally to the tooth. This is sealed and left for several days and maybe repeated once or twice. Once the required shade is achieved the bleach is removed and a normal resin restoration is used to seal the tooth.
If the required shade change cannot be achieved by this method the only option remaining is to cover the tooth with the appropriate porcelain restoration.