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By Dr. Salina Suy

Last month, we spoke about the different variables that may have an effect on how our teeth whiten — each one of us is so unique! This month, we will be talking about the different ways to whiten, products, and what whitening really is.

“Whitening” is any process that will make the teeth seem whiter — usually a bleaching agent that changes the natural tooth color or a non-bleaching agent that contains ingredients that physically or chemically remove surface stains.

Bleaching agents

Carbamide peroxide and hydrogen peroxide are the two main bleaching agents. Carbamide peroxide breaks into hydrogen peroxide; hydrogen peroxide itself is three times as strong as carbamide peroxide.

These work equally as well for whitening. The main difference is that hydrogen peroxide breaks down faster (30-60 minutes) while carbamide peroxide has 50 percent of its whitening power in the first two hours but can last up to six hours.

On the shelf, your carbamide peroxide product will last longer but refrigeration can extend the life of both products. With many patients, the product efficacy depends on the individual. If you don’t use the product correctly or drink coffee right after, you may need more maintenance.

Non-bleaching agents

Non-bleaching agents in toothpaste whiten through gentle polishing, chemical chelation, or some other non-bleaching actions. These ingredients will vary depending on the company but can include alumina, silica and calcium carbonate, along with many others. Essentially, these ingredients will assist in scrubbing off surface stains.

Ways to get products to whiten

— From your dentist: Professional-grade products can be delivered in the chair by a hygienist or the doctor.

— Over-the-counter: Most drug stores have a oral health section where you will find an array of products.

— At-home “remedies”: We will not get into home remedies; however, if you choose a concoction of your own, avoid citrusy foods like lemon, oranges and strawberries whose acid can break down your enamel.

The aftermath

Tooth sensitivity and irritation of the oral tissues is our No. 1 concern. This can cause pain, irritation and in rare cases, irreversible tooth damage has been reported. If these symptoms occur, you have options to try to alleviate some of that pain.

Options include using sensitivity toothpaste, which will help cover sensitive areas; chewing more gum, because more saliva can protect the teeth; warm saltwater rinses to help gum healing and avoid whitening for a while to take a break from the agents.

Sometimes, teeth will have what we call “rebound” where they are very bright and then they get less bright a couple days later. This effect can happen due to dehydration of the tooth and once the tooth is hydrated again, it appears less bright. This depends on the product you are using and is not unusual.

Whitening is not a permanent, once-in-a-lifetime procedure. Like many things, whitening needs to be maintained with regular oral hygiene and periodic touch-ups.

Remember that using whitening products such as mouthwash, whitening pens, strips or trays are good ways to supplement your normal hygiene habits. If you choose a bleaching product, you should only do so after consultation with your dentist. That is especially important for patients who have fillings, crowns and extremely dark stains.

Regular cleanings and checkups twice a year is the best way to maintain a healthy, bright smile.