Let there be white

The perfect smile is a grin away, thanks to the miracle
of cosmetic dentistry. Choose from options that dazzle.

Cosmetic dentistry has been on the frontlines of dental practices in the Middle East because many people seek ways to brighten or whiten their teeth to look youthful, and possess a radiant smile.

In the early days of cosmetic dentistry, the so-called tooth whitening or bleaching was done for non-vital teeth or severely stained teeth. Today, however, it is one of the most frequently performed cosmetic dental procedures.

The rising demand for teeth whitening can be attributed to the fact that this procedure carries almost no risk. Which is also why many people frequently attempt it at home with readily available, over-the-counter (OTC) products.

Critical issues

But, the uneducated consumer must be cautioned about the critical issues linked with this cosmetically enhanced look.

The truth is, no one can have absolutely white teeth and it is futile to keep trying. However, the plus side is that the existing colour can somewhat be bleached to a lighter shade.

Stained or dark teeth are commonly caused by food, age and some therapeutic drugs. Developmental anomalies or genetic factors are other reasons.

We all tend to consume staining and acidic foods, such as tea, coffee and tobacco, and also subject our teeth to hot and cold foods.

Colour conscious

Acidic foods open the pores of the teeth, exposing them to staining. Thermal recycling causes expansion and contraction of the teeth resulting in further stains. Ageing generally increases staining.

The discolouration caused by various foods, drinks and tobacco are extrinsic stains and can be treated by scaling and polishing. These treatments can also be complemented by bleaching techniques.

But, the intrinsic tetracycline stains and fluorosis caused by medicines can only be controlled with a combination of bleaching procedures and alternative cosmetic therapy — such as porcelain veneers or bonding.

Effective bleaching procedures include dentist assisted, in-office power bleaching, laser-bleaching techniques, take-home dentist supervised night-guard bleaching and over-the-counter bleaching products.

The dentist-in-office power bleaching technique is the most effective. A bleaching agent is applied to the teeth and activated with a powerful light or heat source.

Laser bleaching is similar to, and as good as, in-office power bleaching. The only difference is that lasers, not light or heat, are used to activate the bleaching agent.

Pros and cons

Both methods are quick and convenient, but relatively expensive. The procedure achieves results in one to two hours or lesser.

The take-home, dentist supervised procedure requires the use of a custom-made bleaching tray with a bleaching agent, which needs to be used for a few hours of overnight application daily for a period of three to four weeks.

This is a comparatively inexpensive method but the results may not be as effective.

Over-the-counter bleaching products are, in my opinion, a waste of time and money. They seldom achieve the desired results and, if at all, only bring about a change in the shade. The change may happen over a long period. Also, overzealous use of these products may lead to complications, such as sensitivity of the gums and, in some cases, gum irritation.

No guarantees

In contrast to bleaching, a wide array of whitening toothpastes are available in the market. Though not as effective as bleaching, whitening toothpastes can marginally improve the appearance of the smile. They may not exactly work towards whitening, but they help remove debris and certain stains from the tooth surface and improve appearance.

Like with all cosmetic procedures, tooth whitening also cannot guarantee specific results. Nevertheless, it is a low-cost, safe, conservative and generally effective cosmetic treatment.

If fillings and crowns are present, these will become conspicuous because they do not absorb the bleach and need to be redone or re-fabricated to match the new shade.

The longevity of bleaching depends on the person — whether he or she smokes or eats and drinks staining foods. The bleaching can definitely be made to last longer with periodic checks, top-up bleaches (if advised) and changes in lifestyle.

— Dr Murali Srinivasan is a specialist dentist at the Department of Advanced Dentistry, Jebel Ali Hospital