WHITENING: IN A DENTIST'S OFFICE OR AT HOME?

Teeth whitening, also known as brightening or bleaching, has increased by more than 300 percent since 1996, according to the AACD. The American Academy of Esthetic Dentistry describes whitening as one of the most requested dental procedures by patients of all ages.

There are two approaches: office systems, which often employ a light source, and home whitening kits, which include custom-fitted trays for upper and lower teeth. Both methods involve a whitening gel containing hydrogen peroxide or carbamide peroxide.

“Whitening involves breaking down the pigment in teeth and allowing them to turn white,” Gray says. “You’re doing it by introducing oxygen in the form of peroxide.”

Office treatments use the highest concentration of whitening agent—15 to 50 percent—while home systems tend to use 10 to 20 percent. The solutions can cause temporary gum and tooth sensitivity, but your dentist can provide a desensitizing agent.

Davison started her whitening with an office treatment that lasted about an hour. No light was involved.

“The light was gimmicky,” says Watkins, who has offices in DC and McLean. A study by Clinical Research Associates, dentistry’s version of Consumer Reports, endorses this view. The organization tested office systems by using a combination of whitening gel and light on 31 patients. Bleach alone was used on one side of the patients’ mouths while bleach with light was employed on the other. All teeth whitened, but no difference was noted in the two sides.

Most of the dentists we interviewed agreed with the findings. Some hypothesize that teeth seem brighter immediately following light-enhanced treatments because the light has a dehydrating effect. Once the teeth rehydrate, they remain whiter than before treatment, but the white is a more realistic shade.

Patients opting for office whitening generally have barriers applied to gums to protect them from the whitening gel. If a light source is involved, patients wear protective glasses.

Davison followed her office treatment with home whitening using custom-fitted trays and gel. Imholtz used home whitening exclusively. Rather than having special trays made, he used his Invisalign aligners, which were already custom-fitted. Imholtz continues to whiten once or twice a week.

Most of the dentists we surveyed say home and office techniques produce similar results. The difference comes down to time. Office whitening produces near-optimal results in one to three hours. Home whitening requires wearing mouth trays filled with gel for 30 to 60 minutes a day for about two weeks to achieve comparable results. Many dentists prescribe more home treatments because patients can attain great results for less money—often hundreds of dollars less.

Some, though, say office whitening remains popular. “We see much more in-office whitening,” says Sidney Markowitz, who has a practice in downtown DC. “It’s an immediate gratification. You usually get two or three shades lighter, and some people have gotten eight or nine shades lighter. It just depends on the individual and their enamel.”

Over-the-counter products such as Crest Whitestrips contain a lower concentration of peroxide than dentist-supervised treatments but can produce good results.

“If someone has mild staining and can put on Crest Whitestrips for a couple of weeks, they’re going to do fine,” Gray says.

Immediately following a whitening treatment, teeth are more porous due to the peroxide in the whitening gel. For 24 hours, you want to stay away from staining foods such as soy sauce and marinara, which could penetrate the pores.

Office whitening isn’t recommended for patients in their early teens or younger, Pollowitz says. The nerve canal in these patients is still developing—it’s wider and nearer to the surface—making teeth and nerves more susceptible to pain. Over-the-counter products are a safer choice.