To bleach or not to bleach?

Getting your teeth whitened is becoming more popular, but what treatments are on offer and what do they entail, asks FIONA REDDAN

WE MAY be heading towards the much feared “double dip” recession, but if there is one part of the economy which appears to be faring better than most it is tooth whitening.

Indeed, Dublin’s compact South Anne Street is home to no less than four outlets offering such services, and according to a recent American Dental Association survey “more people want white teeth than straight teeth”.

But are there any differences between what’s on offer among these outlets, might you be better off checking out what’s available at your local pharmacy first, and why does the Irish Dental Association describe many such products as ranging from “useless to dangerous”?

Firstly, it’s important to be clear on just what the tooth whitening process involves. In order to effectively improve the colour of your teeth, they must be bleached, a process which uses hydrogen peroxide.

Too little hydrogen peroxide and your teeth won’t be bleached – too much and it could affect the sensitivity of your teeth as well as burning your gums.

Most whitening products such as toothpastes and strips you can buy over the counter in a supermarket or pharmacy contain just 0.1 per cent hydrogen peroxide.

However, according to Dublin dentist Dr Tom Feeney, who is also the Irish representative of the Council of European Dentists, products need to contain at least 3 per cent in order to be effective.

Instead, many of these products appear to work as they contain glycerine, which dehydrates teeth making them appear white. When it wears off and the teeth rehydrate again, the effect is gone and the teeth return to their original colour.

“It just gives a temporary improvement,” says Feeney, adding: “It’s a quick fix for a weekend – not for the long term.”

So, rather than waste your money on such products, what other options do you have?

There are two other main types of long-term whitening processes:

1) in-surgery bleaching where the bleach is applied and a laser used to speed up the process; and

2) at-home bleaching using trays, which involves a mouthguard which is moulded to your teeth and worn during the night for up to two weeks.

Typically, the faster the treatment, the greater the concentration of hydrogen peroxide used. One approach involves a very high concentration of hydrogen peroxide for a short period of time, while the other method uses a low concentration over a longer period.

According to Feeney, both are equally effective, and yellowish discoloration responds very well to bleaching, although greyish discolorations can be more difficult to treat. With home bleaching, it will need to be topped up in a year or two.

Many dentists will recommend that you have your teeth cleaned by a dental hygienist before getting them whitened, as it makes the treatment more effective.

However, certain people should avoid the procedure, including pregnant women, children under 16 or heavy smokers or drinkers.

The procedure can cause some discomfort, with studies showing that 65 per cent of people report a bit of sensitivity.

Of those who do, most tend to have mild sensitivity for a day or two afterwards, with about 5 per cent finding it extremely sensitive for some time.

However, more serious problems can arise when it comes to the levels of hydrogen peroxide used and who carries out the procedure.

Tooth whitening is completely unregulated in Ireland, which means that the next time you visit your hairdresser you may just be offered the procedure.

However, according to Feeney, there are several reasons why it should be carried out by a trained professional.

These include being able to recognise different types of discolorations, such as those caused by genetic hereditary conditions.

In such cases, bleaching often won’t work, while if you have a dead tooth it must be bleached in a particular manner.

In addition, Feeney adds that the person carrying out the bleaching should be able to do a full oral examination and medical history.

He recently had a woman in his surgery with a tongue condition, and he wouldn’t carry out the procedure because adding chemicals to potentially pre-cancerous cells could be dangerous.

The European Commission is set to table proposals at the end of this month looking to regulate the sector, and prevent unqualified people administering very high concentrations of hydrogen peroxide.

It will also look to restrict the use of hydrogen peroxide by allowing only products with no more than 0.1 per cent be available for sale over the counter, while products between 0.1 per cent and 6 per cent will have to be administered by a dentist. Anything over that will be deemed illegal until it can appropriately regulate the sector.

While it’s perfectly legitimate to apply high levels of hydrogen peroxide – a recent European Commission study found levels as high as 35 per cent – it must be used in a proper way, says Feeney.

“When done properly, it’s safe,” he says. If administered incorrectly, hydrogen peroxide can burn the mouth, stomach and eyes.

The variations in who administers the service may account for the wide differences in price for tooth bleaching.

Feeney charges €300 for his bleaching service, but there are cheaper alternatives – it will be up to you to decide whether or not you want to pay a premium to get the work done by a dentist.

ON THE BRIGHT SIDE: WHITENING OPTIONS

Colgate Total Advanced Whitening

What is it: Toothpaste.

Where: Supermarket.

Cost: €2.

Rio Professional Teeth Whitening System

What is it: Uses blue light treatment technology to give “professional results in the comfort of your own home”.

Where: amazon.co.uk.

Cost: £60 (€67.76).

Whizzer Whitening Strips

(56 pack)

What is it: Whizzer Whitening strips claim to allow a sustained, controlled release of peroxide and speed up the absorption of the active ingredients into the teeth enamel

Where: Pharmacies.

Cost: Approx €24.99.

The White Room

What is it: Laser teeth whitening which claims to whiten your teeth in just 36 minutes.

Where: Walkinstown, Dublin 12.

Cost: Special offer of €99, with money-back guarantee.

White Smile Clinic

What is it: Laser teeth whitening in three 12-minute cycles, giving an average improvement of five to 15 shades whiter. The procedure is carried out by dentist or dental nurse.

Where: Six locations nationwide.

Cost: €199.

Crown Dental

What is it: Zoom Whitening system is used, promising whiter teeth in 60 minutes.

Where: Harold’s Cross, Dublin 6.

Cost: €99 by a dentist; €169 by a dental hygienist.

BLEACHING: WHAT TO ASK BEFORE DOING IT

What types of tooth whitening are available and what are the differences between them?

What sort of results can I expect?

What can be done about stained veneers, crowns or dentures to make sure they match my natural teeth?

What are the risks? Will it hurt?

Who will be carrying out the procedure? What training and experience do they have?

Is the work guaranteed for a certain length of time?

What aftercare is provided and

who can I contact for advice after treatment?

What happens if I am unhappy with the results?

Source: UK General Dental Council