Doctor’s Blog

Approximately 20 years ago, I started providing professional tooth whitening to my patients when manufacturers perfected a user friendly delivery system and a peroxide formulation that was safe and easy to use. At that time, there was only one kind of whitening system available – dentist supervised tray delivery. After taking a mould of the patient’s teeth, we fabricate a soft plastic, custom fitted tray that adapts intimately to the patient’s teeth and does NOT cover the gums. The patient is then provided with the tray and a 15% – 30% carbamide peroxide gel syringe.

To use this whitening system, the patient places the peroxide gel into the custom tray, inserts the tray into their mouth, and leaves the tray in for 30 minutes. This procedure is used twice a day. The key to getting good results with this method is for the patient to remain motivated. A motivated patient will usually see results in one to two weeks. To get the best results possible, sometimes it may take as long as six weeks.

Since the above method was introduced, slick marketers have tried to introduce techniques that are “faster” or perceived to be less expensive. This includes a one appointment technique where a gel is applied to the teeth (in the dental office), and a specialized light or laser is applied – supposedly enhancing the results and only requiring one to two hours in the dental office. I have used several brands of this technique, and have found the results disappointing compared to tray bleaching. Not only were the results disappointing, the procedure was very expensive due to the amount of time spent in the dental chair. In fact, independent research has shown that the use of special lights or lasers has no effect on the results. The teeth are whitened only because the patient sits still in a chair with a strong bleach on their teeth for 2 hours. Don’t be fooled by slick technology claims for this type of whitening.

Manufacturers have also come out with something that appears similar to the custom tray technique discussed above that can be purchased over the counter. The “custom” trays are made by the patients by heating up the tray, and placing the tray in the patient’s mouth while soft – creating a “mould” of the mouth. The problem with this technique is that the mould allows the bleach to cover the gums – which can create burns and damage to the gums. Since the bleach comes in contact with the gum tissue, the manufacturers can only use very low strength bleach.

Another whitening technique developed is the use of whitening strips that can be purchased over the counter at drug stores. If a patient is highly motivated, these strips can produce decent results. However, they are very awkward to use – they whiten only the front teeth, not the back teeth – and are very slow to produce results. Once again, since these strips must come in contact with the gums tissue, the manufacturers can only use very low strength bleach. Therefore, the patient must use these strips for a long time – continually needing to purchase more strips to get good results. To get results anywhere near the custom tray method provided by a dentist, the cost is almost equal. Plus, remember you are only bleaching the teeth that can be reached by the strips.

Since patients are always looking for inexpensive way to get white teeth, I am constantly being asked about the “whitening” toothpastes that are now on the market. To quote Consumer Reports Magazine, “None of the 41 ‘whitening’ toothpastes we tested did any better to actually whiten teeth than any other toothpaste. We say don’t put the extra money where the mouth is.” And, I concur. I have never seen a patient get any results using a whitening toothpaste.

In summation, after 20 years of trying to improve on the original custom tray technique, I still find this technique to be the most cost effective and predictable way to whiten your teeth. I have had patients use all of the other techniques, and have found that the original dental office fabricated custom tray technique still works the best and is the most cost effective. Anyone can get whiter teeth if they consistently use this technique.