Pearly whites

A Columbia dentist explains whitening methods used to get those
Wednesday, December 10, 2003 | 12:00 a.m. CST; updated 3:50 p.m. CDT, Sunday, July 20, 2008

From extreme dieting and exercise to cosmetic surgery, people go to many extremes to conform to ideals of appearances. But those ideals aren’t limited to body shape or size — many people’s ideal body also includes a dazzling smile.

“In our culture, white teeth and a pretty smile are important,” said Charles Mattingly, a Columbia dentist. “It says something about a person who whitens their teeth, that they care about their appearance.”

The color of a person’s teeth can influence how others think of him or her, Mattingly said. “The face and smile are our organs of identification,” he said. “People get an impression about what a person is like by they way they look. Part of that is their smile.” Teeth whitening, which can help people who want an impressive smile, removes surface stains. It goes into the grooves, pits and scratches on teeth and bleaches them out.

According to Mattingly, the most popular form of professional teeth whitening is a take-home kit customized for patients. With the kit, an impression is made of the patient’s mouth, a mold is created, and a custom tray is fitted to the mold. Patients put bleaching gel in the tray and are able to whiten their teeth at home. This procedure costs about $390 for the trays and bleach.

Another at-home option is to use a pen-like dispenser to apply a bleaching substance to teeth. This procedure also costs about $390, Mattingly said. In-office whitening comes in concentrations of 10 percent to 22 percent carbamide peroxide, the whitening agent. The results of professional whitening are more predictable because the concentration can be adjusted, Mattingly said.

One of the most popular in-office whitening treatment is called Zoom. It is a one-hour procedure that consists of three 20-minute applications. The procedure costs about $600.

“First we apply a protective coating to the gums, then the first application of bleach to the teeth,” Mattingly said. “We shine a light on the teeth to increase speed. Then we remove that bleach and apply more. We do this one more time, and the process is done. We also recommend the patient follows up with take home bleaching.”

For those with big bucks to spend, porcelain laminate veneers are a quick fix to create a near-perfect smile. Porcelain laminate veneers are thin layers of porcelain applied to the front of the tooth. “They are about as thick as a potato chip,” Mattingly said.

One millimeter or less of the front surface of the tooth is removed, using a diamond tool to grind the tooth down. Impressions are taken and the lab fabricates the veneers.

Porcelain laminate veneers are beneficial if patients’ teeth don’t bleach to their liking or if they want to correct other aesthetic concerns. This process costs about $700 per tooth.

Composite laminate veneers, or tooth-colored material bonded to the front surface of the tooth, are less pricey at about $490 per tooth, but they are not quite as effective as porcelain laminate veneers.

These procedures are generally not covered by insurance since they are mainly aesthetic corrections.

Depending on the habits of the patient, professional teeth whitening can last several months before needing a touch up.

At-home whitening systems may bring whiter smiles, but the use of such products can result in uneven bleaching or damaged teeth. Although people may believe that whitening toothpastes will help maintain whiteness, “they are abrasive, and over a long period of time, they may damage teeth,” Mattingly said.

Other products such as Crest Whitestrips, invisible strips that adhere to teeth with whitening gel, don’t adhere to teeth perfectly in every case, Mattingly said. Because of this, the whitening may look blotchy, and the strips may cause gum irritation and sensitivity.

Before using take-home whitening kits, Mattingly suggests consulting a dentist.

But even if patients do get professional bleaching jobs, they might not be satisfied with the result.

Some stains and teeth don’t whiten as much as others. If a patient has tetracycline staining caused by antibiotics, it might be hard to whiten to the desired extent. Some colors of teeth, mostly gray, are also harder to whiten. Gray teeth usually turn a different shade of gray and may end up looking chalky.

The shape and thickness of a tooth might also affect how well it whitens. Thin teeth whiten more easily than thicker teeth. Mattingly said abrasion and wear and tear can also affect how parts of teeth whiten differently than others.

Concerns of teeth whitening include tooth decay and sensitivity of the teeth and gums. Sensitivity can occur if bleach gets into cavities, so cavities need to be restored prior to bleaching, Mattingly explained. Before having teeth whitening treatments, he recommends using a fluoride gel or toothpaste one week in advance to diminish sensitivity.

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