People ask me all the time whether they should have laser bleaching to whiten their smile. “It all depends on whether you are in a hurry to get your teeth whitened, and whether or not you are a candidate for tooth whitening in the first place” – my typical response! The benefits of laser bleaching over an over-the-counter home solution include instant results, a painless experience and a completely guided procedure. If your teeth can benefit from teeth whitening, at-home tray bleaching techniques will work for most people unless their teeth are sensitive, eroding, severely worn or if they have gum recession. If you do have severely discolored teeth, a combination of laser bleaching and home bleaching would be the best approach to obtaining and maintaining a bright and dazzling smile.
Laser bleaching utilizes laser light energy to accelerate the chemical reaction of a bleaching agent, typically a hydrogen peroxide base product. Hydrogen peroxide is very unstable in response to light and heat (which is why over-the-counter 3% hydrogen peroxide solution is stored in opaque dark brown bottles). Because of this, light energy can excite peroxide molecules, breaking the covalent bonds of the bleaching agent. The agent then reacts to and breaks the long, discolored molecule chains into shorter-chained molecules, lightening the tooth color. The bleaching agent used with laser bleaching is a high-strength solution when compared to home bleaching agents or over-the-counter kits. Your mouth will be protected with an isolator to protect the oral tissues , and placement of the bleaching agent is done in a very controlled manner by a highly trained dental professional. Once a 10-to-15 minute bleaching cycle is complete, the teeth will be cleaned and evaluated to discern whether additional applications of bleaching agent will follow. Normal bleaching procedures involve three applications of the bleaching gel, with an “instant average” of six shades of whiteness typically resulting. Laser bleaching is instantly gratifying. In my office, you can watch a movie through virtual i-glasses while the procedure takes place, and before your movie is finished your teeth will have been transformed into a younger, prettier and whiter smile!
Many different types of lasers (or light) are used for eliciting fast chemical reactions in teeth whitening. Some people will experience more sensitivity when infrared energy (heat) is utilized, which appears in most dental offices, but a few alternatives like Argon or KTP lasers (which emit blue and green light) exist. These lasers have the correct level of energy required to excite the bleaching gel, but they leave the teeth cool and comfortable. Most sensitivity is transient, and should subside within a day (Ibuprofen will be helpful if there is any available). After a smile has been bleached with a laser, one must be very careful to maintain his or her newly brightened smile lest the brilliant white color fade and dull over time. Alcohol, soft drinks and smoking are all bad habits which can stain teeth and regress any laser bleaching process. A healthy diet will also be beneficial for your physical and oral health. If you take care of your mouth, your reward will be apparent with a happy and healthy smile.
Brushing your teeth is probably the most universally recognized and practiced personal hygiene routine. After every meal (and both before and after sleeping), you should brush your teeth to prevent food particles from breeding harmful bacteria in your oral cavity – however, what is the role of toothpaste?
The basic benefit of a pea-sized dollop of toothpaste on your toothbrush when cleaning your teeth is its ability to lubricate – when combined with a proper brushing technique, toothpaste fortifies your brushing routine to remove plaque (built-up bacteria that grows on your teeth causing cavities, and when left long enough, gum disease).
As you probably know, toothpaste contains fluoride, which when applied to the outer enamel layer of a tooth makes the entire surface structure more resistant to decay and promotes remineralization, tooth strength and rigidity, which aides in preventing cavity formation. Fluoride can even repair early decay before damage can be seen! I have previously written about the possible dangers of fluoride, but if toothpaste is not swallowed (and application is strictly monitored by parents of children), fluoride can be a very helpful addition to toothpaste, making the use of toothpaste when brushing one’s teeth quite beneficial.
Finally, toothpaste does incorporate several special ingredients to provide different side-benefits: triclosan fights against plaque forming microbes, pyrophosphate is a tartar control agent, potassium nitrate is a desensitizer, carbamide peroxide is a bleaching agent, baking soda is a mild abrasives and PH neutralizer and sodium lauryl sulfate is detergent to carry away debris. Ask your dental professional if your dental condition requires special toothpaste in order to receive the maximum benefits of a typical tooth brushing routine. In general, the inactive ingredients in toothpaste like thickeners and water softeners provide the right consistency, moisture, flavor and sweetness for a more pleasurable experience.
If you are getting lip sores, check to see whether the toothpaste you use has lauryl sulfates, which can be irritating to certain tissues. All-natural herbal toothpastes like Tooth & Gum Paste exist which are in fact antibacterial but contain no artificial chemicals.
So remember, choose your favorite toothpastes and use them! You can even have several different toothpastes and tooth-brushes to make your tooth brushing routine more interesting! A proper brushing (and flossing) technique will keep out the stains, lower the risk of dental diseases, help freshen breath and fight mild halitosis. Be confident with your smile, brush and floss!
“Does it hurt? How long will it last? How long will it take? How much does it cost?”
These are common questions from patients looking for cosmetic dentistry.
If you’re interested in cosmetic dentistry to get yourself a winning smile, whether the problem is mis-alignment, cracked or chipping teeth, unsightly spacing, uneven or dark colored dentition, uneven or too much (or not enough) smile showing, or even gum erosion, the eternal question always arises: What would be the best solution?
In the past, crowns were the primary choice for masking tooth problems, but since the late 1980s, cosmetic dentistry has offered both bonding and veneers to improve your smile. This leads to the eternal question: “Bonding or veneers?”
Dental bonding involves the application of a durable composite material directly to the surface of the tooth, by your dentist, which is then sculpted and artistically shaped to the exact look the patient desires, to blend naturally and seamlessly with the patient’s existing teeth. A laser (or high intensity light) is then used to cure the composite material, hardening and reinforcing it to the surface of the tooth. This bonding technique has many applications, not only for aesthetic uses but also for prosthodontics and pediatric dentistry. The advantages to dental bonding are a quick treatment time (can be completed in one office visit after a consultation), and a relatively low cost per tooth when compared with porcelain veneers. Durability of bonding will be affected by the oral environment. Since composite bonding is a mixture of quartz particle (70% – 80% filled) and resin, discoloration and breakage is inevitable if your mouth has a high acidic pH value (if you are a soda drinker, lemon lover or candy sucker), if the bonding was not supported by a solid tooth structure, or if you are a night grinder.
Porcelain veneers are fabricated in the laboratory. They are 100% filled with hard mineral particles, and are fired at a high temperature with a vacuum (to procure the best physical properties to sustain the veneer’s strength in the harsh oral environment). Compared to bonding, there is more procedural work involved with porcelain veneers. There are different techniques to fabricate the veneer pieces (which call for different methods of preparation for the tooth); the pressing technique produces a stronger veneer, but requires 0.8mm thickness of the veneer. The porcelain powder build-up technique can produce super thin veneers (0.3mm), which produces a very conservative look on your tooth structure, while at the same time keeping a natural silhouette. The veneer piece lays on top of the tooth structure and is similar to a press-on nail. They chemically adhere to the tooth with bonding composite cement; since porcelain is acid resistant and stronger in physical properties than composite material, this restoration provides long-term service. When getting the veneers, the first visit consists of preparation and imprints f the teeth (which might involve anesthetic). After this, you will leave the office with temporary veneers which look like natural teeth. A wafer-thin veneer is then crafted out of porcelain which is seamlessly cemented to the front side of the tooth on the second visit. In addition to straightening teeth, porcelain veneers can close gaps between teeth, whiten teeth that do not respond well to bleaching, and can also be used to protect damaged tooth surfaces. The advantages to porcelain veneers over bonding is that veneers are much longer lasting (and stronger) than composite bonding material.
Whether you decide to invest in dental bonding or porcelain veneers, make sure you have all work done at a reputable dentist, preferably at a practice which has its own in-house ceramic lab. When ceramic work is done by an in-house lab with an in-house ceramist, any changes that need to be made to the length or color of the veneers can be done without requiring an additional office visit. Remember, the result of the cosmetic procedures are truly varied depending on the ability of the dentist, ceramist, your clinical situation and the communication between all parties involved. Do your research!
Both bonding and veneers are additive procedures, depending on the position, alignment and shape of your teeth, which is the foundation for any new restorations. This foundation will need to be in the right fundamental situation to receive restorations to result in a fabulous smile. In other words, sometimes, you do not need to do much to your own teeth before applying cosmetic restorations. It might be necessary to reduce or modify the tooth structure before anything can be added onto it to make it look perfect.
There is some risk involved with cosmetic bonding or veneers, so be cautious with any cosmetic procedure. A comprehensive evaluation of your present dental condition is absolutely necessary as a first step; blue prints of your teeth and of your prospective dental project are needed to establish clear verbal communication between all parties involved (including you), including possible mock-up or wax-up models to preview possible changes, which could avoid costly mistakes.
Do your homework: finding the right dental professional, discussing every aspect of your dental needs, understanding the pros and cons of each procedure, and making an educated decision will ensure you get the smile you’ve always wanted.
If your eyes are the gateway to your soul, your smile is the gateway to your heart. There are many factors that contribute to a beautiful smile in my line of work, but teeth whitening is one of the simplest ways to give your smile a brighter, whiter lease on life.
When we are children, our deciduous teeth (baby teeth) are bright, white and full of life – that is, until they fall out and are replaced by permanent teeth. From this point onward, our teeth are exposed to a multitude of conditions which endanger the white enamel surface of the tooth. Foods, dark liquids such as tea, coffee, red wine and caffeinated beverages, smoke and even some prescribed medication can all cause your teeth to loose their whiteness. A history of dental trauma can also cause tooth discoloration, which would require a different approach to reach the desired whiteness. Generally speaking, the teeth bleaching only applies to oxidizing normal tooth enamel. Whitening will not change the color of any dental restorations, and should not be used on darker root structures of the tooth or with tetracycline staining. Sometimes, cosmetic procedures such as porcelain veneers or bonding would be a better solution, in which case a consultation with your dentist would be necessary.
There are two ways to whiten your teeth: with whitening kits, and laser whitening (power bleaching). Over-the-counter kits to whiten teeth are sold both at your local pharmacy and from your dentist’s office. Custom fitted kits sold from your dentist’s office include retainer-like trays which are made from custom impressions of your teeth, whereas over-the-counter varieties are not as effective. The active ingredient breaks down into hydrogen peroxide, which oxidizes the stain deposits in the enamel of your teeth. Application is done for a few hours per day, for one to two weeks. The advantage to whitening kits is that you can keep your impression trays for future use, and only have to buy the whitening gel again. Regular dental check ups are necessary to make sure your teeth are healthily receiving the bleaching process.
Laser whitening is the method to whiten teeth I use in my office. Employing the use of an argon laser enables fast, painless and safe whitening of the teeth without potentially harmful UV damage, or heat which can irritate the pulpal tissues of the teeth. Arc lamps, a more common light-based whitening treatment, use energy that comes in a wide range of electro-magnetic waves, which could cover from the UV range into the infrared (heat) range, which could pose a health risk. Also, arc lamps can cause pulpal inflammation, leading to heightened gum sensitivity. The laser whitening process takes about 1 hour, providing instant gratification of the whitening results and the convenience of minimum work at home.
For the best teeth whitening results, I usually recommend my patients use a combination of in-office laser whitening, and usage of our take home kit, allowing for touch-up treatment by the patient at the convenience of one’s own time and own place. Once the desired bleaching result is reached, with proper care, it can last up to 3 years. If touch-up bleaching is needed, the time investment is extremely low (almost instant).
Remember, your smile is the gateway to your heart! Let it shine!
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to whiten their smile. “It all depends on whether you are in a hurry to get your teeth whitened, and whether or not you are a candidate for tooth whitening in the first place” – my typical response! The benefits of laser bleaching over an over-the-counter home solution include instant results, a painless experience and a completely guided procedure. If your teeth can benefit from teeth whitening, at-home tray bleaching techniques will work for most people unless their teeth are sensitive, eroding, severely worn or if they have gum recession 
