Over-the-Counter Whiteners. You can do this at home!

Last week I spoke about how teeth can become discolored.  This week I will focus on over the counter whitening agents and some examples.  Please note that whitening toothpastes only remove surface stains. This is the first part of the series of whitening!

1. Crest White Strips come packaged in pairs (one upper and one lower) in individual pouches. The contents of each pouch are used for one treatment session and then discarded. You should give your teeth a quick once-over cleaning (using a toothbrush without toothpaste) before applying your whitening strips.  Strips cover only the 6 front teeth upper and lower.  You will pay usually between $26.00-60.00 per box depending on what type you purchase.

Crest Whitestrips whiten teeth using a formula containing typically 5 percent to 10 percent hydrogen peroxide gel, depending on the product.
 
Whitestrips are designed to hold the gel against teeth long enough to remove stains below the surface enamel.  Almost all forms of lightening gels contain a diluted form of peroxide called carbamide peroxide containing a mild acid to open the pores of the enamel.  This is how the whitening gel penetrates the teeth.  Peroxide oxidizing agent penetrates pores in the rod like crystal structure of enamel and bleaches stain deposits in the dentin which is the layer closest to enamel on the inside of the tooth.
 
Unless you use strips beyond what the recommended treatment time is, this is not typically harmful to enamel and considered safe. 

I have known individuals who needed a few more strips from a second box after the first one did not produce enough results and once 4 or 5 strips in on their second box they achieved whitening.  This is more unusual and they may have needed a higher strength.  This is ok, but once the desired whitening is achieved then discontinue use. 

I do know some individuals who use 1 strip per week just to keep up the lightening effects of the teeth.  This practice is a bit excessive.  If in maintaining your overall whitening you acquire a slight transparency on the edges of the teeth then you are using the product too much.  I don’t usually recommend doing this once a week practice.  Typically once whitened, then it should last between 6-12 months depending on how much you do to stain your teeth.  Your teeth should be as white as the whites of your eyes.

Crest manufactures six types of Whitestrips (buying a box from your dentist has a higher percentage of carbamide peroxide): 

• Crest Whitestrips Classic was the first available product, and it is advertised as the most affordable as well as most appropriate for first-time whiteners. The Classic strips are worn twice a day for 30 minutes and achieve full results in 14 days.
• Whitestrips Premium is a more intense version of the Classic, with strips being worn twice a day for 30 minutes and achieving full results in seven days. 
• Pro Effects are advertised to deliver professional-level whitening at home after wearing the strips twice a day for 30 minutes for 10 days.
• Whitestrips Advanced Seal, the newest product, whitens in the same time as Classic strips but contains an adhesive formula. Users can continue with activity as normal.
• Five Minute a Day strips are promoted for users who have tooth sensitivity, seek color maintenance or only have a short time to whiten. 
• Daily Whitening Multicare and the Daily Whitening + Tartar Protection are used once a day for five minutes. Teeth are whitened gradually.

2.  Bleaching Trays.

• Fitted Trays: These give you complete coverage of all teeth, not just the first 6 anteriors like the strips.  Trays that are fitted from a dental office by taking an impression of your teeth are the most effective. Dental impressions and fitting can be as much as $400.00-500.00 , but are usually permanent and last for several years and gel is to be placed in them for around 27.00 . The amount of gel carpules usually lasts up to 8-12 months for many treatments.  You will only use a very small amount in the trays so the gel treatments ( usually 4 carpules) may last you longer than a year. If you refrigerate them, they will keep their strength for 2 years. The amount of carbamide peroxide is usually anywhere between 20-35%.
• Generic Trays: come with the product of carbamide peroxide and usually have to be heated and molded by you in order to conform around your teeth.   They are also extremely effective.
• Overnight Bleaching Trays:
  Should only be 10-15% carbamide peroxide if overnight.   There are no exceptions usually due to sensitivity on the gumline and the teeth themselves for safety. 

Most gels are usually between 20-22% This is the safest for tooth sensitivity and can be left for up to 30 minutes to an hour on your teeth. We use opalescence in our office.

3. Bleaching Pens are extremely useful for applying whitening product to hard-to-reach areas or trouble spots that build up stain frequently.  These types of areas are common in crowded areas or misaligned teeth that whitening gel may not coat evenly in other kits.  Pens tend to not whiten as quickly as other types of gel products like whitening strips or trays.

Using a gel pen usually assists in keeping your teeth white after you have used a strip or a tray.  This is my experience with the product.  Also the high percentage of diluted peroxide could have the potential for high tooth sensitivity.

Forever White Whitening pens

• Costlier than other whitening pens (priced around $40.00)
• May take up to 2 weeks for best results
• Effective for hard to reach areas
• Small size fits in most pockets
• 36% carbamide peroxide is one of the stronger solutions available
• No drinking or eating 15 minutes after application

Brite Teeth : also 36% carbamide peroxide  much more affordable at $10.00-12.00. However,  I have seen it up to 50.00 for some reason!  I don’t have much experience with this product and their company but it has the same results as above pens.

4.  Foaming toothpastes:
Daily White (non peroxide) and Daily White Fusion (with peroxide.  Foaming action helps target tight areas between the teeth

• Available in both peroxide and non-peroxide solutions (non peroxide is usually sodium bicarbonate)
• Comfortable and sensitivity free
• Not as effective as strips, trays or gels.

5.  Other things to know:

Peroxide vs. Carbamide Peroxide

Full strength peroxide (non- diluted) 7.5% = 22% carbamide peroxide.  This works best for those who have sensitive teeth to temperature and sugars. Look for 22% when you are shopping.

Full strength peroxide is 9.5% = 28% carbamide peroxide.  Look for this higher percentage if you have no sensitivity at all.

Any percentage over 28% is usually found in gel pens that don’t stay on teeth as long as trays and strips.

If you are experiencing tooth sensitivity with any of these products I suggest you use Sensodyne toothpaste with potassium nitrate to block the tubules from sending moisture back and forth to the nerve system.  Use while lightening the teeth and about a week after.Once you have whitened and stop usage the sensitivity declines to where you had started with none hopefully!

The opalescence carpules come with desensitizing fluorides and agents you can purchase to use on the teeth every other day.  Some products come with sodium fluoride already in them.  I will review some of these next week.

 
MI paste has calcium phosphate and sodium fluoride in it to quell sensitivity and can be rubbed onto the teeth before bed at night with your fingers. You can purchase at a dental office.

Clinpro fluoride 1.1% a sodium fluoride tooth paste is another option to brush with at night.  Also purchased at dental office.

Act fluoride rinse .02% to rinse with at night before bedtime.  Over the counter.

Basically becoming tooth sensitive is a normal reaction to the deposition of peroxide and other agents into the tooth rods of enamel. If you are experiencing sensitivity, whiten every other day for most comfortable results.

Next article I will be reviewing methods with out peroxide and in office bleaching treatments with light assisted LED and over the counter light assisted LED.

I Hope this helps!