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At Home Whitening Compared to Dentist Whitening


Published: April 11, 2011
Author: Dr. Mike Williams ( Michael Williams )
Tagged: teeth whitening, dentist, at home

Image: At Home Whitening Compared to Dentist Whitening

Compare at home teeth whitening to dentist in office teeth whitening.


The internet is ablaze with teeth whitening offers from online stores.  But how does the at home whitening compare to the whitening that you get at the dentist’s office?

What is teeth whitening?

Teeth whitening is a process used to change the color of natural teeth to a brighter and whiter color.

What causes teeth to darken?

Teeth darken and yellow with age. The color is a result of years of accumulated pigments from food and drinks (coffee, tea, sodas, wine and others) and the natural darkening of the dentin layer of tooth structure below the enamel.  Also,certain drugs can accumulate in they dentin layer below enamel causing a dark grey or brown color (tetracycline tooth staining).

How do the whitening systems work?

The most effective systems being used today incorporate the use of an oxidizing peroxide type gel known as carbamide peroxide. The whitening gel is placed over the enamel portion of the teeth. Some dental offices  use a whitening light to accelerate the chemical process.  At home dental whitening may use a dental mouthguard type whitening tray which will holds the gel closely to the teeth while the whitening chemical reaction occurs. The better fitted trays will produce improved results since the solution can remain in close contact to the tooth structure for a longer period of time without leaking out or being diluted by the saliva. Depending on the concentration of the gel, the trays with gel may remain in place for a time as short as 15 minutes or possibly overnight. The process may be repeated over several days till the desired whitening result is attained. The whitening occurs as the accumulated pigments in the dentin layer of the teeth are oxidized by the oxygen compounds in the whitening gel products. The carbamide peroxide comes in strengths ranging from 10% to 44%. Higher strengths require shorter times for results but are associated with more teeth sensitivity.  All strengths produce similar whitening results over time.

What are the options to whiten teeth?

Dental in-office teeth whitening

Dentists may provide laser assisted teeth whitening (also known as power whitening) for their in-office teeth whitening.  This particular wave length of the light activates the peroxide molecules in the gel to initiate the bleaching process. Most dentists also offer custom laboratory fitted teeth whitening trays for home use with bleaching gels and can oversee the whitening process to optimize results.

At home whitening

The FDA considers teeth whitening as a cosmetic process and as such is available from online stores and other retailers. Traditionally, the at-home whitening involves applying bleaching gel to the teeth using thin mouthguard type trays. These trays can be obtained from your dentist or can be self-fabricated by the user themselves. Some whitening trays can be self-molded to fit by using the common “boil and bite” fit system similar to athletic mouthguards.  Now, custom laboratory fit trays are available to the user without going to the dental office. The whitening user makes their own dental impression and sends it to a dental laboratory which then fabricates and returns the custom fit tray.  Generally these “custom-fit” system trays are more effective.  All whitening systems either at the dental office or otherwise commercially available, use the same chemicals and concentrations. Careful adherence to instructions optimizes results. These at-home teeth whitening carbamide peroxide kits are readily available online and are much more cost-effective than the in-office dental procedure.

Other Whitening Options

Other less effective options include these: whitening tooth pastes, whitening strips, whitening pens and paint on teeth whitening.

How long does the whitening benefit last?

Some studies say that the whitening may last as long as seven years with gradual darkening over time.  However, most people see a level of whitening that they wish to maintain and will repeat the process several times per year or do touch-ups before special occasions. Life style modification to avoid tooth stain accumulation on your teeth can also help maintain the brighter color. Factors that decrease whitening include smoking and the ingestion of dark colored liquids like coffee, tea and red wine. Avoidance of these substances is especially critical during the actual whitening process.
What are the costs for each option?

In office dental whitening usually cost around $500 or more.  The at-home teeth whitening kits fitted by the user start around $50 for the “boil and bite” fit variety.  While the “custom laboratory fit” whitening trays and kit made from the user’s own impression average around $125.  Costs for these systems vary according to chemical concentration, volume of materials and fit systems. Maintenance accessories are readily available online or from dental offices.

How does the at home whitening compare to dental in-office whitening?
In an article http://jada.ada.org/cgi/content/abstract/141/11/1357 published by the American Dental Association (ADA) in 2010 it was concluded that either the in-office or at-home whitening techniques were equally effective.  

Actual ADA Abstract

Comparing At-Home and In-Office Tooth Whitening Techniques
A Nine-Month Follow-up authored by: Luca Giachetti, MD, DMD, MSc, Fabio Bertini, MD, DMD, Claudia Bambi, DDS, Michele Nieri, DDS and Daniele Scaminaci Russo, DDS

Background:  The aim of this split-mouth, randomized controlled trial was to compare the whitening results of at-home and in-office tooth bleaching techniques and the longevity of their effects at nine months after teeth had been bleached.

Methods:  The authors conducted a study involving a 14-day bleaching period, during which the first maxillary premolars of 17 participants, who were 20 to 25 years of age, were bleached by means of either an at-home technique involving 10 percent carbamide peroxide or an in-office technique involving 38 percent hydrogen peroxide. The authors recorded color variables as proposed by the Commission Internationale de l’Eclairage—lightness (L*), redness (a*) and yellowness (b*)—by using a spectrophotometer at baseline and at one week, one month and nine months after bleaching. They also calculated a whiteness (W) index that was based on the distance of the color value in the color space from a nominal white point.

Results:  At the nine-month recall visit, comparison between the at-home and the in-office techniques did not show significantly different values for L* (P = .448), a* (P = .350), b* (P = .144) and W (P = .151) color variables. None of the participants experienced any adverse events related to the bleaching during the treatment period.

StudyConclusions:  The study results showed no clinically significant difference in bleaching efficacy. Both techniques produced satisfactory and long-lasting bleaching results.

Clinical Implications.  In young adults, either the at-home or the in-office technique can be used effectively.

Conclusions

According to the study published by the American Dental Association both the dentist supervised whitening and the at home whitening produce similar results.

Using the traditional system of teeth whitening carbamide peroxide gels with properly fitted whitening trays at home produces satisfactory teeth whitening results when compared to in-office dental whitening.



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