Dental teeth whitening: types of procedures and their description. Teeth whitening: at home, the best ways in dentistry Preparations for whitening teeth in dentistry

When it comes to professional teeth whitening, reviews on the Internet and among acquaintances can vary greatly. Someone was satisfied with the procedure, the other called it "pumping money." Why are there so many different opinions on what seems to be such an unambiguous issue? There are several reasons.

Why might results differ?

The degree of contamination of the teeth and the reasons that led to it are different. It is enough for one patient to remove the yellow plaque from the enamel so that his smile sparkles white again. And in another, a black plaque covers the teeth, deeply penetrating into the tissues. And it is extremely difficult to achieve instant lightening, even when using professional teeth whitening techniques. Often multiple procedures are required.
Methods for whitening teeth in dentistry vary. Some allow you to cope only with external plaque, while others are able to eliminate pigmentation deep in the tissues. As a rule, the first methods are cheaper, which attracts the attention of patients. The latter are more expensive, which is why not everyone can use them, but they are much more effective.
Individual characteristics. Before starting the procedures, the specialist always conducts diagnostics, determining the degree of wear of the enamel. This allows you to predict how likely it is to develop sensitivity after bleaching. If the enamel is strong, teeth whitening at the dentist will leave only the most positive memories. If it is covered with cracks and chips, even after the most gentle procedure, you will experience discomfort and pain for a couple of weeks.

professional ways

Which whitening is best? What are the types of teeth whitening in dentistry and how does it work? To date, there are 5 best effective and safe methods.

airflow. Hardware technique for removing external plaque, which allows you to lighten the enamel by 1-3 tones. It is recognized rather as a hygienic procedure, which is desirable to take place twice a year. When performing it, the doctor sends a powerful stream of water and air mixed with soda to the teeth, which literally removes all impurities from the enamel, including the beginnings of a stone, a film from cigarette tar. This teeth whitening procedure eliminates enamel damage, is safe and gentle.
ultrasonic cleaning. It is not used for whitening as such, but to remove deposits of plaque and tartar. Combine with the Air-Flow technique to give the enamel whiteness. Regular ultrasonic cleaning allows you to eliminate all types of dirt, keep your teeth healthy.
Chemical professional teeth whitening. Its types vary from manufacturer to manufacturer, but the technique is almost identical. The doctor cleans the teeth, then applies a bleaching compound with a high content of hydrogen peroxide (urea). After some time, the composition is removed, and the teeth are treated with a mineralizing agent. The result is lightening by 5-7 tones. This technique is the least safe teeth whitening in dentistry, as it often causes the development of sensitivity. But when performing the procedure with an experienced doctor, you can be sure of its gentle effect.
Hardware methods of teeth whitening. In dentistry, photobleaching using the ZOOM system is currently used. It provides clarification by 8-10 tones in one procedure. It is recognized as more gentle than chemical, since it uses a gel with a lower concentration of hydrogen peroxide. But thanks to the influence of ultraviolet radiation, it acts more efficiently. The procedure does not cause discomfort, after which the teeth are treated with an amorphous calcium composition that strengthens the enamel. The most popular in-office teeth whitening. Reviews testify to its affordable cost and performance.
Laser whitening - the most expensive teeth whitening in dentistry and the most effective. It does not have a negative effect on the enamel, moreover, it strengthens it by 40% under the action of a laser beam. The minimum exposure time of the gel with carbamide peroxide (only 2 minutes) eliminates the destruction of enamel. The result of clarification is visible immediately and is up to 12 tones.

Advantages

Professional teeth whitening techniques demonstrate efficiency and lasting effect. So after mechanical cleaning with Air-Flow, the result is preserved for at least 1 year. And the laser technique guarantees enamel lightening for 7-10 years with proper care.
Other benefits of in-office whitening:

professional medical examination if you decide to whiten your teeth at home, you cannot be sure that they are completely healthy, and the chosen remedy will not damage the enamel. In the dental office, the doctor will diagnose and select the best technique for you;
quick result teeth whitening in dentistry - reviews confirm the whitening of the enamel after the first procedure. Whereas at home it is necessary to follow the manufacturer's recommendations for 10-30 days;
visible effect - not a single home remedy will provide you with 10 tones of teeth whitening, but a professional one can.

These benefits will be apparent only if you contact an experienced specialist. Therefore, it is extremely important to choose a dental clinic with an ideal reputation and positive reviews.

A snow-white smile always attracts the attention of others and is a hallmark of a person. However, a very small percentage of people have naturally white teeth. That is why many are looking for a way to whiten tooth enamel. In modern dentistry, a large number of methods of cleaning teeth are used. There are types of both home and professional in-office dental whitening. Choosing the right procedure for you is quite difficult. In this article, we will describe the main methods of whitening tooth enamel and contraindications to them.

Types of teeth whitening

Today, there are many dental techniques, each of which differs in the following terms:

composition and reagents used;
frequency and number of procedures;
whitening speed;
degree of patient involvement.

For the procedures, modern preparations are offered, the manufacturers of which promise safe and high-quality whitening with their help. Professional clarification is carried out on modern equipment and is in great demand.

Dental in-office whitening methods

With the help of professional cleaning of tooth enamel in the shortest possible time, you can achieve excellent results and long-term effects. At the same time, during the procedures, a sparing effect on tooth enamel occurs.

All dental office whitening is divided into several ways:

mechanical;
chemical;
laser;
ultrasonic;
photobleaching.

Mechanical bleaching

Dental mechanical cleaning is based on professional oral hygiene. With this procedure, you can get a very pronounced visual effect, although dentists do not consider it whitening.

During the mechanical procedure, dental deposits in the form of plaque and stones are removed. As a result, the natural color of tooth enamel returns to the patient. And if he has white enamel by nature, then a Hollywood smile is guaranteed.

Many people who drink coffee, red wine, cola and smoke what their natural enamel looks like have long forgotten. In these cases resort to chemicals, hydrogen peroxide, various pencils and strips are impractical. First of all, you need to carry out oral hygiene in the dental office.

During mechanical cleaning, the impact occurs on the deposits that are on the surface of the teeth. That is why such a procedure is completely safe for enamel.

But there are cases when, after dental plaque and calculus removal, the cervical region of the teeth is open. As a result, the teeth begin to react to hot and cold. Previously, dental stones saved them from all these irritants. In this case, it is necessary to contact a periodontist who will carry out fluoridation of sensitive enamel and prescribe treatment.

Among the mechanical methods of clarification, the most common is dental ultrasonic cleaning.

Ultrasonic whitening procedure

With the help of ultrasonic devices, both supragingival and subgingival stones are easily removed. Ultrasound allows you to clean even the tooth enamel of a smoker, which neither professional brushes nor special toothpastes can handle.

How does ultrasound work?

At the end of a special tip, due to ultrasonic vibrations, plaque and stones are destroyed. Separating from the enamel, they do not injure the tissue. At the same time, water enters the teeth through the tip, which is necessary for the effectiveness and safety of the procedure. Water does not allow them to overheat and, due to the movements of the tip, creates vortex flows. With their help, there is an improvement in the exfoliation of plaque and stones.

Airflow technology

The method of restoring tooth enamel is carried out with Air-Flow device, inside which there are water-air channels and sodium bicarbonate used as an abrasive. During the procedure, a jet of water, air and baking soda acts on the surface of the tooth enamel under high pressure, which are mixed closer to the end of the apparatus. The working part of the device is installed in a special connector, and water mixed with soda is ejected under high pressure, cleaning the enamel surface from any, even the hardest plaque, in seconds.

The released jet easily penetrates into the most inaccessible places. With its help, you can clean the area above the gum and under various artificial structures, the gaps between the teeth. In just 30-40 minutes, the enamel will acquire its natural natural color.

Air-Flow technology has one big drawback - does not clean teeth. In addition, prolonged exposure to the jet on one area can lead to increased sensitivity after the procedure.

Chemical bleaching

The procedure for restoring the whiteness of enamel with the help of chemicals involves the use of special gels, which include highly concentrated hydrogen peroxide. The gels can be used alone or as an aid in photobleaching and laser cleaning.

Due to the high concentration of hydrogen peroxide, the dental chemical procedure has a good whitening effect. In one visit, you can achieve a pronounced whiteness of tooth enamel. You can bleach it immediately for 5-7 tones.

The disadvantage of chemical bleaching is the damage done to the enamel. It is restored by fluoridation and remineralization of teeth.

The use of chemicals requires consultation with a dentist and preliminary preparation. It is not recommended to carry out the procedure in the presence of various artificial restorations.

Photobleaching

This whitening method involves the use of a special lamp, which serves as a catalyst, and gels with active ingredients. Under the influence of a lamp, oxygen is released from the gel, which breaks down the pigments in the enamel. As a result, the teeth are brightened.

Stages of the procedure:

With the yellowness of the teeth, photobleaching copes perfectly, and gray plaque almost does not remove. In some cases, after the procedure, there is an increased sensitivity of the teeth. In this case, the dentist prescribes the use of remineralizing pastes.

Home teeth whitening

At home, you can use both mechanical and chemical means of lightening tooth enamel.

To dental home whitening methods relate:

Contraindications for dental whitening

No matter how much you want, but not everyone can whiten tooth enamel with the help of dental procedures. Teeth whitening contraindicated in the following cases:

increased sensitivity of the teeth;
allergic reactions;
gum disease;
exposure of the roots of the teeth;
caries;
rapid abrasion of the dentition;
wearing braces;
pregnancy and lactation;
children under 14 years of age.

The obvious advantage of whitening is getting a quick aesthetic result like a white smile. The disadvantages of the procedure include the possibility of increased sensitivity of the teeth and thinning of the enamel. In addition, in order to maintain the whiteness of teeth after dental whitening, it is not recommended to smoke, drink coffee, tea and red wine, or use coloring products. Not every patient will decide on such restrictions. Therefore, those who want to have white teeth should first weigh the pros and cons, and only then choose the best dental whitening for themselves.

Update: December 2018

Everyone wants to have a beautiful snow-white smile, and many at least sometimes thought about how to whiten their teeth without visiting a dentist, but using various methods and devices at home. It is quite difficult to say unequivocally which is the best way to whiten hard tissues, as it depends on many factors.

At different times, there were completely different ideas about the fashion and beauty of a smile: white, yellow, brown and even black were preferred.

At the beginning of the 19th century in Europe, many wealthy people tried to give their teeth a yellow tint, as against their background the face looked whiter, which was a sign of aristocracy.
Residents of some African tribes, as well as individual cities in India, Japan, and Europe, considered black teeth to be the most attractive. Women rubbed their teeth with charcoal, or applied a banana peel to them, which darkened in the air and, after drying, firmly adhered to the enamel.
Toward the end of the 18th century, a fashion arose to decorate teeth with gold crowns. And if now crowns are installed, if the tooth is destroyed, then even healthy tissues were specially turned, since gold plating served as a sign of wealth.
In India, as well as in Russia, brown teeth were an indicator of high social status. The reason for this shade was the usual caries. People believed that if a person's teeth are destroyed, it means that he is not starving, and he has money for sugar, which in those days was considered a luxury.
In the thirties of the twentieth century, the first thin overlay on enamel appeared - veneer. They made my teeth look straight and white. It was in those days that the phrase "Hollywood smile" arose.

How to whiten your teeth yourself?

There are many different ways to remove pigmentation from enamel: you can brush your teeth with whitening pastes, use special pencils, caps and strips, and also use the advice of traditional medicine.

Whitening pastes

In fact, the name of such funds is not entirely correct, since it does not reflect the essence of their action, but rather misleads customers and is a marketing ploy designed to increase sales. No toothpaste can whiten enamel! It would be more correct to say that the pastes only slightly lighten it.

According to the principle of action, whitening pastes can be divided into two groups:

Pastes containing highly abrasive components

Due to the content of large abrasives, mechanical cleaning of the teeth from plaque occurs, due to which they acquire their natural color, altered by the use of coloring products, as well as soft and mineralized deposits. In order to understand what kind of paste is in front of you, you need to read the composition. If an RDA index of more than 80-100 units is indicated there, then this is a highly abrasive agent. In order not to harm hard tissues, such pastes cannot be used regularly, as large particles can damage the enamel and cause it to thin.

The most popular pastes are: ROCS Sensation Whitening, President White Plus, Lacalut White, Blend-a-med 3D White, Crest 3D White, Rembrandt Antitobacco and Coffee.

Products with carbamide peroxide

Such funds should not be used for more than four weeks in a row, as this can lead to hypersensitivity and damage to the enamel structure:

Splat Extreme whitening- contains peroxide, as well as the enzyme papain, which promotes the breakdown of deposits. Silicon dioxide is included as an abrasive. To strengthen the enamel and prevent caries, fluoride is present at a concentration of 500 ppm. The cost is about 250 rubles;
ROCS oxygen bleaching- in addition to carbamide peroxide, it contains a highly abrasive component of calcium glycerophosphate. Fluorine is absent. The cost is over 300 rubles;
Rembrandt plus - contains carbamide peroxide, as well as a patented Citroxine complex, consisting of enzymes and abrasives. The concentration of monofluorophosphate is 1160 ppm. The price is about 500 rubles.

Whitening strips

Teeth whitening strips are rectangular cuts of a transparent adhesive tape, on one side of which a special active gel is applied. Upon contact with the surface of the enamel, it begins the action. As a result, free oxygen atoms are released, which “push out” the coloring matter from the structure of hard tissues.

Each strip is covered with a protective strip, which must be removed before use, and packed in an individual bag. It can only be used once.

The main difference from professional procedure to eliminate discoloration is a very low concentration active substance- carbamide peroxide. Manufacturers do this so that their potential buyers do not harm themselves. The fact is that with careless handling of this active compound, side effects: there will be chemical stomatitis on the mucous membrane oral cavity, or if the time of wearing the strips is exceeded - damage to the enamel structure, which is accompanied by its thinning and hyperesthesia.

If the strips have been certified and also purchased from a reliable store, then they can be used to carry out safe home whitening:

Before the procedure, you should thoroughly brush your teeth.
Remove the strip from the packaging, tear off the protective tape and stick to the vestibular surface of the teeth.
Wrap the free edge of the strip inward, bending around the cutting edge of the incisors and canines.
After the manufacturer's recommended wearing time has elapsed, carefully remove the strip.
Rinse your mouth with clean water.
If necessary, the procedure can be repeated no earlier than a day later.

Advantages of the procedure:

you can change the shade by 2-3 tones without a visit to the dental clinic;
safe for enamel, provided that certified products are used;
ease of use;
reliable gluing in the surface of the teeth ensures their uniform clarification;
the result appears after 2-3 sessions;
cheaper way compared to office procedures.

Among the shortcomings, one can single out the fact that it will not be possible to obtain particularly noticeable results, however, it is quite possible to refresh a smile and give it a natural shade with the help of strips.

The most famous are the stripes:


Crest 3D White Whitestrips the cost of which for a pack of 28 pieces is about 2000 Russian rubles.	dr. White Premium is a set of 28 strips for two weeks of use. The price is about 1500 rubles. for packaging; dr. White Intensive - an intensive course, costing 2100 rubles;	Bright White Crestal is a gentle lightening system that is suitable even for people with hypersensitivity. Price - from 1000 rubles, depending on the number of strips in the package;

Bright Light Professional Effects is a classic 14 day system. Price from 1500 rubles;	Rembrandt are unique stick-on strips that do not need to be removed after use, as they dissolve on their own. The cost per package is about 2000 rubles.	Extreme White Crestal - allow you to achieve quick results. To avoid negative consequences, you can not keep on your teeth for more than five minutes. Price - 1230 rubles;

Whitening pencils

Another option for home use is a teeth whitening pencil. The product is a small tube with a brush on one end and a rotating body on the other. When it is turned, a small amount of active substance appears on the tip of the pencil, which must be applied to the teeth. A cap is included to prevent drying out and also to protect against contamination.

Before each procedure, it is necessary to brush the teeth with paste, and also floss the interdental areas. After rinsing the mouth with water, smile broadly and apply the gel to the front surface of the teeth in the smile line. After 30-60 seconds, the product must be washed off and for an hour avoid eating food and any drinks other than water.

It is necessary to use such a remedy in a course for two weeks, two or three times a day, depending on the instructions in the instructions. In the first days, a slight hypersensitivity may develop, but it quickly disappears.

Advantages of the method:

convenience and ease of use;
the speed of the procedure;
safety for enamel, subject to the use of products of well-known companies in compliance with the instructions;
cheap way to whiten teeth.

Disadvantages:

whitening occurs only a couple of tones;
with inaccurate application, contact with mucous membranes is possible;
may cause allergies;
possible increase in sensitivity.

Global White 400 rubles	Bliq 1700 rubles	Luxury White Pro 1800 rubles	Teeth Whitening Pen 400 rubles

Pencils cannot be a full-fledged replacement for an office procedure. Moreover, with their frequent and uncontrolled use, enamel can be destroyed. Teeth stain removal pencils can be used as a additional method maintaining the result obtained after professional whitening, but not more often than one course every six months.

Standard whitening trays

A home teeth whitening kit consists of a cap and a syringe with an active gel, or the substance is already initially applied to the inner surface of the product. Using it is very simple: you need to brush your teeth, distribute a small amount of the active substance in a thin layer over a standard cap and put it on the dentition. After time will pass, specified in the instructions, the product must be carefully removed and rinsed with water.

This method has several downsides.

Since the mouthguards are produced factory-made according to the average size of the jaws, they will often not be very comfortable: somewhere it will press a little, but somewhere, on the contrary, there will be free space through which the gel can flow into the oral cavity.
Standard mouthguards are extremely inconvenient to use for night whitening, since they need to be in them from 6 to 8 hours.
Contact with a concentrated substance on the mucous membranes can cause burns.
To get a visible result, you will have to wear mouthguards daily for several hours for 14-21 days.
Wearing during the day makes speech difficult, so it is necessary to choose a convenient time when a person can devote time to the procedure.

Advantages of the technique:

even distribution of the gel for home whitening in the mouthguard ensures teeth whitening from all sides;
no need to keep the mouth open for a long time, as with professional whitening;
if discomfort occurs, the mouth guard can be easily removed and rinsed with water;
low cost compared to office procedures.

In addition to classic plastic caps, thermoplastic caps are also produced. They are not individual, however, due to the use of modern materials, there is less discomfort during their use. Before first use, dip the product in hot water and then fix on the teeth. As it cools, the material will take the shape of your dentition. This method provides a secure fit to the enamel and protects against gel leakage. The representative of thermoplastic caps is Treswhite Opalescence (photo11), the cost of the set is 4500 - 5000 Russian rubles. The included gel contains 10% hydrogen peroxide.

Folk methods

There are many different whitening methods on the Internet. folk remedies. Reading them, one can only be surprised at what people are able to come up with in the hope of getting a snow-white smile, just not to go to dentists and not spend money on it.

It should be understood that any exposure to aggressive substances: acids, large abrasives, various medications - all this is more likely to do more harm than help to brighten teeth.

Teeth whitening with activated charcoal. As folk "craftsmen" advise, it is necessary to crush the tablet into powder, then apply it to the brush and brush your teeth. This method works on the principle of mechanical cleaning with a highly abrasive substance. Charcoal removes plaque, and the enamel becomes a natural color. However, this technique can greatly harm hard tissues, as large particles of coal scratch the enamel, which leads to its thinning.
Teeth whitening with baking soda. A prepared slurry of sodium bicarbonate and lemon juice or hydrogen peroxide is used as toothpaste. This is very harmful way, since it is not possible to accurately dose the peroxide compound on its own, and its excessive concentration has a destructive effect on the enamel. Aggravates the negative impact of soda, which, like activated charcoal, damages teeth.
Cleansing with citric acid. Such home recipe bleaching is one of the most aggressive, since hard tissues are destroyed under the influence of acid. Even a short, but regularly repeated exposure to lemon provokes the development of acid erosion or necrosis, which not only worsens appearance smiles, as brown depressions appear on the teeth, but also leads to increased sensitivity.
Removal of pigments with tea tree oil. This substance is widely used in cosmetology, as well as medicine, as it has anti-inflammatory and antibacterial action. However, there is no scientific evidence that tea tree oil has any whitening effect. Its use will not bring harm, however, the teeth will not become whiter from this either. But the oil will perfectly cope with increased bleeding and inflammation of the gums, as well as disinfection of the oral cavity.
Salt. If you use salt as a tooth powder, then this will lead to the formation of microdamages on the surface, and rinsing does not have any effect on the enamel, so the method can be considered ineffective.
Rinsing with peroxide. The technique really helps to make a smile whiter, since it is this compound that is part of special preparations for professional whitening. However, you should not take risks, as exceeding the permissible concentration can damage the enamel.
Vinegar. The principle of action of vinegar is the same as that of lemon juice. By its nature, it is an acid, therefore it can also cause erosion and necrosis of hard tissues.
Banana peel. Many people advise wiping your teeth with the inside of a banana skin and claim that this will freshen up your smile and make it whiter. The method is absolutely safe, simple, but also ineffective. The trace elements and useful substances contained in the peel are not capable of exerting a destructive effect on pigments.

These are the most popular folk ways teeth whitening. Some of them simply will not bring the expected result, while others (acid, soda, peroxide) can cause serious harm.

Professional whitening

There are two types of professional teeth whitening: office whitening, which is performed only by a doctor in a dental chair, and home whitening. For its implementation, individual caps are made, after which the patient independently carries out the procedures at home.

Office whitening

Procedures that are performed by a doctor in a dental office are called office procedures. There are several varieties:

chemical;
laser;
photobleaching.

Chemical bleaching

The essence of this technology is as follows: upon contact with saliva and enamel, a chemical reaction occurs, as a result of which oxygen is released. It is he who "pushes" pigmentation from the structural elements of the enamel, due to which the smile becomes white.

For clarification, a highly concentrated gel containing 35% carbamide peroxide is used. In many systems, the gel is initially in an inactive phase, and to start the reaction, the contents of two syringes must be mixed by attaching them to each other, pressing the plunger several times to thoroughly mix the gels. Opalescence Boost has such a mechanism. There are also kits where the container with active substances consists of two compartments, when the piston is pressed, the two solutions are uniformly supplied and automatically mixed in the cannula nose.

Manufacturers specifically produce the gel in this form, since after activation the composition remains active for only a short time. Average term the safety of the activated connection is 10 days.

Professional teeth whitening kits include the following products:

concentrated gel based on carbamide peroxide;
liquid rubber dam - a special substance that is applied to the gum in the cervical region to protect it from accidental gel ingress;
remineralizing agent - the drug contains calcium or fluorine compounds, which strengthen the enamel and reduce possible hypersensitivity after the procedures.

Before starting the procedure, the dentist conducts professional hygiene, after which he determines the initial tone of the enamel on the Vita scale. For convenience, a labial retractor is installed, which moves the cheeks away from the front surface of the dentition, and then a protective gel is applied to the gums and polymerized using an LED lamp. Pre-dried enamel with a brush is covered with a concentrated peroxide solution and it is evenly distributed over the surface. After the time specified in the instructions, the product is washed off and the results are evaluated. For ease of use, the gel has a bright shade, which allows you to control the uniformity of the coverage of the teeth.

According to the described scheme, external bleaching is carried out, however, there is also intracanal bleaching, which is used on depulped teeth, since the first method is ineffective for them.

With intracanal, as the name implies, the active gel is introduced into the tooth. To do this, a filling is drilled, the root canal is partially unsealed and closed with a bandage. The gel is injected into the cavity, and after the end of the procedure, it is closed with a temporary filling, since at least 2-3 sessions are usually required to obtain a good aesthetic result.

Advantages of chemical bleaching:

usually a couple of procedures are enough to make the smile noticeably whiter;
hard tissues are bleached, regardless of the reasons that led to the darkening;
the result is stored for up to 1.5-2 years, subject to the dental recommendations for nutrition and care;
lower cost in contrast to laser and photobleaching.

Disadvantages:

with inaccurate application of the gel and its contact with the mucous membranes, stomatitis of chemical etiology develops;
hyperesthesia may occur;
if the exposure time is exceeded, the gel has a damaging effect on the enamel;
in rare cases an allergy to the components of the drug develops;
loss of natural luster and the appearance of chalk spots.

The cost of the procedure for external whitening of one dentition is about 11,000 rubles when using the Opalescence Boost system. Intracanal exposure to pigments will cost about 900 rubles per unit.

Laser whitening

According to many dentists, effective teeth whitening without harm can be done with a laser. Since the technique is very expensive, it is carried out much less frequently than other methods of dealing with pigmentation.

Advantages:

high degree of efficiency;
when the gel is activated by a laser beam, there is no heating of hard tissues, so the process does not cause irritation of the pulp, as it can be with photobleaching;
the procedure takes less time;
absolute painlessness of manipulations, as there is no heating of tissues;
the laser has antibacterial properties, thanks to which it eliminates pathogenic microflora and has a preventive effect on hard tissues.

Disadvantages:

does not brighten fillings and crowns, so after the procedure they will have to be replaced;
hypersensitivity may occur;
when the permissible parameters are exceeded, the teeth acquire an unnaturally white shade;
high cost of the procedure.

Whitening with a laser is safer, because unlike photobleaching, here you can set individual parameters for the intensity of the diode beam, which makes the whole process controllable. Moreover, the laser beam has a directed effect, not a scattered one, that is, it affects only a certain area.

The cost of one session of laser whitening is from 25 thousand rubles, two or three procedures may be needed to achieve the desired effect.

Photobleaching

The peculiarity of the procedure is that after applying a special concentrated composition containing carbamide peroxide, diode or ultraviolet cure flows are directed to the teeth, which activate the preparation and promote the release of pigments from the structure of hard tissues.

Some interesting facts:

the beam leads to an increase in the temperature of the active substance, which allows it to split into atoms that penetrate deep into the enamel and “push out” the pigments;
the agent used for bleaching has a similar composition with the drug for the chemical elimination of discolorations;
to achieve the result, you will have to spend 1 - 1.5 hours in the chair at the dentist;
when carrying out manipulations, the eyes of the doctor and the patient must be protected by orange glasses that absorb harmful rays and prevent damage to the retina.

To date, the most popular system is Zoom (photo14), which already has 4 generations, and each of them is more perfect and efficient in comparison with its predecessors.

Advantages:

painlessness or slight discomfort during the procedure;
long-term preservation of results proper care behind the oral cavity;
the effect always occurs regardless of the causes of discoloration;
already in one session you can get visible results;
short recovery period;
safer way than chemical clarification.

Disadvantages:

hyperesthesia may appear;
when the gel gets on the gums, irritation occurs;
if the work technique is violated, the enamel becomes dull white.

Cost of the procedure Zoom system 3 starts from 10,000 rubles, and Zoom 4 starts from 12,000.

The Beyond system (photo15) is another type of system for dealing with discolorations. It is also called "cold" because the blue light does not heat the dentin. Its principle of operation is exactly the same as that of Zoom, but the main difference lies in the type of rays: it does not have ultraviolet radiation, which is safer, but gives less pronounced clinical results.

The cost is from 13,000 rubles.

Home whitening

If there is a desire to get a snow-white smile, but you do not want an aggressive effect on the enamel, then a home whitening system, selected individually, is a good alternative to office procedures.

You can’t do without a visit to the dentist, as the doctor evaluates the initial state of hard tissues, on the basis of which he selects the necessary concentration of the gel. The faster the result is needed, the higher the peroxide content in the solution. Teeth whitening occurs with trays, which are made individually according to casts of the jaws.

Advantages of this method:

perfect fit of the structure to the teeth, which prevents the active composition from leaking and soft tissue burns;
no or minimal discomfort during procedures;
the ability to independently choose a convenient time when to wear them;
uniform distribution of the gel over the surface;
lightening occurs gently and gradually;
you can control the process and, if necessary, remove the product.

Disadvantages:

the shelf life of the results is shorter than with photobleaching;
an allergy to the composition may occur;
a more expensive way than using ready-made trays for teeth whitening.

The use of custom-made mouthguards is the most best method home whitening, as the anatomical features of the patient's teeth are taken into account.

Systems are produced by Zoom (Day White or Nite White) (photo16) and Opalescence. The concentration in "night whitening" is always lower (16%), since continuous wear is required for 6-8 hours every day for a minimum of 14 days, however this is a more gentle method than the aggressive treatment with 35% carbamide peroxide, in which the result appears after the completion of the first procedure.

The cost of a set of Nite White and Day White is 6 thousand rubles.

Opalescence Oh (photo 17) for home use contains disposable gel capsules at a concentration of 10%, 15%, 20% or 35%. The drug is supported depending on the condition of the enamel and the preferences of the patient. The cost of such a set is 7,500-8,000 rubles, excluding the price for dental services and the manufacture of an individual mouthguard.

Cosmetic whitening

Separately, it is necessary to mention the so-called cosmetic teeth whitening. Many argue that this method goes completely without harm to the teeth, since it does not contain hydrogen peroxide, but there is carbamide peroxide. Such statements are designed for a person without elementary knowledge of chemistry.

In fact, carbamide peroxide is a combination of hydrogen peroxide with urea, i.e. the same substances are used as for professional clarification. The only difference is only in the percentage of carbamide peroxide.

Causes of tooth discoloration

All existing types of discolorations can be divided into three large groups:

Outdoor discolorations. Occur due to the contact of tooth enamel with various dyes coming from food or drinks.
Age changes. These are combined changes due to the fact that with age the dentin acquires a brownish-yellow tint, and the use of foods containing dyes leads to the fact that the enamel also changes its shade.
Internal changes. Under the influence of various factors, darkening of the dentin can occur, which also worsens the aesthetics of the tooth:
- congenital pathology of hard tissues. This can be as a violation of the development of enamel (imperfect amelogenesis, hypoplasia or aplasia), dentin (imperfect dentinogenesis), as well as all dental structures (imperfect odontogenesis);
- insufficient intake of calcium and phosphorus during the laying of the rudiments of permanent teeth, as well as during their mineralization;
- taken by a woman during pregnancy antibacterial drugs tetracycline series;
- excessive intake of fluoride in the body (fluorosis);
- inflammation on the root of a milk tooth, which led to a violation of the formation of the germ of a permanent one;
- trauma to the tooth, accompanied by hemorrhage in the cavity;
- damage and death of the pulp;
- endodontic treatment, especially with the use of resorcinol-formaldehyde paste.

A tooth can acquire different shades, which is due to many reasons.

Color	Causes
Red	It occurs with a hereditary disease - porphyria, which is characterized by the appearance of red pigmentation on soft tissues, as well as on the teeth. Another cause of reddening of hard tissues is a traumatic rupture of the pulp with hemorrhage.
Pink	Often indicates that endodontic treatment with the resorcinol-formalin method was previously performed.
Gray	Installed metal anchor without insulation with special materials; long-term pulpless tooth; poisoning with lead or other salts of heavy metals; previously installed amalgam filling; early tetracycline treatment childhood.
Brown	Smoking; drinking coffee and black tea in large quantities; prolonged exposure to iodine preparations on the body; acid necrosis of enamel; with Rhesus conflict, when there is an increased destruction of red blood cells.
Yellow	Age changes; increased abrasion of enamel; long-term use of certain antibacterial drugs; smoking; abuse of sugar-containing products; diseases of the adrenal glands; Addison's disease; jaundice.
Cyan (blue)	Pulp damage (infection, trauma, necrosis); excessive intake of iron in the body; installation of metal pin structures; hyperthyroidism.

Contraindications

Procedures to eliminate pigmentation on the teeth, like any other dental procedures, have their own indications, as well as conditions when it is better to refuse them.

Enamel bleaching is prohibited in the following situations:

age under 18 due to insufficient maturity of hard tissues and incompleteness of mineralization processes;
a previously identified allergic reaction to one of the constituent components: carbamide peroxide, ultraviolet rays or additional ingredients of the active gel;
period of pregnancy and breastfeeding due to the fact that at this time a large amount of calcium, which is necessary for building the child's skeleton, leaves the woman's body;
areas of damaged enamel: cracks, chips;
wedge-shaped defects in the cervical region;
hyperesthesia;
unfilled carious defects or the presence of foci of demineralization. Through weakened enamel, aggressive substances of bleaching systems can penetrate into the pulp chamber, causing irritation of the dental nerve, so it is recommended to cure caries before the procedure;
cancerous diseases;
the period of chemotherapy and radiation, as well as rehabilitation after oncology;
psycho-neurological disorders, since it is impossible to predict how the patient will behave, and whether his actions on medical manipulations will be adequate;
epileptic seizures;
pronounced photosensitivity;
use medicines which enhance the body's response to ultraviolet radiation.

How to save the result

During the first days after bleaching, dental tissues are vulnerable, since their structural elements of the crystal lattice are open and not protected from the negative effects of the environment in the oral cavity. Therefore, the best way to maintain the achieved changes is a "white" diet for 14 days after the procedure. This means that for this period it is necessary to exclude all foods and drinks that can stain the enamel and dentin. Be sure to give up black tea and coffee, cigarettes, red wine and other dark-colored drinks. Blueberries, strawberries, beets, chocolate, many sauces and ketchup are banned. Ideally, in order to keep your smile fresh and white for as long as possible, the listed products should be consumed as little as possible.

Another prerequisite is regular professional cleaning – at least twice a year. Plaque builds up on teeth no matter how thoroughly they are brushed and toothpasteed every day. Over time, these deposits accumulate pigments, minerals and become hard, which leads not only to a change in the shade of the teeth, but also provokes caries, as well as gum disease.

As dentists advise, you should not whiten your teeth too often, so as not to damage its structure. It is optimal to perform such a procedure no more than once every two years. However, the result achieved cannot be maintained for a long time, therefore, to give a radiance and a fresher look to the smile, you can use whitening strips or whitening toothpaste with a low concentration of hydrogen peroxide.

Consequences of unsuccessful whitening

If the procedure was performed in the presence of contraindications to it, as well as in case of non-compliance with the rules for its implementation, negative consequences may occur, which will be quite difficult to eliminate, and sometimes impossible.

The effect of "re-whitened" teeth. With an increase in time or frequency of execution, the enamel loses its natural radiance and becomes chalky-matte. Such a sign indicates the beginning of demineralization processes in the hard tissues of the tooth, which will require a course of treatment with the use of calcium and fluoride preparations.
Hyperesthesia. A person develops excessive sensitivity to various stimuli of a chemical (sour, sweet) or physical (hot, cold) nature. To get rid of it, remineralizing therapy will be required, as well as the use of desensitizers - products that seal the dentinal tubules and prevent the irritant from affecting the fluid in them and transmitting a signal to the pulp chamber.
Gingivitis and stomatitis. The inflammatory process in the gums develops when a highly concentrated gel gets on soft tissues which causes chemical burns. To reduce the severity of discomfort, it is necessary to abandon foods that can cause irritation, such as salty, sour or spicy. On the recommendation of a doctor, local painkillers and anti-inflammatory drugs can be used. To accelerate the healing of ulcers, keratoplasty is used - sea buckthorn oil, an oil solution of vitamins A, E. Solcoseryl dental paste has also proven its effectiveness.
Pulpitis. If the doctor agrees to the patient's persuasion, first to whiten the teeth, and only then to cure caries, this leads to irritation of the pulp. The patient explains his request by the fact that carbamide peroxide does not affect the fillings, so after the procedure they will still have to be replaced due to a color mismatch. In fact, a competent dentist can prepare cavities and close them with temporary fillings, and after all the procedures to eliminate discoloration, perform a permanent restoration.

A person must always remember that dental health is much more important than the desire to have a snow-white smile. And if for some reason this cannot be achieved, then it is better not to take risks, but to leave everything as it is.

Prevention

If it is quite difficult to prevent congenital discolorations, then it is quite easy to avoid external staining of hard tissues of teeth. To do this, you must follow the recommendations of dentists.

Brush and brush your teeth twice a day: morning and evening. This will prevent soft plaque from accumulating on the teeth, and its timely removal does not allow pigments to penetrate deep into the structure.
Perform professional oral hygiene at least once every six months.
Limit the use of foods that contribute to the staining of enamel and dentin.
Give up smoking.
After eating, rinse your mouth with water to remove food particles and prevent dyes from penetrating into hard tissues.
Contact your dentist in time to treat caries, as its complications, accompanied by the death of the pulp, often give internal staining, which is much more difficult to get rid of.
Pay attention to the intake of fluoride, especially in childhood, as its excess can lead to fluorosis.

Common Questions

Question:
How often can teeth be whitened?

Unfortunately, bleaching cannot permanently change the shade of enamel. The use of foods rich in dyes (beets, blueberries, strawberries, carrots, chocolate, etc.) invariably leads to the fact that the teeth begin to darken. It is recommended to repeat the procedure for clarification no more than once every 1.5 - 2 years, however, this is determined only by the dentist based on the following factors:

patient's age;
the condition of the enamel and its thickness;
natural shade of teeth;
previous procedure.

When deciding on such a procedure, the patient must understand that in order to maintain the result, he will have to radically change his taste preferences, and also pay special attention to the health of the oral cavity.

Question:
At what age is whitening allowed?

According to average data, exposure to peroxide compounds on enamel is not carried out until the patient reaches the age of majority. In some cases, teeth are whitened even at the age of 16, but this is decided on an individual basis and only by a dentist, depending on the condition of the enamel. If, according to its characteristics, it resembles “adult” enamel, then the procedure can be carried out without waiting for the age of eighteen.

Even though it's not Thursday, I'm going to break with tradition a little bit by not having any dental information from me for a week now. Today we will talk about beauty again.

Without pretending to be absolute truth (don't forget that I'm still a doctor of a slightly different specialty), today I will tell you about teeth whitening. The topic is relevant, mainly for the fair sex, but recently, quite often, men who are not indifferent to how they look have turned to this method of “beautifying”.

An impeccable appearance contributes to self-confidence, confidence inspires the trust of others, trust, in turn, helps to successfully conduct business - probably no one will argue with this. That is why aesthetic dentistry, which includes teeth whitening, is growing both qualitatively and quantitatively.

There is no advertising in this article, from it you will not recognize the names of clinics, the names of doctors or brands of whitening preparations - this would be highly incorrect. But still I will try to provide you complete information about teeth whitening and even show some examples of such work.

What are the methods of teeth whitening?

With all the variety of whitening systems, they can be conditionally divided into two groups:

Rapid whitening systems (also called office or clinical)

Slow whitening systems (so-called home systems)

Therapeutic and orthopedic methods for correcting the color of teeth - veneers, inlays, crowns and semi-crowns, which we talked about in the last article, as well as restoration of teeth with filling materials, stand apart. We will not consider them.

I will not burden you with the chemical and physical aspects of the effect of whitening compounds on tooth enamel, I will only say briefly - any whitening gel contains a strong oxidizing agent (usually atomic oxygen in bound form), which, interacting with pigments, oxidizes them to colorless compounds . ALL teeth whitening methods are based on this principle. The difference between them is only in the rate of release of the oxidizing agent and its quantity - hence the division into groups.

What is important to know about whitening and what dentists are sometimes silent about

Any whitening systems are harmful to teeth. No matter what dentists and manufacturers of whitening systems claim. Another issue is that the damage done to the teeth varies with different whitening methods.

Rapid discoloration of teeth requires a high concentration of oxidizing agent. Therefore, all office whitening systems are quite aggressive and most harmful to teeth. A change in the shade of the teeth by two or three tones in a few hours suggests a serious intervention in the structure of the enamel - and this does not go away without a trace.

When using home bleaching systems, the color change takes a long time, within 1.5-2 months, since they have a low content of oxidizing agent. In addition, although there is a long, but small effect, the tissues adjacent to the enamel have time to “tune in” to its new structure and give a minimum of adverse reactions.

After any type of whitening, the enamel permeability is significantly increased (this is just the answer to those who claim that whitening is harmless), so the teeth actively absorb any dyes (from products, cosmetics, etc.) and react quite painfully to any irritants. Therefore, after the teeth have whitened, they must be re-saturated with calcium and fluorine.

"Laser" or "Plasma" whitening is just a publicity stunt, nothing more. In some office whitening systems, bright light (ordinary LEDs) is really used, it is needed to activate the whitening gel (similar to how fillings “light up”). No lasers and, especially, plasmas are used here.

Teeth whitening and professional oral hygiene (including the use of AirFlow "sandblasting") are completely different procedures. Sometimes in some advertisements you can see this - "professional teeth whitening Air-Flow!", And the word Air-Flow is spelled with two errors. You just need to run away from such clinics.

Smoking and coffee are the two things that ruin the color of your teeth the most. If you want to get a lasting effect from whitening, you must, as far as possible, abandon these bad habits. Moreover, smoking does not decorate anyone at all. Even a girl with dazzling white teeth.

Before changing the color of the teeth ...

... it is necessary to bring the oral cavity into relative order.

All teeth that need to be treated must be cured and covered with temporary fillings. EXACTLY TEMPORARY, and not permanent highly artistic restorations, because after bleaching the color of the teeth will change, and the fillings will remain the same and become noticeable against the background of whitened teeth. Permanent restorations are best done after you have achieved your desired tooth color.

Those teeth that require extraction must be removed.

If it is planned to prosthetic teeth with crowns, then it is best to close the prepared teeth with temporary plastic crowns, and postpone the manufacture of permanent prostheses for the time being. For the same reason as with fillings.

Before whitening, it is necessary to undergo a professional oral hygiene procedure - to remove soft and hard plaque (this is done with the help of AirFlow and other special tools). It would also be nice to learn from Dr. proper hygiene oral cavity, conduct a controlled brushing of the teeth (with a special plaque indicator).

Most importantly, any bleaching, whatever it may be (fast or slow), should be carried out under the supervision of a specialist doctor. The bleaching system must be known, standardized and certified - in no case is it allowed to use self-made and folk-Malakhov compositions. Otherwise, there is a chance to simply remain without teeth. And, without all at once.

Changing color...

It is important to know that the faster the discoloration of the teeth goes, the more harmful it is. The record holder for harmfulness are office bleaching systems.

Home teeth whitening is the best choice for most cases. Firstly, due to the low concentration of the oxidizing agent, it is much less harmful than any other. Secondly, it allows you to more clearly and accurately control the shades of the teeth, preventing them from “overexposure” - when the teeth become lighter than necessary (this is important, for example, if the teeth have an uneven color along the crown, there are age spots, and the teeth themselves are of different colors ). Thirdly, it causes a minimum of discomfort - during the bleaching period, the tissues adjacent to the enamel have time to adapt to its new structure, so such pain due to increased sensitivity of the teeth is minimized.

Let's take a closer look at how it works

Before the procedure, it is necessary to make a special mouthguard for the whitening gel. To do this, the doctor takes impressions and sends them to the dental laboratory, where the technician casts models on them and makes a transparent tray. This thing is also convenient because, in the future, the kappa can be used repeatedly, including for fluoridation of teeth.
This is how the casts and mouth guards made from them on the upper and lower jaw:

After the mouthguard is made, it is tried on and corrected. The doctor teaches the patient the rules of hygiene, diet, the use of a mouth guard, and also gives the required amount of whitening gel (as a rule, it is packaged either in syringes or in tubes according to the number of doses).

The patient wears a mouthguard with a whitening composition for several hours once or twice a day, observes oral hygiene and follows all the doctor's recommendations. In particular, at the time of bleaching, it is necessary to give up colored fruits and vegetables, juices, coffee, carbonated drinks, and smoking. Also, you can not use lipstick, especially men))).

A gradual change in the color of the teeth occurs within one and a half to two months. Since the shade changes slowly, the patient himself has the right to stop the procedure at any stage, when he considers that the desired result has already been achieved. This is the undoubted advantage of slow bleaching systems.

After the whitening is over, you need to contact your doctor for remineralizing therapy. As I wrote above, with any whitening, tooth enamel invariably changes its structure, so the teeth become sensitive to various external stimuli. This is what needs to be treated.

The mouthguard made earlier helps here very well. It is filled with a special remineralizing solution containing calcium and fluorine ions, dressed and worn for some time. Gradually, procedure after procedure, everything returns to normal.

For example, I will show you some before and after photos. This is a small part of the archive of our hygienists who have vast experience in teeth whitening. By the way, almost the entire female staff of our clinic went through this procedure, so we can say with full confidence: “Tested on myself!”.

Case one. A very sweet and beautiful girl, 21 years old, is finishing her oral cavity sanitation in our clinic and finally decided to make her teeth even more beautiful. On the left is the original version. On the right - two months after the application of the home whitening system:

Notice the dates in the corner of the photo. Just two weeks - and we get such a result.

Second case. This is one of our doctors. I have already said that almost all of our girls have experienced the home whitening system on themselves. On the left is the "before" photo, on the right is the "after".

Case three. And sometimes men also resort to bleaching. Here is the result of such work (unfortunately, there is no "before" photo):

Case three.
White teeth look beautiful at any age. The main thing is not to overdo it - it is very important that they look natural:

But what if only one tooth has an abnormal color, and all the other teeth have a normal shade?

Times of mass abuse of resorcinol-formalin dental treatment have left an entire generation of people with unnaturally pink teeth. Worst of all, if a lazy dentist thus “cured” the frontal group of teeth, forever repelling the patient’s desire to smile. Most often, such teeth are not subject to retreatment, due to their fragility.

How can the color of such teeth be corrected? Very easy, in fact.

First, the old filling is removed, a whitening compound (very similar to the one used in home whitening) is placed in the resulting cavity, the tooth is closed with a temporary filling and remains in this state for some time. Periodically, the gel is updated until the desired shade is obtained. The tooth is then covered with a permanent filling.

Thus, gradually we get beautiful teeth of the same color.

There are many options for using a whitening gel, and it can be used (in reasonable amounts) almost always when tooth color correction is required. Most of them manage to achieve the desired shades. In the case when the color of the tooth cannot be restored, it is possible to use veneers, crowns and semi-crowns, which we talked about earlier.

Conclusion…

Beauty requires sacrifice... Our task as doctors is to reduce these sacrifices to a minimum. In the end, shoes with high and super high heels are also not very useful, but many women (and men too) cannot imagine their lives without stilettos. Therefore, I can give only one advice - contact reliable, trusted specialists in well-known clinics. And consider what you now know about teeth whitening.

I wish you great health.

Sincerely, Stanislav Vasiliev.