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What to expect during your bleaching treatment

Your dentist has given you a bleaching kit to take home with you together with your
bleaching trays. It is essential that you follow the instructions given to you by your
dentist and the manufacturer’s instructions in wearing the trays and applying the
bleaching agent.
How long should I wear the trays for?

This depends on the amount of lightening that you desire and the original shade of your
teeth. If your teeth are quite dark or very yellow/grey/tetracycline stained it will take
longer to bleach the teeth. If you are not experiencing any sensitivity you may wear the
trays for 1-2 hours and even sleep with the trays in your mouth. It is very important to
remove all the excess material around the gums or the plate prior to sleeping with the
trays.
The darker the teeth the longer your teeth will take to get lighter. Tetracycline stained
teeth can take 6 months or up to one year to become whiter. Some teeth can whiten
after one month.
If you cannot wear the trays for a few days because of your hectic schedule, it does not
matter. Bleach your teeth according to you own schedule. Some people put the tray in
after dinner and wear them for the first hour while watching TV or doing the dishes; then
if everything is fine they replenish the trays and sleep with them in the mouth.
What do I do if I have any sensitivity?
Sensitivity of the teeth is the most common side effect of home bleaching. In fact many
patients suffer from sensitive teeth any way - this occurs usually around the necks of the
teeth where the gums have receded. If you are experiencing any sensitivity you should
stop bleaching your teeth for a few days. You can resume after about 3-4 days. If the
teeth become ultra sensitive you can place sensitive toothpaste into the bleaching trays
for an hour a day - that will usually stop the sensitivity. Alternatively you can rub the
sensitising toothpaste into the gum margins with your finger 5 times per day for a few
days. If you are concerned, please call your dentist.
What happens if the teeth do not bleach evenly?
If the teeth have white spots on them before bleaching, these spots will appear light
during the first few days; however the contrast between the spots and the rest of the
teeth will be less and eventually they will not be noticeable. Sometimes the dentist can
do a special procedure call Micro abrasion for you where the white spots can be more
permanently removed. Ask your dentist about the procedure if you are concerned about
this.
You may notice new white spots occurring on the teeth while you are undertaking the
bleaching treatment. These white spot were already present on the teeth before
bleaching. As the teeth become lighter they become more visible - do not worry as the
whole tooth itself becomes lighter these spots will fade. You may notice these white
spots immediately after a bleaching session or in the morning if you have been wearing
 www.newentdentalcare.co.uk  [email protected] the trays for the whole night.
Some teeth may appear banded with lighter/whiter areas. Again these bandings are
originally present on the tooth. As the tooth is dark these banding are not obvious; as
the tooth becomes lighter, the lighter parts of the tooth will lighten first followed by the
darker banded area. After a week or so these will not be noticeable any more.
How will my teeth feel?
Normally the teeth feel clean after the bleaching procedure. The bleaching materials
also have an indirect effect on the gums in helping them to heal or improving the health
of the gums. This is how the technique was invented as it was used to heal gum
irritation during orthodontic treatment.
What about my smile?
Your smile will appear brighter as a bonus. It is very rare but sometimes the teeth do not
lighten at all - if this happens and you are wearing the bleaching trays recommended,
you may need to try a different bleaching product of a slightly higher concentration of the
bleaching material. The dentist can do a few “power bleaching sessions” for you while
you relax in the chair. Discuss this with your dentist.
If you have white fillings in the front teeth that match the existing shade of your teeth
before you bleach your teeth, they may not match the teeth afterwards. This is because
your teeth can lighten, but the fillings do not lighten. When the desired colour has been
achieved, the dentist can replace these fillings with a lighter shade of filling material to
match the new shade of your teeth. Normally the dentist will wait a week before
changing the fillings.
How long does the bleaching last? Will I have to bleach my teeth again?
Normally the new white colour of your teeth keeps quite well. The effect is dependent on
what caused the teeth to discolour in the first place. If you drink lots of coffee, red wine,
cola drinks the effect may darken slightly. Some patients have a top up treatment after
3-4 years. Some patients do not need to.
The dentist will normally ask you to return your trays after the desired shade of lightening
has been achieved. This is to ensure that you do not over bleach your teeth.
Does bleaching harm the teeth or gums?
Safety studies have shown that bleaching teeth using the dentist prescribed home
bleaching technique is perfectly safe on the teeth, cheeks, gum and tissue of the mouth.
Bleaching the teeth with the dentist prescribed kits is equivalent to drinking one soda
drink. The bleaching material has a ph, which is neutral.
There are problems with the bleaching kits which are purchased over the counter.
Although they are inexpensive, they normally contain an acid rinse, which can damage
the teeth or thin down the enamel of the teeth. This acid rinse can be extremely harmful
to the teeth. There was a case where a patient purchased the kit over the counter, and
bleached their teeth. The teeth went darker and the patient continued over using the
 www.newentdentalcare.co.uk  [email protected] treatment - this was because the acid rinse had worn the enamel away and the darker shade was the dentine that was exposed. It is not however advisable to bleach your teeth if you smoke. It is best to stop smoking for at least 3 weeks before commencing the bleaching procedure. Smoking causes the teeth to darken anyway and the effects will be diminished. The technique of bleaching teeth is not for everybody. There are some situations where bleaching teeth is contraindicated such as where the front teeth are already crowned or where there are very large fillings on the front teeth or where the teeth are already excessively worn and there is no tooth surface loss. The most ideal situation is where there is not much wrong with the teeth except for the colour which has become more yellow with age.  www.newentdentalcare.co.uk  [email protected] 1. The active ingredient is Carbamide Peroxide in a glycerine base. If you know of any allergy or are aware of an adverse reaction to this ingredient, please do not proceed with this treatment. 2. As with any treatment there are benefits and risks. The benefit is that teeth can be whitened fairly quickly in a simple manner. The risk involves the continued use of the peroxide solution for an extended period of time. Research indicates that using peroxide to bleach teeth is safe. There is new research indicating the safety for use on the soft tissues (gingival, cheek, tongue, throat). The long-term effects are as yet unknown. Although the extent of the risk is unknown, acceptance means acceptance of risk. 3. The amount of whitening varies with the individual. Most patients achieve a change within the first 2-5 weeks. Try not to drink tea, coffee, red wine or eat berries or curries during or after treatment for at least 1 month. Please use the toothpaste supplied with the kit to clean your teeth during treatment. 4. It is advisable not to smoke during the course of bleaching treatment for at least 5. Sensitivity may result after a few days. This is usually slight and temporary. If this should occur refrain from using the bleaching treatment for 3-4 days. 6. Do not use bleaching treatment if you are pregnant. There have been no adverse reactions, but long-term clinical effects are unknown. 8. After the desired amount of tooth whitening has been achieved, you will be requested to return the bleaching trays to your dentist. It may be necessary to do a top up treatment in 18-24 months depending on the amount of staining. I have read the above information and agree to return for the examination in ………… days after treatment begins and at any time afterwards. I have read and received a copy of this information sheet I consent to treatment and assume the risks described above. I consent to photographs being taken. I understand that they may be used for documentation and for illustration of any treatment. Signed: ……………………………….Patient. Date: ………………………….  www.newentdentalcare.co.uk  [email protected] Quick Reference Sheet
Standard Home Whitening
Before Bed

1.
Brush your teeth thoroughly for 2 minutes with normal toothpaste. Prepare your tray by placing a little whitening gel into each of the reservoirs. Place the tray in the mouth and ensure that it is well seated. Remove excess bleaching material with a cotton wool roll or tissue. Dab the front teeth on the front and at the back with a tissue.
On Wakening
1.
Leave in open box to air dry during the day
Bleaching for Sensitive Teeth
1.
For one week before bleaching - apply Sensodyne toothpaste or fluoride gel in the bleaching tray every evening . This will de-sensitise the teeth before commencing bleaching treatment. If sensitivity should arise when bleaching, place Sensodyne or fluoride gel into the trays and sleep overnight with the tray in place. If the teeth are frequently sensitive when bleaching, alternate nights by placing Sensodyne or fluoride gel one night and the whitening material the next.
Source:
Dr Linda Greenwall BDS MGDS MSC MRD RCS FFGDP

Restorative Dentistry
5 Elm Terrace
Constantine Road
Hampstead
London
NW3 2LL
Tel (0207) 267 7070
Fax (0207) 267 0123
 www.newentdentalcare.co.uk  [email protected]

Source: http://www.newentdentalcare.co.uk/wp-content/uploads/2012/04/teeth_whitening.pdf

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