A Dentist’s Guide to Teeth Whitening in Singapore (2022)

We all appreciate a good smile – one with perfectly aligned pearly whites that look and function well. Vanity prevails for good reason, so we have put together this one-stop guide to help you understand how teeth whitening can help you achieve that million-dollar smile.

In this article, we compare the different teeth whitening options available in Singapore according to budget, their respective effectiveness, and when you should consider other cosmetic dentistry options instead.

What causes teeth stains?

Tooth discolouration takes place over time due to external and internal factors like our diet, ageing, and tooth injuries.

We broadly categorise the type of tooth discolouration according to the location of the stain:

Type of stain	What it is	Caused by
Extrinsic stain	Stains that occur on the outer surface of the tooth, or the enamel Extrinsic stains are very common as enamel is exposed to everything you consume and inhale	Certain food and drinks that contain staining agents e.g. coffee, tea, red wine Smoking
Intrinsic stain	Stains that occur in the inner layer of the tooth, or dentin Discolouration is more severe and can appear brown or greyish Harder to treat with conventional teeth whitening products as the stain particles are build up within the tooth	Certain medication e.g. antihistamines, antibiotics Injuries to the tooth Overexposure to fluoride Genetics Tooth decay Root canal treatment

Apart from the above, tooth discolouration can occur as a natural byproduct of ageing. As we age, enamel wears out and exposes dentin, which gets yellower with age. In addition, dentine (which is the yellower, inner part of the tooth) gets denser over time. This makes teeth appear more discoloured.

How does teeth whitening work?

To achieve whiter teeth, bleach agents – namely hydrogen peroxide and carbamide peroxide – are used to lighten the colour of your teeth. Our teeth are semi-permeable, which allows the bleaching agents to penetrate past the surface into the tooth enamel and break down chromogenic molecules that cause stains. Once broken down, the hydrogen peroxide and carbamide peroxide converts into water and oxygen molecules that are harmless to your body. This is how in-office teeth whitening treatments and take-home whitening kits usually work and is especially useful in removing intrinsic and extrinsic stains.

Whitening toothpaste, on the other hand, may contain components that gently remove stains on the surface of the teeth, or chemicals that help break down stains. However, its efficacy remains hotly debated – whitening toothpaste can only remove superficial stains and cannot lighten the shade of your teeth[1]. Results are also short-lived. Furthermore, some toothpastes can be abrasive and might damage tooth surface over time.

What are the teeth whitening options in Singapore?

There are three broad categories of teeth whitening options that you can consider.

Treatment	How it works	Pros	Cons
In-office Treatments	In-office treatments use a higher concentration of hydrogen peroxide for teeth whitening procedures. Your dentist may also use light while applying the whitening product in a bid to speed up and enhance the whitening process; however its clinical efficacy has yet to be proven[2].	Most effective out of all the teeth whitening options. Done safely by professional dentists. Quick results that are usually noticeable after one session, hence a great option for those with busier schedules. Longer-lasting results. Aesthetics catered to your skin tone, appearance and overall facial features.	Tend to be more expensive. Requires time spent in the dentist’s office. May experience temporary tooth sensitivity after treatment, but this does not indicate underlying tooth damage.
Take-home Kits	A take-home teeth whitening kit requires you to add a gel to a customised tray worn on your teeth for up to an hour a day, or as recommended by your dentist. Your dentist will first take teeth scans to make a soft gel-holding wearable similar to retainers. These are called teeth whitening trays. At home, you will apply a layer of gel (carbamide peroxide) in the tray and put them on, according to your dentist’s directions. The trays are customised to your teeth to ensure it is most comfortable for use.	Gradual results that can be adjusted according to your desired outcome. Done at the flexibility of your schedule. Can be easily purchased at the dental clinic. Aesthetics catered to your skin tone, appearance and overall facial features. Great for sensitive teeth as it is a gradual process.	Longer to achieve results (results can only be seen after 14-21 days of consecutive use) May be less cost-effective in the long run depending on your goals Troublesome as you will have to apply them on yourself Self-application means that you might get the whitening gel on your gums that might cause some discomfort
Over-the-counter Products	These include whitening strips, whitening toothpastes and whitening gels that can be easily purchased over-the-counter without a dentist’s supervision. Unlike products dispensed by dentists, over-the-counter products contain little to no carbamide peroxide. They can remove stains only to a certain degree, and do not work on intrinsic stains. In selecting your choice of over-the-counter product, you should also check the source of and ingredients in the product. Some products contain chlorine dioxide, the same chemical used to clean swimming pools. In Singapore, the Health Sciences Authority[3] cautions against the selling of OTC teeth whitening kits that contain more than 0.1% hydrogen peroxide.	Cheaper, easily accessible.	Not an effective solution for those looking for safe, long term teeth whitening Cannot treat every form of discolouration Improper use can lead to: Tooth sensitivity and gingival[4] irritation Stripping of tooth enamel Permanent teeth damage

Regardless of choice, regular visits to the dentist go a long way in maintaining healthy and clean teeth. This is why at Dental Designs, all four of our teeth whitening options under our WHITEN+ program start with a full dental scaling & polishing, followed by airflow prophyjet stain removal.

This allows us to remove existing surface stains on your teeth and whiten your teeth in a gentle, non-invasive manner. Removing existing surface stains and plaque before whitening is so important in ensuring that your whitening treatment has the most optimal effect.

Is teeth whitening safe?

Regardless of what teeth whitening procedure you opt for, we recommend that you consult a professional dentist who can guide you in making an informed decision.

In-office procedures executed by a qualified dentist are generally safe. Take-home whitening kits prescribed by your dentist would also be a safe option, as long as you follow your dentist’s directions.

However, you do want to be more cautious with whitening toothpaste, strips, and homemade bleaching agents – essentially OTC products that can be purchased without a dentist’s approval.

Always exercise caution when purchasing such products, especially those that promise instant results or results that sound too good to be true – those likely contain high levels of hydrogen peroxide, which can permanently damage teeth.

If you have been using OTC teeth whitening products and experiencing the following adverse reactions, please see a dentist immediately:

A burning sensation in your gums
Burns around your mouth and skin
increased tooth sensitivity
Gum recession
Mouth infections

Does teeth whitening hurt?

In-office teeth whitening performed by a qualified dentist is safe and painless. It is a minimally invasive procedure with no downtime. You may experience some teeth sensitivity after your first or second treatment, but this will subside over time. To address this temporary sensitivity, your dentist may recommend products with potassium nitrate and sodium fluoride gel. A painkiller might be taken pre-treatment as a precautionary measure.

Other rare side effects of teeth whitening include;

Gum irritation and burns

Your gums may become irritated if they come in contact with the whitening product. This is more likely to occur with take-home whitening kits or in-office treatments. When they occur, however, they are usually mild and should quickly resolve on their own, after your treatments.

Whitened gums

In addition to gum irritation and burns, another side effect of the teeth whitening procedure is whitened gums. Similarly, this occurs when the gums come into contact with the bleaching agent. The loss in colour is temporary and your gums should revert to its natural pink once the bleaching agent wears off.

Gastrointestinal irritation

You may end up with an upset stomach if you accidentally swallow a whitening product. As these are bleaching agents, you may experience a burning sensation in your throat as well.

How long does teeth whitening last?

Teeth whitening treatments are designed to reduce stains, not prevent them. Hence, their effects are not permanent. How long effects last would depend on;

The type of teeth whitening treatment you underwent
Your lifestyle

Your lifestyle plays a significant role in keeping your teeth bright. Chromogenic food and drinks such as coffee and curry will stain your teeth faster without proper oral hygiene. In addition, smoking also greatly reduces the longevity of your whitening treatment.

As an average time span, both in-office and take-home treatments teeth whitening can last up to 3 years. However, this depends on a number of factors. To ensure longevity of results (regardless of procedure), it is recommended to undergo teeth whitening treatment every now and then to correct extrinsic and intrinsic discolouration.

Do’s and don’ts after teeth whitening treatment in Singapore

For the first few days after treatment, it is important you:

Most importantly, good oral habits will keep your teeth clean and prolong its pristine colour for a long time. Keeping your teeth clean will also reduce the likelihood of cavities and gingivitis. Some good oral habits to practise include:

Brushing your teeth at least twice a day and after meals, especially if you consume foods or drinks that stain

If you have consumed anything acidic, it is advisable to wait at least half an hour before brushing your teeth; and if brushing your teeth is not doable, then drinking or gurgling some water can help to remove some particles that stain.

Flossing daily

A water floss has proven to be exceptionally effective in removing pesky particles.

Add a mouth rinse or whitening toothpaste to your dental routine

Try to opt for one that has ingredients like alcohol, menthol, or eucalyptol. These ingredients are useful against bacteria in your mouth and on your teeth, but cannot and should not be used in place of brushing or flossing.

Read: Why flossing is not optional but necessary

Everyday habits play an important role in maintaining healthy and clean teeth. You should also see your dentist every 6 months for routine cleaning.

Also keep in mind that teeth whitening treatments work only for natural teeth. If you have dentures, implants, crowns, or bridges, you will need to speak to your dentist about how to achieve a uniform colour.

How soon can I see results?

In-office treatments

Immediate results, as they involve using a strong bleaching agent with whitening content higher than most take-home kits and over-the-counter products.

Take-home kits

About a week, with maximum results achieved in 2 to 4 weeks. The degree of whitening will vary based on the amount of peroxide used and the length of time you wear the custom-made tray.

OTC products

Whitening toothpaste

Several months
May develop sensitivities to the ingredients in the toothpaste

Whitening mouthwash

Can be used daily to remove small degrees of staining, but results are minimal on its own
Best paired with other treatments such as in-office procedures or whitening strips
Up to 3 months to see any effect

Whitening strips

Different brands produce different results

How white should my teeth be?

Teeth whitening treatments can surely help you achieve brighter, white teeth. However, how white your teeth can be is dependent on the current state of your teeth, extent of stain, and most importantly, genetics.

Although teeth whitening solutions can brighten your teeth by up to 8 shades, the natural colour of our teeth is actually inherited. While these solutions brighten the surface of your teeth, you may sometimes notice a yellowish tint remains because the inside of your teeth is naturally darker. Essentially, what teeth whitening treatments do is to help you go back to your natural-coloured teeth as much as possible – whatever that shade may be.

In terms of the level of whiteness for your teeth, it really depends on your personal preference. However, a good gauge is by comparing the teeth colour to the whites of your eyes. The colour of your teeth should not be brighter than the whites of your eyes.

What happens if I have tried whitening so many times and I still dislike the colour of my teeth?

As mentioned, your teeth can only be whitened so much before it reaches its limit. That limit is defined by the structure of your teeth, its composition and genetic factors. Multiple dental fillings also prevent your teeth from whitening to an optimal level. Blemishes or structural defects on your teeth may also not be removed by whitening agents.

At that point of time, you may consider having dental veneers done.

Can I whiten a single tooth?

If you have just a single discoloured tooth, that may indicate a condition beyond superficial discolouration that cannot be resolved with teeth whitening.

You may notice that this single discoloured tooth has:

Traces of black or brown spots
Extra sensitivity
A persistent ache that is aggravated while eating
A hole or pit in the affected tooth

This is likely tooth decay.

In the early stages of tooth decay, when the decay is nearer the surface of the tooth and has not yet affected the tooth pulp or nerves, your dentist will recommend fillings. Once it develops to a more advanced stage and reaches the soft core below the enamel layer, it can inflame or infect the tooth pulp. When this happens, you would need to undergo a root canal procedure to clean out the decay.

Following the root canal procedure, you will follow up with your dentist to make sure the infection has been completely removed. At this point, your dentist would also replace the temporary filling with a more permanent one, but you may opt to fit a permanent dental crown or dental veneer instead.

In selected cases, your dentist might elect to do a single tooth whitening procedure called Internal Bleaching (also known as Walking Bleach Technique) This technique is used to whiten teeth that have had root canal treatments but are not badly damaged. It involves bleaching the tooth from the inside of the tooth.

Other causes of black or brown spots on your tooth are injury, tartar buildup, and certain medical conditions including celiac disease.

Am I able to permanently whiten my teeth?

Unfortunately, no teeth whitening process will give you permanently white teeth. The good news is, however, permanently white teeth are achievable with dental veneers.

Dental veneers are thin, tooth-coloured shells customised to fit over the surface of your teeth. They are used in extreme cases of discolouration that cannot be lightened through other methods. Apart from discolouration, veneers are also an option for those looking to cover up any other imperfections on their tooth surface.

Veneers can be applied to one tooth or multiple teeth at the same time, depending on your needs and preference.

Find out the difference between a dental crown and dental veneer.

Is teeth whitening suitable for everyone?

Those with active cavities, other dental works in progress, or existing medical conditions may not be eligible for in-office teeth whitening treatments, especially if these treatments involve UV light and bleaching gel.

Apart from the above groups of persons, please also bear in mind that teeth whitening treatments tend to work better on extrinsic stains.

Relatedly then, teeth whitening treatment might not be suitable if you have intrinsic stains, cracked or damaged teeth that leave dentin exposed.

It is best that you consult your dentist who would be best-placed to assess if you are a suitable candidate for teeth whitening treatment.

How much does teeth whitening cost in Singapore?

Treatment	Cost
In-office Treatments	A single in-office treatment can cost between $800 to $1,300 per session.
Take-home Kits	A take-home kit prescribed by your dentist can cost between $400 to $600.
Over-the-counter Products	There is a wide range of over-the-counter products. On the cheaper end of the scale, whitening strips can be purchased for as low as $11.80. Whitening strips are readily available online and in many stores around Singapore. Several other at-home treatments, such as gel with an LED light, are available for $33.90 and in your regular drug stores like Watson’s and Guardian.

Is teeth whitening Medisave claimable?

According to the CPF Board, you will be able to use your Medisave for surgical dental treatments that are carried out for medical reasons. Hence, you will be able to claim for treatments like wisdom tooth removal, dental implants, or surgical removal of damaged teeth.

As teeth whitening is considered a cosmetic procedure, you will not be able to tap onto your Medisave for this treatment. Other similar cosmetic procedures include dental crowns and bridges, dentures, and braces.

Read: What dental procedures can be claimed with Medisave?

If you have any questions regarding teeth whitening, feel free to reach out to us and we will get back to you!

References

https://www.mayoclinic.org/healthy-lifestyle/adult-health/expert-answers/whitening-toothpaste/faq-20058411#:~:text=Answer%20From%20Thomas%20J.,deeper%20than%20a%20tooth's%20surface.
Maran, B. M., Burey, A., de Paris Matos, T., Loguercio, A. D., & Reis, A. (2018). In-office dental bleaching with light vs. without light: A systematic review and meta-analysis. Journal of dentistry, 70, 1–13. https://doi.org/10.1016/j.jdent.2017.11.007
https://www.hsa.gov.sg/consumer-safety/articles/online-diy-teeth-whitening-kit-pain

10 Things You Should Know Before You Start Invisalign

Invisalign is an innovative orthodontic treatment that allows your dentist to design your smile. It is a patented technology which uses proprietary software and state-of-the-art aligner material which is designed to be more comfortable and effective in orthodontic treatment. The dentist takes 3D scans of your teeth to produce an impression of your teeth. This impression is sent to Invisalign which uses the digital model to create a clinical simulation created using Invisalign’s proprietary software called Clincheck that is used to fabricate your personalised aligner trays that help to realign your teeth for a straighter smile. This Clincheck allows you to visualise every step of your treatment plan and provide a clear timeline of your treatment duration, while traditional metal braces are only able to provide an approximate duration of your treatment time. Wearing these aligner trays applies pressure onto your teeth which moves them gradually until they are in their desired position.

Invisalign refers to orthodontic treatment using clear and removable trays which are custom fitted to your mouth.

These transparent aligners which are virtually invisible allow you to smile with confidence. Invisalign is able to offer a more aesthetically pleasing for teeth straightening treatment compared to the traditional metal braces. Wearing Invisalign braces presents a more aesthetic image compared to the very visible brackets or wires of traditional wires. The clear aligner trays are almost invisible, therefore it is the preferred option for people who want to look good and present a professional image.

Invisalign is suitable for people of any age.

Invisalign treatment is best utilised for people who are responsible and committed to wearing their aligners for 22 or more hours a day. Parents are able to keep tabs on their children’s wear if they opt for blue compliance indicators on their aligners to make sure they are worn for an adequate amount of time.

Wearing Invisalign aligners means no to drinking fizzy and sugary drinks.

This is to prevent pooling of the beverage in your mouth which may cause tooth decay. This is important as Invisalign aligners are worn for most of the day. For best treatment results and to mitigate tooth decay, patients are advised to adhere to only drinking water while wearing their aligners. Other beverages can still be consumed by taking out your aligners, drinking quickly, and then brushing your teeth and flossing before replacing your aligners.

Invisalign aligner trays are removable which means more flexibility in eating and activities.

The ability to remove the aligners makes it easy to enjoy your favourite foods, play sports, and brush and floss to keep your teeth clean without having food stuck in the brackets or wires of traditional braces. In traditional braces, it is easy for food or plaque to get stuck or accumulate in the metal brackets resulting in poor dental hygiene. Playing sports while wearing traditional metal braces is also a concern as there is a risk of getting hit in the mouth and damaging the brackets and wires.

Invisalign needs to be worn throughout the day for 20-22 hours.

Even though Invisalign is removable, patients have a responsibility to wear the aligners for most of the day in order for the treatment to be effective and produce the best results which is a straighter smile.

Teeth whitening can be performed with Invisalign.

As you are wearing the Invisalign aligner trays for most of the day, make the most of the effort by whitening your teeth. Invisalign trays are custom fit to your teeth, so you could whiten your teeth, while straightening them at the same time. Please consult your dentist for advice before doing this, as using whitening gels while the Invisalign attachments are on your teeth will result in a patchy, uneven whitening result. Your dentist will be able to advise you if it is possible to whiten your teeth during the Invisalign, and when the best timing would be as well.

Your aligners and retainers are not the same.

The material used to fabricate your aligners are not designed to be wear resistant and they would not retain the shape and position of your teeth. After your Invisalign orthodontic treatment, your dentist will prescribe fixed or removable retainers for you. It is important to wear your retainers nightly so that your teeth do not become misaligned again.

Most Invisalign cases involve attachments or buttons for more complex cases.

Typically the more complex the orthodontic treatment, the more attachments are required. These attachments are necessary for cases where teeth need to be rotated or pulled down. These attachments are small, tooth coloured composites bonded onto certain teeth and assist the aligners in retention and helping to move teeth to the correct position. These attachments create anchor points that apply pressure to move certain teeth. They are usually unobtrusive and barely visible.

Brushing and flossing after each meal and before re-inserting your retainers is a must.

Wearing your aligners means that your teeth are constantly in contact with whatever liquid or food substance you have consumed. Therefore maintaining your teeth hygiene is a must when wearing your aligners. This routine of keeping up with oral hygiene habits is beneficial even after Invisalign treatment.

We are an Invisalign platinum elite provider.

Dental Designs Invisalign Platinum Elite Provider

Our dentists are Invisalign accredited, and our clinic has achieved the Invisalign Platinum Elite recognition. Our dentists have extensive Invisalign experience and are able to treat a wide variety of teeth conditions.

References

Esthetic Orthodontic Treatment Using the Invisalign Appliance For Moderate To Complex Malocclusions
Robert Boyd - (http://www.jdentaled.org/content/72/8/948)
Patient Perceptions Of Speech, Discomfort, and Salivary Flow While Wearing Invisalign® Aligners - Research
William Jr - (https://www.orthopracticeus.com/research/patient-perceptions-speech-discomfort-salivary-flow-wearing-invisalign-aligners)
Clinical Limitations Of Invisalign
Xiem Phan-Paul Ling - (https://www.ncbi.nlm.nih.gov/pubmed/17439714)
Esthetic Orthodontic Treatment Using the Invisalign Appliance For Moderate To Complex Malocclusions
Robert Boyd - (http://www.jdentaled.org/content/72/8/948.short)
Advances in Digital Technology and Orthodontics: a Reference To the Invisalign Method.
Aristides Melkos - (https://www.medscimonit.com/abstract/index/idArt/16149/act/3)
Periodontal Health During Clear Aligners Treatment: a Systematic Review
Rossini- Gabriele- Simone- Tommaso- Andrea- Debernardi-Cesare L. - (https://academic.oup.com/ejo/article/37/5/539/2599972)

10 Things You Need to Know about Tooth Whitening

Ever wanted pearly whites like your favourite movie stars? Tooth whitening can provide you with a bright and white smile that you can confidently show and make a great first impression.

How does tooth whitening work?

Tooth whitening uses bleaching agents to lighten the colour of your teeth. The tooth is semi-permeable. This allows for the tooth whitening chemicals, which are carbamide peroxide and hydrogen peroxide, to permeate into the tooth enamel, which removes the extrinsic and intrinsic stains.

How much improvement to the whiteness can I expect to see?

The extent of whitening and brightening of the teeth is reliant on the individual tooth condition and also the cause of discolouration and whether following the dentist’s instructions was carried out. Your dentist will be able to guide you to achieve a shade of white which you will be happy with after treatment, and will consult with you before the treatment starts to diagnose and plan your treatment.

Correct stained or discoloured teeth

Our teeth colour is due to the layer of tooth enamel on each teeth. Teeth may be intrinsically discoloured as tooth enamel also naturally come in different shades varying from light yellow to off white. Teeth may be extrinsically discoloured due to lifestyle factors such as heavy smoking, or food consumption habits such as coffee, tea, red wine or coke. Teeth also discolour with age and darken or turn yellow with increasing age. The age-related discolouration is due to long term exposure to extrinsic discolouration and tooth structure. It is becoming increasingly common for older people who want to look younger to opt for tooth whitening.

There are three treatment options for you to consider

Immediate in-office whitening, take-home whitening kits, and comprehensive tooth whitening which comprises both in dental office whitening and take home whitening kits. Let’s explore each of these options.

Immediate in-office whitening offers you instant results.

By opting for immediate in-office whitening, you will see a brighter smile of at least 2-4 shades whiter than your current teeth. A laser or light activated whitening gel is used and a laser is shone into the mouth which results in an accelerated whitening process. Your lips and gums are protected from the bleaching agent with rubber seals or gel that the dentist prepares beforehand. You may expect mild to moderate sensitivity. It takes about an hour to happen and most of the treatment time can be spent. Multiple sessions may be required for increased brightening results if the starting shade is very dark. Maintenance of tooth whitening includes avoidance of staining food and drinks, good oral hygiene such as brushing and flossing, regular dental cleaning visits, and occasional bleaching touch-ups may be required to keep your smile bright and white.

Take home whitening kits offer gradual whitening with minimal sensitivity.

The dentist will fit you by taking a mould of your teeth for custom-fit trays and instructions on how to use the trays with the bleaching gel tubes. The gel is filled into the custom-fit trays and worn at home between an hour to overnight depending on your dentist’s instructions. The gel-filled trays are needed to be worn for two to four weeks continuously, during which it is advised to avoid staining food and drinks. There is minimal teeth sensitivity with this method of tooth whitening. You are also able to whiten tooth shades according to your preference as the process is gradual. The gel tubes are able to be purchased on their own from your dentist in order to maintain the whiteness of your teeth throughout the years.

Can I treat a single dark tooth?

A single dark tooth is usually due to two factors. The first factor is due to root canal treatment on the affected tooth. In this instance, your dentist might recommend the internal bleaching of a root-filled tooth. This process involves drilling a small hole at the back of the tooth, removing, some of the filling from the root canal of the tooth, and inserting of the bleaching agent. The hole is then patched up with a temporary filling, and the bleaching agent plus the temporary filling will be removed in about one week’s time after insertion. This internal bleaching process may have to be repeated again to be able to adequately whiten the tooth. Your dentist may also suggest both internal and external bleaching depending on the state of your root canal tooth. Other options to this internal bleaching include veneers and crowns which are effective methods to achieve similar results.

The second reason for a single dark tooth is pulp degeneration. Such pulp degeneration is caused by either trauma to the tooth that causes the discolouration of the tooth (usually dark or reddish) or minor trauma that results in the deposition of secondary and tertiary dentin in the pulp (tooth will appear more yellowish). Whitening treatment of a single dark tooth is, therefore, more complex and may require veneer or crowns to cover up the colour. Your dentist may be able to recommend a successful and safe tooth whitening procedure that does not remove any of your tooth structure. Therefore in the case of a single dark tooth, please consult with your dentist who will be able to recommend an effective treatment.

Treatment of teeth that have blue or grey discolourations.

Such blue or grey discolourations typically respond less well to tooth whitening procedures and as a result, require a longer treatment time. The cause of such discolouration may be due to antibiotics such as Tetracycline consumed when younger, causing a band of discolouration affecting many teeth. Thus, it is important that the patient’s expectations are moderated. Your dentist should be able to recommend a treatment plan that will lighten such discolourations and provide effective lightening treatment usually in combination with veneers or crowns to achieve a natural whitened result.

Tooth whitening only affects natural teeth and not restorations.

However, patients may see a slight whitening effect if there is discolouration around the anterior composite resin fillings because the whitening material is able to remove the discolouration. If the discrepancy of shade between the natural tooth and filling is too big, the restoration may need to be replaced after whitening to blend in. Teeth with laminate veneers are also whitened from the lingual side and appear whiter.

Over the counter tooth whitening kits versus professional whitening.

Over the counter tooth whitening kits are cheaper than professional bleaching, however, unsupervised use of such kits may damage your teeth and gums. This is because some whitening kits contain strong chemicals that abrade the tooth enamel which also results in the patient developing tooth sensitivity with a thinned enamel layer. In the short term, the teeth may appear whiter, but in the long term, such prolonged damage of your teeth while using at-home whitening kits unsupervised might end up more costly to repair than professionally managed tooth whitening procedures.

Your treatment options are best discussed with your dentist.

Poor oral hygiene due to improper brushing or flossing habits, or certain medications can also contribute to teeth discolouration. Teeth may also discolour due to tooth decay, thin tooth enamel, tartar or calculus, and old fillings which can change the colour of the teeth to brown, grey or black. Excessive fluoride intake during early childhood may also stain and mottled teeth. Teeth that are discoloured due to staining or age see the best treatment results.

The dentist will be able to provide you with a comprehensive diagnosis and treatment plan for planning your smile treatment. The first step a dentist takes in your tooth whitening treatment plan is to carefully listen to you as to what you want to achieve with tooth whitening. It is important to tell your dentist the main cause of your tooth discolouration or staining due to lifestyle factors such as smoking, drinking coffee etc.

During your consultation, your dentist will perform a comprehensive intraoral examination with a tooth shade evaluation, followed by an analysis to complete your proper prognosis of the treatment outcome. You should also disclose to the dentist any previous tooth whitening treatments whether attempted at home or during previous dental visits. Other treatment options include composite resin bonding, porcelain laminates or all-ceramic crowns if bleaching is not able to achieve your desired whiteness.

References:

Tooth Whitening: Facts and Fallacies
H Heymann - (https://www.nature.com/articles/4812298)
Us6783363b2 - Discolored Teeth Bleaching System
(https://patents.google.com/patent/US6783363B2/en)
In-office vital tooth bleaching--what do lights add?
(https://europepmc.org/article/med/12793211)
Three-Month Evaluation of Vital Tooth Bleaching Using Light Units—A Randomized Clinical Study
(https://www.jopdentonline.org/doi/full/10.2341/12-041-C)
Effect Of Light Energy on Peroxide Tooth Bleaching
Karen Luk-Laura Tam-Manfred Hubert - (https://www.sciencedirect.com/science/article/abs/pii/S0002817714639337)
Effect Of Bleaching Agents on the Microhardness Of Tooth-colored Restorative Materials
Arzu Mujdeci-Osman Gokay - (https://www.ncbi.nlm.nih.gov/pubmed/16616125)