A Certain Smile

Everybody wants to flash it: that confident smile that flaunts gleaming, brilliantly white, practically glow- in the- dark teeth. The demand for whiter teeth is the single most requested dental service today and an estimated $1.4-$1.7 billion business, having increased a staggering 33% in recent years.Teeth whitening
Unfortunately, like every other body part, as we get older our teeth show our age. And the effects of what we’ve been doing over all those years: smoking, sipping coffee and tea, swilling cola, and ingesting teeth staining things like blueberries and cherries. Too much tartar and plaque, too much fluoride, tetracycline use for acne and trauma to the teeth all contribute to turn our original pearly whites to yellow, gray or even brown. A sparkling white smile spells youth, and we want it, we need it, we demand it!
And the dental profession and tooth paste companies are only too happy to provide.
All whitening is based on the use of peroxide based compounds which whiten the teeth through oxidation. Drug store systems use hydrogen peroxide while in-office procedures generally use both carbamide and hydrogen peroxide.
• In the dental office you can opt for power whitening where a much higher concentration of peroxide than available over the counter is applied to the teeth. The sexy sell here is the use of light to accelerate whitening but there is disagreement as to whether this really enhances the result or is even necessary for success. The patient is then sent home with custom trays and gel to be used once a day for continued results. The upside: dramatic results in 90 minutes. The downside: it will set you back between $400 and $500 and may cause temporary sensitivity to teeth and/or gums.
• At home you can utilize custom trays and peroxide gel from your dentist. It will take longer and require more commitment. The trays need to be worn 20-60 minutes per day for several days. The greater the time the compound has contact with your teeth, the better the result. The upside: a significant and long lasting improvement with lesser cost, between $200 and $300. The downside: possible sensitivity to the gums and/or teeth from contact with the gel. A new wrinkle is non- custom, pre-loaded disposable trays, an even less expensive option.
• DIY choices are crowding the shelves at your local CVS. Shakira is hawking Crest 3D White Strips from the pages of every magazine and who wouldn’t want that smile? Can I get the hair too?

shakiraCrest dominates this market with six, count ‘em, versions of white strips: Professional, Advanced Vivid, Vivid (for coffee, wine and ciggy stains);Gentle, for sensitive teeth; One Hour Express, if you have a hot date; and Supreme Flex Fit which they claim gives you the same results as that $500 professional treatment. Choose a system ranging from$35 to $60 depending, I guess, on your time constraints and urgency to brighten with a commitment from one hour to four weeks required, depending on system.
The only other player is Rembrandt which offers two options. Intense Stain Dissolving Strips do their job in a quick 5 to 10 minutes a day for two weeks. But here’s the rub, they dissolve on your teeth! That means the chemicals that whiten your teeth are also being ingested. This concept really concerns me. Less horrifying is their Deeply White 2 Hour Kit for the truly impatient. It comes with “comfy” trays as opposed to strips for $23.

Tooth whitening toothpaste is a misnomer. While it will help remove surface stains with mild abrasives or enzymes, it will not whiten since true discoloration of the enamel occurs below the surface. The upside: May improve the appearance of surface stains. The downside: Overuse can wear down the enamel. And it cannot be used by those with veneers and caps made of composite or porcelain as it will wear away the finish.

Power swabs are heavily advertised but reviews by most users give them a very low rating.
Not only are the swabs themselves of poor quality and easily broken, there was little improvement reported and several claims of “scam” and credit card charge issues.
And although they claim to be appropriate for use on dental restorations, you may wind up with teeth of uneven color. No upside that I can discern for the $60 investment. I would stay away.

Disclaimer: Finally, I must reveal that my husband is a general dentist whose practice encompasses restorative and preventive dentistry as well as cosmetic procedures, when indicated. (“Cosmetic Dentistry” is not a recognized specialty so be careful of those who identify themselves as bonafide cosmetic specialists.)
To those who come to him wanting whitening, he recommends the custom fitted trays ($200-$450) to be used at home with gel ($10 a tube). If someone wants immediate improvement, he applies a highly concentrated solution directly to the teeth without light which takes about 90 minutes. He emphasizes that if you do in-office whitening that it be done by a dentist only and with great care, as the strong solution can cause (temporary) damage to soft tissue if not carefully placed. Success with any method is dependent on the specific color and condition of your teeth at the outset and is not predictable.

Coincidentally, he has a great smile and gorgeous white teeth!

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