What’s In Your Whitening?
With patients requesting whitening procedures like they’re going out of style, now’s the time to brush up on your bleaching basics
‘Tis the season for whitening procedures, but sifting through the dozens of whitening systems on the market can be a headache for even the most seasoned dental professionals. There are many options available to dentists and consumers alike, including in-office whitening, office-distributed take-home kits, and a variety of over-the-counter products. Because of this, you might find your patients asking you, “what’s the best method?” The answer is partly subjective and includes consideration of the speed of whitening, in-office or at-home treatment, convenience, and cost.
Types of whitening agents
Tooth whitening is affected by (1) the concentration of the peroxide in the whitening agent and (2) the length of time it is in contact with the enamel. Higher concentrations are faster but lower concentrations can achieve the same result by extending the amount of time it is on the enamel. In-office products contain the highest concentration of active ingredients, making them more efficient in rapid whitening.
Types of active ingredients
There are two types of active ingredients that can be used for whitening procedures: carbamide peroxide and hydrogen peroxide. Both agents remove both intrinsic and extrinsic stains (unlike whitening toothpastes, which only remove extrinsic stains). Carbamide peroxide is a combination of urea and hydrogen peroxide. Once applied, it breaks down into these two components, thus releasing hydrogen peroxide. The addition of urea to hydrogen peroxide acts to stabilize the hydrogen peroxide and increases its shelf life. Thus, carbamide peroxide is most often found in OTC whitening products as well as some take-home kits. The hydrogen peroxide released is about 1/3 the concentration of the original carbamide peroxide, a process that takes about 4-6 hours. As a result, carbamide peroxide is best used in overnight trays.
In comparison, uncut hydrogen peroxide is less stable and more potent. High-concentration hydrogen peroxide whitening agents are more appropriate for in-office use.
Tooth sensitivity is a common complaint during tooth whitening that can actually be well-managed. Sensitivity results in sharp, painful impulses in individual teeth. Continuing to remind patients that these “zingers” are not abnormal is a good way to mitigate their distress. There are many options available to reduce and treat sensitivity:
- Advising your patient to use a desensitizing toothpaste containing potassium nitrate for 2 weeks prior to their whitening procedure
- Administering a whitening agent that contains potassium nitrate
- Using potassium nitrate alone or with fluoride
- Applying a high-level (5,000 ppm) fluoride dentifrice
- Using amorphous calcium phosphate (ACP) in the whitening agent or as a stand-alone gel
Potassium nitrate desensitizes the nerves, while fluoride and ACP work by plugging the open dentinal tubules.
Equip your practice
At PureLife, we carry both in-office and take-home whitening systems, many of them available in several concentrations of hydrogen peroxide and/or carbide peroxide. To help with sensitivity issues, some even contain fluoride.
No matter which type of whitening products you use, there’s no doubt your patients will be asking for bleaching procedures. Having a handle on each specific type can save you money…and help your practice to be more efficient. Happy whitening!