Tooth whitening is very popular and we get asked about this at least once a day.

Question: Who can whiten?

Dr. Shuster: Anyone, can with a few cautions. Pregnant women.... don't do anything elective in dentistry until your baby is born. Check with your O.B. but it's often a good idea to get them cleaned in THE MIDDLE TRIMESTER. No whitening though, why take a chance? Similarly if you have a breastfeeding baby, probably not a good idea to complicate Mom's body chemistry with anything. Don't whiten if you have openings in your teeth due to lost fillings, or cracks, or certainly decay (cavities).

Question: What products and techniques work best?

Dr. Shuster: Even though there are hundreds of products out there, this is an easy question to answer, custom fitted trays and the high end gels available from virtually every dentist office, do work better than other methods (but read on... you don't need the most expensive) This is the system where patients take home custom made trays and put the pricey good whitening gel into the trays, these work the best in my experience. Your dentist can recommend some great products. There are a handful of excellent, carbamide peroxide gels, sold through dental offices similar to what is seen on the makeover shows on TV Notice I said there are a HANDFUL of great product. What I'm not saying is since there are hundreds of products available, there are 900 that are unknown, personally I wouldn't put them in my mouth.

Question: What about home made trays, and product off of TV offers?

Dr. Shuster: It sounds a little self serving but I'd advise you to avoid them. Their formulation, quality control and efficacy are unknown. The trays are often ill fitting and people end up not using them. There is a more serious issue also. Now in today's world of toxic toys from China, and poison dog food etc... be safe and get something made in the U.S.

Question: OK, so no foreign made junk but do the over-the-counter "White Strips" work?

Dr. Shuster: Yes, with some qualifications... they can work. I've seen patients actually be satisfied with the whitening improvement they got from over the counter whitening strips. Even though they may not be the easiest, fastest or "white-est" it is over the counter, and really cheap. This process works best with straight teeth, and since it is inexpensive and the patient has complete control, they've enjoyed some popularity and success. Most of my patients eventually want to have a "better job" of it and opt for professional whitening; but not all. some patients are satisfied with the great "bang for the buck" that over the counter whitening promises. I have seen some people get a noticeable whitening result. Inside scoop though.... the best thing about whitening over the counter is that it's cheap, it's not wonderfully effective as the trays are.

Question: What about LASER whitening?

Dr. Shuster: It's more expensive and doesn't work ANY better! Regular whitening with custom trays and high end stabilized carmamide peroxide gel is going to cost $500 plus or minus $200. Light enhanced whitening can easily be double or triple, that cost. And there is NO scientific evidence that the light does anything at all. Here is the hard truth though; according to one of the pioneers in dental cosmetics. The light does NOTHING to enhance the whitening treatment, and the process as done commonly can cause tooth pain! So my advice here is save your money on the so called LASER whitening, and get well made custom fitted trays and take home gel and do the job right over about a two week period. Get white teeth and avoid the possible toothache.

Question: What if I have fillings in the front, or a single crown made out of porcelain, what will it look like when I'm done?

Dr. Shuster: My response, still go ahead and whiten, if you're interested in whiter teeth. It's true that all the different materials will whiten at different rates; but overall your smile gets whiter (if a little unevenly) people still have a lot of fun whitening and it still looks good. Chances are they are not uniform in color now, after whitening they will not be uniform but they all will be whiter, and people still seem to enjoy this result as much as anyone. If you want to, do it.

Question: What if I drink coffee, or smoke?

Dr. Shuster: First of all choose life, and quite smoking (the subject of a whole other article). Seriously, adult life can be hard, and I'm no saint. But smoking is one of those MEGA things you can address, and not choose to do anymore. By becoming smoke free, you choose to live, and stay out of the hospital, and I encourage you all to become smoke free ASAP. Enough said, call our office though if you need help in quitting smoking. But lets say your going to quit smoking, then have your teeth cleaned and have tobacco stains, or some other surface stain. Perfect! Bleaching the way I've recommended here is very effective on these causes for darkening or yellowing of teeth. Whiten away... you should get a good result from any 'surface" staining.

Question: What if I had antibiotics as a kid, or had fluoridated water and have stains inside my teeth.

Dr. Shuster: Now we are getting late into the interview and the harder "what if's" are coming out... good. Many of these stains are much more resistant to whitening, but we've found in our study clubs that continued whitening, provides more whitening effect. Stay with it and you will likely see pleasing results. Now if you are unfortunate enough to have some dramatic coloring issues with your teeth; YOU ARE NOT ALONE OR WITHOUT HOPE. Some discolorations, are severe and persistent, and .... well ugly. Consult with a dentist with significant cosmetic experience because this can be a great opportunity for other tooth treatments. Veneers for instance, usually achieve great color change, fast, and beautifully uniform. Additionally Veneers can address shape alignment issues, black triangle appearance between teeth, smile line and shape changes all at the same time. Some cases corrected by Bonded Porcelain Veneers are just gorgeous and amazing transformations. Not for everyone, due to cost and greater commitment to treatment in many ways... but for people, for whom whitening just isn't enough, results can really be spectacular.

Incidentally, if you are going to have some front teeth beautified in some way, via veneers or bonding or white fillings etc.... it's often a great idea TO WHITEN FIRST, and then have your new crowns, or filling done to match the whiter color. Besides if your reading this and haven't whitened your teeth, you are probably in the minority of 21st century Americans. So many people have whitened their teeth now, there is what I call "Whitening Inflation". What is considered white, in our culture has drifted to a lighter and lighter shade than ever before. Because so many people have done a nice job of whitening. When done correctly a persons teeth just look "cleaner" than they ever have, not so obviously kitchen sink white that you think they should be on late night TV talk show... but several shades lighter. It looks nicer, healthier, sexier, younger and most people want that.

Question: Is it harmful to whiten my teeth?

Dr. Shuster: Not if done correctly and under supervision of a dentist familiar with cosmetic procedures, and potential complications. I know I keep alluding to the idea that you will get better results with a skilled Dr. in your corner. but likely you will. In an ideal world there would be no complicating factors, and these health questions would be easy. But often there are complications; and a Dr. with care, skill and your best interests in mind, can help you avoid myriad unpleasant outcomes, not to mention help you get to where you want to be, on a straighter path.

OK, now more directly to your question, Our study club evidence demonstrates that Whitening (bleaching) done correctly has about the same negative effect on enamel as drinking a Dr. Pepper soft drink. Now that's now swishing or holding your teeth in the drink. Studies suggest whitening with take home trays, has about the same effect as simply drinking a Dr. Pepper. A little barely measurable weakening of enamel that recovered on it's own, in 24 hrs. There is some enamel demineralization (acid melting), that appears to be reversible with normal saliva, and does not represent much of a risk. Find a dentist with some experience (prescott is blessed with many) someone you can communicate with, that has the good gel, get your exam done, (this often works best right after your cleaning) and go ahead! Enjoy whiter teeth.

Whitening is one of the most fun things ever to come to the public from dentistry, it's fun, and beautiful, and pretty easy.

OK, time for my obligatory anecdote

One of the Doc's in my study club does cosmetic dentistry for the fashion industry, IN ITALY, we call him "Tuti". He was appalled at how white American's have their teeth turn out, and says something like "That color white, doesn't exist anywhere in nature.... Americans have their teeth too white". He may have a point from some of the cases I've seen in Newport Beach California... but check out my puppies teeth in the following photograph. We got her teeth to a very light shade of what dentists might call shade "B1".

Now you'll notice she has some dark spaces between her teeth that she doesn't like.... so we are considering veneers or invisalign to straighten them....

What, are you guys kidding? She's a DOG! for goodness sakes.

But it does show my Italian cosmetic dentist friend, how white teeth can naturally be.

Chao!