Teeth whitening using tray-based teeth bleaching systems.

A) The pre-bleaching dental examination. Your dentist will need to perform a thorough dental examination prior to the initiation of the teeth whitening process, so they know that you are in good general dental health. As a part of this examination your dentist will document the current shade of your teeth, sometimes by taking photographs, and also discuss with you the history related to your current tooth shade. This discussion will help your dentist both identify the nature of the discoloration of your teeth and determine if tray teeth whitening is an appropriate method by which to make a change. Once having determined the most likely cause of your tooth discoloration your dentist will be able to provide you with an idea of what type of improvement can be expected and how long the bleaching process might take. During the examination you and your dentist must discuss and decide if you will whiten both your upper and lower teeth, or just one or the other. Usually a person's greatest concern is the appearance of their front upper teeth, and some people start out by just bleaching them. There are some good reasons to approach the whitening process in this manner. One of them is related to the fact that a person's unbleached teeth can provide a source of comparison. This contrast can make it easy to visualize exactly what progress a person's whitening efforts have achieved. Sometimes this ready reference provides a source of encouragement and helps to motivate a person to continue on with their bleaching regimen. Another good reason is related to cost. Dentists often charge for teeth whitening by the "arch". An arch is dental terminology for either the upper or lower teeth. A person's complete set of teeth is composed of two arches. If you whiten just one arch you could expect your costs to be approximately half of what you would pay to bleach both arches. After you have successfully bleached one arch you can, of course, always begin the whitening process on your other arch. During the examination process your dentist will identify any dental work which exists on those teeth you have chosen to whiten. It is imperative for you to realize that the shade of existing dental restorations will not lighten. Restorations on whitened teeth will need to be replaced after the bleaching process has been completed. Prior to initiating the whitening process you should be aware of the time and cost associated with performing this dental work, it might be substantial.

B) Taking impressions for the bleaching trays. An important feature of dentist dispensed tray-based teeth whitening systems that can both increases the technique's effectiveness and minimizes its side effects is the use of custom fitted bleaching trays. The first step in creating these trays is for your dentist to take impressions of your teeth. From these impressions your dentist will create plaster casts. Your bleaching trays in turn will be crafted on them. Usually, once impressions have been taken, your dentist will need at least a few days to complete the tray fabrication process.

C) Fitting the custom bleaching trays. Your dentist will ask you to make an appointment where you return to their office so they can evaluate, and refine as necessary, the fit of your bleaching trays. The bleaching trays themselves are usually clear, they are often made from a soft flexible plastic, and one is made for your upper teeth and a separate one is made for your lower teeth. Usually bleaching trays have been trimmed so they fully cover each tooth but come just short of lying on your gums.

D) Instructions about how to place teeth whitener in the trays. During the dental appointment when your bleaching trays are fitted your dentist will also dispense to you an initial quantity of teeth whitener (10% carbamide peroxide). Usually this is a gel that is contained in a small syringe or plastic bottle. Your dentist will show you how and where to place the whitener in your bleaching trays. As a means of minimizing the amount of whitening gel used during each application, the whitener is usually just placed on those aspects of the tray which touch the front side of your teeth and only in those portions of the tray which cover the teeth you want to lighten.

After the whitener has been placed into the tray and the tray has been positioned over your teeth, there will usually be some excess gel that escapes from the tray up and onto your gums. As a way of minimizing any gum irritation the whitener may cause, it is best to wipe this excess away with your finger or your toothbrush.

E) How long should bleaching trays be worn each day? Your dentist will provide you with specific recommendations regarding the amount of time your bleaching trays should be worn each day. If your dentist gives you a range of times, in general the more hours you wear your bleaching trays the more rapidly you will notice results. The whitening process is simply one of cause and effect. One option usually given to patients is to wear their bleaching trays at night while they are sleeping. The advantages of this method are that both the total amount of whitener and the total number of individual bleaching episodes that are needed for treatment will be minimized. This is because each application of the whitener will be in the tray long enough to produce its maximum effect. Utilization of this method can be especially beneficial in those cases where the tooth staining being treated is expected to be stubborn. Another common manner in which dentist's instruct their patients to use their bleaching trays is to wear them during the day, however some persons may find that doing so conflicts with their normal daytime activities. While both whitening gels and bleaching trays are usually clear, they can still be visualized somewhat by others. Speech can also be affected by bleaching trays, although because they are usually thin it is usually only minimally. Daytime bleaching for less than 2 hours a day tends to waste teeth whitener and will extend the total number of days needed for treatment. Most whitening gels are effective for up to 4 hours or longer. Some dentists recommend that their patients should refresh the whitener periodically by removing the tray and adding more.

F) Follow up appointments with your dentist. Your dentist will ask you to make periodic follow up visits to their office so they can evaluate the shade change your bleaching efforts have achieved. Tray teeth whitening is usually continued until you and your dentist have become satisfied with the color change which has taken placed or until that point at which no more whitening seems to occur. After evaluating your progress your dentist will, if they feel that more whitening is possible, dispense additional whitening gel to you. Additionally, at each follow up visit your dentist will ask you if you have experienced any side effects from the bleaching process. If you have they will make recommendations so to help you manage them. This does not mean that if you are experiencing side effects you should wait until your next follow up appointment to bring them to your dentist's attention. You should always feel free to contact your dentist regarding any problems or difficulties you have encountered.

G) Terminating the at home teeth bleaching process. Once your bleaching efforts have achieved a pleasing tooth shade, or at that point in time when no more whitening appears to occur, your dentist will recommend to you to terminate the bleaching process. Once you have stopped there can be a period, possibly two weeks or so, where the shade of your teeth will relapse slightly before stabilizing. Once the shade of your teeth has stabilized you and your dentist can make plans to begin the process of replacing your existing dental work so to match the new shade of your teeth.

How long do the effects of tray teeth whitening last? The effects of at-home tray-based teeth whitening can, on occasion, last fairly indefinitely but in most cases a "satisfactory" shade change is found to last for about 1 to 3 years. One study found that 42% of the persons who had under gone the bleaching process were still satisfied with the shade of their teeth 7 years later. Possibly more importantly, no one in this study, including even those who were not happy with their current tooth shade, felt that their teeth had regressed all the way back to their original pre-bleaching color. Of course once initially whitened it is an easy matter to retreat or "touch up" your teeth with additional bleaching at that point in time when it is needed. Usually this touch up bleaching is of much shorter duration than the original whitening process.