Dental Myth Buster series: The Truth about Bleaching

10 years ago or so a little known procedure called ‘dental bleaching’ came over here from the US where it was already in regular usage. (Of course).

Basically, carbamide peroxide (or sometimes hydrogen peroxide) in a gel form was squirted into plastic ‘trays’ which were then fitted over the patient’s teeth and worn over night. After a few nights previously yellow/stained teeth would begin to look noticeably whiter, it really worked!

Brilliant! The incidence of wall to wall veneers dropped through the floor overnight. Dental bleaching was safer (for the teeth) less invasive and a fraction of the cost of dental veneers.

An unbeatable product surely?

Perhaps not. Two things challenged the superiority of this simple, cheap and effective treatment.

  • Firstly (American) patients decided that they couldn’t wait a few days for the result, they wanted it instantly!
  • Secondly big corporates got a wind of this and realised that if they could persuade both the public and the dentists that bleaching could be done in under an hour they would get rich (and the dentists wouldn’t do so badly either).

‘Power bleaching’ aka ‘Laser bleaching’ was born…and well publicised companies like ‘Britesmile’, and ‘Zoom’ were suddenly offering better results than with the humble bleaching tray in under an hour. These companies spent millions on advertising to dentists and the public.

Dentists spent thousands on high-power bleaching lamps and lasers sold by these companies, and using the companies ‘own brand’ power whitening gel coupled with an impressive looking light source, they got on with ‘the business’ of bleaching.

The only problem is that it doesn’t work.

I’ll say that again: the only problem is it doesn’t work…..ok, well it works a bit, but the results from these products are consistently worse than from –you guessed it- those old take-home bleaching trays! What’s more, the old way of doing it keeps the teeth whiter for longer.

Now call me an old cynic but power whitening is regular repeat income: it costs twice as much and lasts half as long – so patients are forced to keep coming back and have it done again! Which is why many of my peers at the Aesthetic Academy (www.BAAD.org.uk) have gone back to the old tray system (or a combination approach).

As for the fancy lights and lasers? Dr Linda Greenwall –one of the UK’s leading bleaching experts – has often said that there is no evidence that these lights accelerate the bleach’s own effects, but that their main use is to “add flair” to the procedure…

To my mind it’s logical: 35% bleach for 45 mins can’t possibly bleach as deeply or as effectively as 15% bleach for 50 hours (overnight for 7-10 days)….what’s more the stronger bleach causes more sensitivity and some of these lights and lasers can overheat the teeth (www.nature.com/bdj/journal/v199/n1/full/4812555a.html) which is bad.

Hang on a minute (I hear you say) don’t you offer Power-whitening at your clinic? Yes I do. We offer it to those in a hurry ‘Doc, I’m getting married tomorrow’ because it does make a difference when time is of the essence – but we always take impressions to have trays made so that the patient can top up/finish the job at their leisure with the tray-system.

I know they will need to.

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