A. There are a variety of methods that can be used to lighten teeth. Probably the most cost-effective, safest technique available is professional, dentist-dispensed whitening. Your dentist can decide what type of whitening is best for you based on the origin of discoloration, your esthetic needs, the condition of your teeth, and your lifestyle. Your dentist can devise a special carrier (also called a night-guard or tray) to fit your mouth. Then, you insert the whitening material into the custom carrier, and wear it over your teeth all night, or for several hours.

2. How long does it take for my teeth to become white?

A. That depends on the type of discoloration of your teeth. It may take only 3 to 5 days to lighten your teeth, or it may take several weeks or months. The average treatment time for moderately stained teeth is 2 to 6 weeks, although for some people it may take less time. Teeth stained by nicotine or by drugs such as tetracycline may require 2 to 6 months, depending on the nature of the staining.

3. How long does the whitening last?

A. Although some stain removal may be permanent, the average duration of the color change is from 1 to 3 years before any darkening is noticed. After that time, there is some color lapse, but not back to the original stained color. Recovering the whitened color generally takes only a few days of re-treatment. Some teeth have remained color stable for more than 7 years. If the cause of the staining is continued (such as smoking), the teeth will discolor more rapidly.

4. What is the material used in the whitening process?

A. The most popular and extensively researched material is a 10% carbamide peroxide, which is a mild form of 3% hydrogen peroxide.

5. Is it harmful to my teeth?

A. No, not if the proper material is used after a proper diagnosis by a health professional who will devise a treatment plan. The effect on the teeth seems to be no different from commonly-ingested foods or regular dental procedures.

6. What is the whitening process doing to my teeth?

A. The carbamide peroxide soaks into the tooth's dentin and enamel. It removes stains that have also soaked into the tooth, as well as changes the color of the inside of the tooth by an oxidation process.

7. How white will my teeth get?

A. This depends on the nature of the staining and length of treatment. You may see up to 13 shades of color change. Some people lighten 7 shades in 7 days.

8. Are there any reasons I should not whiten my teeth?

A. Yes. Restorations (fillings such as composites, bonding, or crowns) do not change color. If you have many fillings on your teeth that show when you smile, they may become more noticeable (look darker) after the teeth get lighter. Your dentist will examine you and advise you as to whether the improvement from whitening is worth the cost and risk of replacement of those restorations.

9. What does the whitening procedure cost?

A. The dental office will discuss the fee for whitening either one arch (top teeth) or both. Generally, the cost for all the teeth is less than the cost of one porcelain veneer for one tooth.

10. Do I have to the wear the carrier all night?

A. No, although all night wear is the best way to get the most benefit from each application of the material. People who have severely discolored teeth find that they are more consistent with application if they make it a part of their regular nightly routine. However, your dentist may prescribe daytime wear of 1 to 2 hours, which will also work, it just may take longer.

11. Are there any side effects or precautions?

A. Yes, some people may have episodes of tooth sensitivity during treatment. These are generally mild, and will stop when treatment is completed. However, your dental office team will work with you to determine the best wearing time to minimize sensitivity. There are also medications available that can be used to reduce sensitivity which can be applied using the same carrier. People who have a history of sensitive teeth can use a desensitizing toothpaste containing potassium nitrate and fluoride during treatment. Occasionally, gingival (gum) irritation can occur from wearing the tray and is relieved by removing tissue contact from the tray.

12. How is this dental whitening technique different from those kits sold on television or at the stores?

A. The 10% carbamide peroxide whitening materials approved by the American Dental Association have passed many clinical and laboratory tests to show how well they work (efficacy) and how safe they are. Over-the-counter products are not recommended because of their lack of proof of safety and efficacy. Also, the over-the-counter products place the consumer in the position of having to self-diagnosis their discoloration without benefit of professional input or possible x-rays. The custom-fitted carrier or tray is a very important component: it holds the material in place long enough to work and is fitted in the right position to avoid problems with the bite (occlusion) or jaw joint (TMJ). The professional carrier can be adjusted in several ways to minimize or eliminate side effects, which consumers cannot do with over-the-counter products.

13. Don't whitening toothpastes do the same thing as the professional dental whitening technique?

A. No. Toothpaste is primarily intended for stains on the outside of the tooth. The dramatic change in tooth color inside the tooth has not been duplicated by whitening tooth-pastes. Some of the toothpastes that contain peroxide may be used to help maintain white teeth after they have been lightened by the dental whitening technique. Other toothpastes are merely cosmetic and add white "paint" to the teeth, or are abrasive and actually remove good tooth structure. Your dental team will work with you to find the best fluoride-containing toothpaste and proper toothbrush habits to maintain your whiter teeth for a lifetime.

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