Everyone likes white teeth. I had my own whitened in Miami, Florida, six weeks ago. Of the three major options for whitening, in-office whitening is probably the quickest. Benefits appear in a short period of time. In-office whitening involves a very careful use of high-concentration peroxide gel, which the dentist applies to the patient’s teeth after protecting the gums with a painted-on layer referred to as “paint-on rubber dam.” The dentist has to protect patients’ gums completely in order to make sure that the high-concentration gel does not touch any soft tissue.

The gel has to be placed every fifteen minutes and a light cure light applied with special equipment. Every fifteen minutes makes the teeth a shade lighter. The patient generally pays for how many shades whiter they want their teeth to end up. I do not recommend more than four shades at a single session. After that, the dentist provides follow-up instructions and a bleaching kit for the patient to use at home, so that the patient can continue bleaching safely at home for the next seven days, if he or she wishes, following the in-office whitening. The visual effect of the process is very rapid and dramatic. It is possible to change the shade of the teeth from almost two to nine shades in the office.
Patients who have sensitive teeth should undergo a treatment plan of desensitising their teeth before receiving whitening. If not, there may be discomfort such as intermittent shocking pain afterwards. It is very common for a patient who comes with worn-down or cracked teeth to have issues with hot and cold sensitivity, since he or she will likely have more exposed nerve endings in the dentin. In such cases, I would give the patient a desensitising gel to use for ten days before whitening, thereby offsetting that sensitivity both during and after whitening. If not, while it is temporary, the sensitivity which manifests as flashes of spontaneous hot, shooting pain on the teeth, can be quite uncomfortable.
Patients who have just had bleaching done in-office should be told to refrain from consuming certain kinds of foods and drink because the process has just opened up all the teeth’s enamel rods, cleaned them up, and bleached them, so they are very easy to fill up again. For example, the worst thing a person can do after whitening his or her teeth is to drink a glass of red wine. An individual who has just whitened his or her teeth has to be very careful to stay away from any food or drink that is coloured for at least a couple of weeks so that the enamel rods do not absorb that stain.
Over a period of time, the individual’s saliva and fluoride in the toothpaste he or she uses will remineralise the enamel and seal the teeth off so those rods are no longer open and ready to accept all stains that quickly. Ten to fourteen days after the bleaching the person can go back to eating normally. However, he or she has to understand that diet was the root cause of the staining. Therefore, the more he or she continues to consume coloured foods such as black coffee, coca-cola, etc., the quicker he or she will need maintenance and touchups.

(Dr. BERTRAND R. STUART D.D.S)