Dr Zahra Majeed of the Saar Dental Specialists improves our smile
Time Out Bahrain staff
Generally, what kind of treatments are available to those wanting whiter teeth? There are many ways to whiten teeth, and assessment for which treatment needs to be done is made on an individual basis. But generally, the various methods include whitening toothpastes, gels available from pharmacies, whitening strips from brands like Crest, home kits available at dental clinics, microabrasion, internal whitening for teeth discoloured due to root canal treatment, and office whitening (plasma or laser), which is often combined with the home whitening procedure for long lasting effects. A dentist will not usually whiten teeth that are worn away, and in cases where the pulp (nerve) is exposed, root canal treatment must come first.
How would you describe each of these treatments? Whitening toothpastes can be used in the daily brushing routine, available at pharmacies and supermarkets, usually taking four-six weeks to see results. They do not usually cause sensitivity and are very affordable.
The gels can also be bought at pharmacies, but are not very reliable because they can be too mild – whitening trays are included in the kit, but they are not customised to fit the teeth exactly and that may allow the gel to leak more, causing burns on the gums. These are similar to the whitening kits sold and available at dental clinics, but not as concentrated, although they are affordable.
Whitening strips have a gel in them that can be applied directly on teeth, although it can be messy. Based on patient feedback, they are not very effective, and the whitening effect may not last that long.
Your dentist can offer the next step up, like your own home whitening kit, which can be effective, but take two-four weeks at least to see results. The dentist takes a mould of the patient’s teeth to make a custom whitening tray, then the patient applies the gel and wears it for up to four hours. It can cause sensitivity and burn the gums, but it is affordable. Microabrasion is a procedure done at dental clinics usually in cases of fluorosis staining (excess fluoride) or slightly yellowish discolouration. A paste is applied to the teeth and it is polished using special brushes. This is slightly more expensive.
For the internal whitening procedure, meanwhile, this is done to any front teeth that have been root canal treated, and their discolouration has become very noticeable. The tooth is opened at the back, just as it was for the previous treatment, and the gel is applied inside the tooth, with an LED light increasing the temperature and initiating the whitening process. It can take up to two visits. This is very effective and often has excellent results.
Office whitening (plasma or laser) tends to be the most effective way to see instant results, but it may not suit all patients, such as those with sensitive teeth or worn enamel, and can cause sensitivity and get expensive, depending on the system used.
Are there any instances where you should not have teeth whitened? This is something the dentist will assess, for example does the patient have sensitive teeth, or are they strong enough to tolerate the bleaching process, and are they cavity-free? Based on the history and dental examination, the best whitening process can be decided upon. The dentist may suggest that the patient tries home whitening before doing the office whitening. If a person has tetracycline staining, caused by a certain type of antibiotic taken during pregnancy or early childhood, which has a dark grayish and yellowish staining, then ceramic veneers or Lumineers would be more effective than whitening.
Bahrain and Arab countries are known for the popularity of their fast food culture – does this directly affect the health of people’s teeth that you see from day to day? Fast food usually has refined sugars, which can cause decay on and in between teeth. It can even cause front teeth to decay and discolouring. Whereas before fast food became popular, the food was more fibrous, therefore dental health was good. In my practice, I see many children with severe decay in the front and back teeth. This is due to prolonged exposure to refined sugars available in sweets, soft drinks and chocolate. This in turn can cause loss of appetite because the child has pain. It is best to take the child regularly to the dentist and be in control of what they eat and promote healthy eating habits.
But is teeth whitening a solution? Is it merely cosmetic, or does it improve the actual health of the tooth? It is a solution, but it is not always the solution. There are many ways to address the discolouration and poor appearance of front teeth, like ceramic crowns and veneers or resin veneers, depending on how much the patient could afford. Whitening is purely cosmetic and not considered therapeutic, unless the discolouration causes the patient to lack self-esteem, in that case you can say it is a form of therapy. Some people have attributed teeth whitening to promotions, increased business and even marriage proposals.
Generally, to ensure that teeth stay white in the first place, are there any foods to avoid or anything else that stains the teeth? Food and drinks such as curries, coffee, tea, red wine and so on may stain the teeth. Smoking can also cause stains, but these are all reversible and are known as ‘extrinsic staining’, and can be treated easily by visiting the dentist regularly and having a cleaning twice a year. There are systemic or hereditary conditions, or medications that may stain the teeth internally (‘intrinsic staining’), and those are more difficult to treat and require extensive and quite expensive dental treatment to give a nicer, healthier-looking smile. More info from Saar Dental Specialists (17 596 444). Call for an appointment.