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Love that SMILE
Tooth-whitening is safe and
effective, but get good advice first
Dr. Lia Dominici-Bly was thrilled when one of her patients called out at her across a shopping mall yelling, "I quit, I quit!"
A cosmetic and family dentist, she had helped George Johnson whiten his teeth, and he quit smoking to keep them that way.
"Having my teeth whitened, or bleached, gives me more motivation not to smoke," he said. "I know it's bad for the lungs, but you see it immediately on the teeth."
Johnson 43, enjoys red wine and espresso, which also stain teeth, said Dominici-Bly. But he didn't indicate that he's giving those up.
Another benefit is that it makes his teeth look straight, said Johnson, a makeup artist at the Paul Brown Salon. He had considered getting his teeth straightened, he said.
As far as his dentist is concerned, however, "he has a beautiful smile."
THE CRAZE for a dazzling white smile has swept the country, resulting in myriad over-the-counter bleaching products and whitening requests to dentists.
Tooth-whitening is a safe and effective cosmetic procedure, but patients should get professional advice about the most appropriate treatment, especially if they have fillings, crowns or very dark stains, dentists say.
"We do believe in tooth whitening," said Dr. Russell Masunaga, general dentist in Kalihi and past president of the Hawaii Dental Association.
But some studies show "tooth whitening junkies" might end up with blue teeth, he said. Although strong, teeth can become so translucent they turn into a gray-blue color with too much whitening with over-the-counter products, he said.
Also, fillings won't change color and will look like "popcorn kernels" between bright white teeth, Masunaga said. The same is true with crowns, which remain dark and are "very noticeable" between white teeth, he said.
Whitening often can be done in one sitting in the dentist's office with a more concentrated hydrogen peroxide product. Or it can be done at home, taking one or two weeks, with a kit prepared by the dentist with a less potent whitening agent and a customized tray or mouth guard that sticks to the teeth. It also can be done with off-the-shelf products.
Costs vary depending on the patient's teeth and treatment.
Dominici-Bly made an impression of Johnson's teeth and from the model made a tray that fit. She gave him a syringe and low-concentrate whitening gel to drop into the mouthpiece.
Newer whitening products with up to 35 percent of carbamide peroxide provide faster whitening but might cause more problems if left on the teeth too long, she said.
The whitening agent penetrates the stain on the enamel in an oxidation process that's "like burning wood in the fireplace," she said.
Most of the whitening occurs in the first hour, she said, suggesting using any products at home only for an hour each day.
Dr. Mitchell Chun, Hawaii Dental Association president, said the fastest way of bleaching teeth probably is in the dentist's office with gel on the teeth activated by high-intensity or laser light. The gel works fine without the light, but it speeds up the process, he said.
He said at-home bleaching kits prepared by the dentist provide good results and allow the patient to control the degree of whitening.
Crest Whitestrips, marketed retail and in different formulations through dental offices, are cost-effective, but they are not as closely adapted to the teeth as the customized tray or mouth guard, he said.
Results from off-the-shelf products also are unpredictable without knowing the condition of the teeth, he said. Only a porous enamel tooth can be whitened, and some people have harder or less porous teeth, he said.
DR. RICHARD MIYAMOTO, a specialist in advanced cosmetic and implant dentistry, said patients are bombarded with information -- and some of it is misinformation.
He said some practices advertise a lighting system to activate the bleaching agent on the teeth. "We do it at times, but honestly, studies show whether you do lighting or not, it doesn't make any difference," he said.
Any dental or gum disease or decay should be treated before any bleaching, Miyamoto emphasized. "But patients are funny. They think the aesthetic side is more important than the disease," he said.
In-office bleaching probably could accelerate the process and reduce prescribed home-bleaching time, Miyamoto said. "However, does that justify the added expense? ... I would recommend just doing home bleaching (with custom treatment trays and whitening agents). It might take a week or two to get the same result."
Patients with straight teeth and mild discoloration "can get a fairly reasonable result" with over-the-counter products, but if their teeth are misaligned or crooked, the result will not be uniform, he said.
By Helen Altonn
haltonn@starbulletin.com
Dr. Lia Dominici-Bly was thrilled when one of her patients called out at her across a shopping mall yelling, "I quit, I quit!"
A cosmetic and family dentist, she had helped George Johnson whiten his teeth, and he quit smoking to keep them that way.
"Having my teeth whitened, or bleached, gives me more motivation not to smoke," he said. "I know it's bad for the lungs, but you see it immediately on the teeth."
Johnson 43, enjoys red wine and espresso, which also stain teeth, said Dominici-Bly. But he didn't indicate that he's giving those up.
Another benefit is that it makes his teeth look straight, said Johnson, a makeup artist at the Paul Brown Salon. He had considered getting his teeth straightened, he said.
As far as his dentist is concerned, however, "he has a beautiful smile."
THE CRAZE for a dazzling white smile has swept the country, resulting in myriad over-the-counter bleaching products and whitening requests to dentists.
Tooth-whitening is a safe and effective cosmetic procedure, but patients should get professional advice about the most appropriate treatment, especially if they have fillings, crowns or very dark stains, dentists say.
"We do believe in tooth whitening," said Dr. Russell Masunaga, general dentist in Kalihi and past president of the Hawaii Dental Association.
But some studies show "tooth whitening junkies" might end up with blue teeth, he said. Although strong, teeth can become so translucent they turn into a gray-blue color with too much whitening with over-the-counter products, he said.
Also, fillings won't change color and will look like "popcorn kernels" between bright white teeth, Masunaga said. The same is true with crowns, which remain dark and are "very noticeable" between white teeth, he said.
Whitening often can be done in one sitting in the dentist's office with a more concentrated hydrogen peroxide product. Or it can be done at home, taking one or two weeks, with a kit prepared by the dentist with a less potent whitening agent and a customized tray or mouth guard that sticks to the teeth. It also can be done with off-the-shelf products.
Costs vary depending on the patient's teeth and treatment.
Dominici-Bly made an impression of Johnson's teeth and from the model made a tray that fit. She gave him a syringe and low-concentrate whitening gel to drop into the mouthpiece.
SHE ALSO CAUTIONED that overuse of tooth-whitening products can result in gum irritation, tooth sensitivity and damage.
Newer whitening products with up to 35 percent of carbamide peroxide provide faster whitening but might cause more problems if left on the teeth too long, she said.
The whitening agent penetrates the stain on the enamel in an oxidation process that's "like burning wood in the fireplace," she said.
Most of the whitening occurs in the first hour, she said, suggesting using any products at home only for an hour each day.
Dr. Mitchell Chun, Hawaii Dental Association president, said the fastest way of bleaching teeth probably is in the dentist's office with gel on the teeth activated by high-intensity or laser light. The gel works fine without the light, but it speeds up the process, he said.
He said at-home bleaching kits prepared by the dentist provide good results and allow the patient to control the degree of whitening.
Crest Whitestrips, marketed retail and in different formulations through dental offices, are cost-effective, but they are not as closely adapted to the teeth as the customized tray or mouth guard, he said.
Results from off-the-shelf products also are unpredictable without knowing the condition of the teeth, he said. Only a porous enamel tooth can be whitened, and some people have harder or less porous teeth, he said.
DR. RICHARD MIYAMOTO, a specialist in advanced cosmetic and implant dentistry, said patients are bombarded with information -- and some of it is misinformation.
He said some practices advertise a lighting system to activate the bleaching agent on the teeth. "We do it at times, but honestly, studies show whether you do lighting or not, it doesn't make any difference," he said.
Any dental or gum disease or decay should be treated before any bleaching, Miyamoto emphasized. "But patients are funny. They think the aesthetic side is more important than the disease," he said.
In-office bleaching probably could accelerate the process and reduce prescribed home-bleaching time, Miyamoto said. "However, does that justify the added expense? ... I would recommend just doing home bleaching (with custom treatment trays and whitening agents). It might take a week or two to get the same result."
Patients with straight teeth and mild discoloration "can get a fairly reasonable result" with over-the-counter products, but if their teeth are misaligned or crooked, the result will not be uniform, he said.
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