ADVICE FROM A PROFESSIONAL

Yellow teeth usually bleach well, brown teeth are more difficult to whiten, and gray teeth may not bleach at all.
By REBECCA SLOAN
VINDICATOR CORRESPONDENT
Who hasn't dreamed of a mega-watt smile -- the kind of grin that can light up a room, turn heads and make members of the opposite sex do a double take.
For those of us whose pearly whites are a little less than pearly, cosmetic whitening might sound like an appealing option.
But what products and procedures on the market will really leave a smile whiter and not just leave a hefty dent in the pocket book?
Different types of whitening methods are not created equal and will not have the same effect on different teeth, according to Kim Bunea, an expanded functions dental auxiliary at Christopher T. Bart Family and Cosmetic Dentistry in Warren.
Bunea said there are six methods to whiten teeth: at-home bleaching; bleaching done at the dentist's office; laser bleaching; the application of porcelain veneers; the application of cosmetic bonding; or the use of whitening toothpaste.
Each method varies in cost and has its own caliber of effectiveness.
Bleaching at home: Bleaching solutions, whether applied at home or in the dentist's chair, rely on carbamide peroxide to whiten enamel and the underlying layers of teeth. Some bleaching kits are available over the counter starting at around $50, but Bunea recommends using a kit obtained through a dentist.
"You'll know the product is safe, and you'll get better results," she said.
Kits bought through a dental office typically require a dental tray -- or a mold that fits around the patient's teeth and holds the bleach in place.
The dental tray is made during an office visit, a procedure that can cost from $300 to $1,000. After the dental tray has been made, the patient places bleach inside the tray and wears the tray on the teeth overnight or for a few hours each day until the desired level of whiteness has been achieved.
At the office: In-office bleaching is performed in the dentist's chair and can cost more than at-home bleaching, starting at about $50 per tooth.
Usually a patient shows up for more than one session, which can last from 30 to 60 minutes.
Before the bleach solution is applied to the teeth during an in-office session, the dentist will apply a protective gel or a rubber shield to cover the gums, which could become irritated during the process.
Bunea said the results with at-home bleaching often are better than those of in-office bleaching.
"Simply because the patient can leave the solution on longer at home. Leaving a bleaching solution on for four hours at home will yield better results than leaving it on for 30 minutes in a dentist's chair," she said.
Lasers: Some dentists are using lasers during in-office bleaching sessions to enhance the action of the bleaching agent. This procedure is fairly new and not many area dentists practice it yet, Bunea said.
Laser bleaching takes about 80 minutes and can cost $500 to $2,000.
Whatever bleaching method a person chooses, Bunea said it is important to remember that the whiter, brighter just-bleached results will not last forever.
"If you bleach your teeth, whether you do it at home or have it done in a dentist's office, it is not going to be a one-time thing," Bunea said. "You will need to update the bleaching periodically. Your teeth come in contact with food and saliva every day, and they will not hold that bright, newly bleached look permanently, especially if you smoke or drink a lot of coffee."
Porcelain: Bunea said having porcelain veneers applied over stained or discolored teeth is one way to permanently whiten them. It is also the most expensive whitening option and can cost anywhere from $550 to $3,000 per tooth.
Porcelain veneers often work best on teeth that are genetically discolored or have been discolored due to medical or environmental reasons.
During the procedure, the tooth is roughed up and covered with a thin porcelain veneer made to perfectly fit the patient's teeth.
"The color of the porcelain veneers will not yellow or fade over time. It is a one-time procedure," said Bunea, who had porcelain veneers applied to her own teeth in 1988 and has been very pleased with them.
Cosmetic bonding: A less expensive alternative to porcelain veneers is cosmetic bonding. During this procedure, which costs about $150 per tooth, discolored teeth are covered with a plastic-like coating.
Bunea said although cosmetic bonding is cheaper than having porcelain veneers applied, cosmetically bonded teeth will stain and eventually the bonding will have to be removed and reapplied to maintain whiteness.
People who have their teeth cosmetically bonded or covered with porcelain veneers must be careful what they eat.
"One woman bit into a candy apple just right and chipped two of her veneers," Bunea said.
Toothpaste: Those who can't afford the more expensive options of teeth whitening often choose to brighten their teeth by brushing with a whitening toothpaste. This is the cheapest option, but, unfortunately, also the least effective.
"We are told by patients that some of the whitening toothpastes on the market work well, but a person cannot possibly get the same effect they would with cosmetic bleaching because toothpastes cannot include the same caliber of bleaching chemicals," Bunea said.
Bunea recommends discussing teeth whitening options with a dentist beforehand since each procedure has its own risks and it is difficult to determine how white teeth will be at the conclusion of a procedure.
For example, yellow teeth usually bleach well, brown teeth are more difficult to whiten, and gray teeth may not bleach at all.
Too much bleaching can make teeth brittle or sensitive, and teeth that are cosmetically bonded or filled with tooth-colored fillings cannot be lightened with bleach.
Teeth become stained and discolored for a variety of reasons.
Some teeth are dark genetically, while others become stained from drinking dark liquids or smoking. Fluoride can make teeth stronger, but it can also discolor them, and medicines such as antibiotic tetracycline can also discolor teeth.
Women who use antibiotic tetracycline while carrying a baby should know that there's a good chance the child will have discolored teeth when he or she becomes an adult.
"The medicine will not affect the mother's teeth, only the teeth of the unborn child," Bunea said.