Tags: dentist, london dentist, nhs, whitening, inman aligner, cosmetic dentist, checkup, dental, anish, anish dentist, london hygienist, dental hygiene, root canal., whitening.
Teeth whitening can be done in the surgery over an hour for an instant result, or done daily for 6 weeks to provide a long-lasting result. To have whitening done you must have a full dental check to ensure you are suitable and there are not more pressing issues to treat first. At Pimlico Dental we only use appropraite concentrations of carbamide peroxide in a controlled environment.
After the check-up we will discuss realisic results for your particular case and whether we would need to replace old fillings in the process, as it must be noted that fillings/crowns/veneers will not bleach like your teeth will, and often if not addressed there is a marked difference between the fillings and teeth at the end of treatment.
There are two groups of staining contributing to darkened teeth-intrinisc and extrinsic. Intrinsic staining as the name implies comes from within the tooth and can be the result of the tooth dying out or inherited tetracycline staining. Intrisic staining can only be helped with bleaching from within the tooth once a root filling has been placed and in extreme cases we have to use whitening with veneers to mask the colour completely.
Extrinsic staining comes from pigmented foodstuffs, such as wines, coffee, tea,tobacco, or colour producing bacteria. Whitening combined with a hygienist clean can normally give you a desirable result.
There are many other causes of discolouration that are due abnormalities in tooth development. An example of this would be an excesive consumption of fluoride as a child causing mottling/pitting of the outer surface of the teeth.This can only be truley cured by coverage (veneer/crown). Staining occuring within these areas can be helped with a abrasive and weak acid pastes over a few visits and is know as micro abrasion.
Take Home Whitening Trays
1.  After the check-up the first appointment will be a discussion of your goals, some before pictures of your smile, and an impression of your upper and lower teeth. This will be sent to the laboratory for your custom bleaching trays to be made.
2.  The second appointment will be to show you how to load the trays with the bleach, when to wear them, how long for, and how to care for the trays and bleach. At this point we will make a review appointment for 6 weeks to assess the results.
3.  At the 6 week review if the instructions were followed we should see a considerable change. After pictures will be taken and direct comparison will be made.If you have achieved your desired shade, we will ask you to stop and top up only when you need to. If not, instructions for continued use and a review appointment will be made.
Some sensitivty of the teeth is to be expected if being used for the first time. The custom trays we use control the spread of bleaching gel and help reduce sensitivity. If you do experience severe sensitivty, we advise you to stop and use sensitive toothpaste and return to the surgery for an evaluation.
Outside of the dental surgery in uncontrolled environments you can be given to unsafe levels of bleach. This can lead to sensivity and in extreme cases tooth death and threfore the General Dental Council only recommeneds you have such treatment with a qualified dental professional. No matter how simple the procedure may seem, having it done by someone trained to perform not only the whitening but also trained to correct problems if encountered is the safest way to proceed.
An alternative, more destructive alternative would be veneers. This would cover the entire front surface of the tooth, and would require some shaving of the tooth. As a conservative practice we would always advise whitening and hygiene if the only concern was extrinsic staining. Heavily filled and discoloured teeth can be treated with full coverage crowns also.
Whitening is done in many places outside the dental surgery, with few of them officially qualified to assess suitability, manage risks, and provide realistic outcomes, as well as offer alternatives when it fails. Whitening is a part of dentistry, should not be seen in isolation, and treated holistically by those qualified and indemnified to do so.