Expert Interview: Teeth Whitening

Today's Expert Interview takes a closer look at one of cosmetic dentistry's most popular procedures: teeth whitening.

DentalFind sat down with
Dr. Nathaniel Lim, DDS, a well-known specialist based in Oak Park, IL, to discuss some common questions about teeth whitening.

Dr. Lim received his medical degree from the Northwestern University Dental School, and his undergraduate degree from UCLA. His area of expertise covers a broad range of cosmetic and general dentistry procedures.

Do you recommend hydrogen peroxide whitening strips?

Dr. Lim: If all you’re looking for is to change the shade by maybe one or two, then they can be suitable. But if you’re looking for substantial change, then obviously it's not what you would use; you’d use something prescription strength.

Dentists advise completely avoiding staining beverages like coffee and tea for a few days after the use of whitening strips. Why?

Dr. Lim: Yes, because of how the chemical reaction works. Whitening causes the tooth to temporarily become more porous, so if you start drinking things that would stain, like coffee, red wine, or coke, then you are subjecting your tooth to more staining.

"It’s not something people have to invest a huge amount of money in anymore."

Does teeth whitening necessarily entail some loss of tooth enamel?

Dr. Lim: No, it does not. People ask about this, mostly because of sensitivity issues. But lately the sensitivity issues arise because they overfill the [teeth whitening] tray. It gets to the gum and the gum gets irritated or the dentin underneath the enamel gets exposed a little bit. That’s actually what is causing the sensitivity, not the actual material causing the enamel to go away.

What’s the most effective in-office whitening procedure?

Dr. Lim: The prescription-strength take-home gel is the most effective. Because things like Zoom and BrightSmile, they do whiten your teeth very quickly, but there’s a rebound effect that I have noticed. So I would actually suggest a take-home kit that you get from your dentist. It’s a clear frame that you put some gel on. It takes about a week or two depending on the level of whitening you are looking to do.

Are some people poor candidates for teeth whitening?

Dr. Lim: There has been research into what will work on people who are traditionally poor whitening candidates, like people with tetracycline staining. They have some new power bleaching that I am not familiar with that claims to actually whiten those teeth as well. Other conditions -- if your teeth have patterns on them, when you are trying to whiten them, the pattern will not go away. That just happened two or three days ago on a patient whose child had a tooth that had a different pattern on some areas of it. They said “I want a whitening so it will look nice and even.” It won’t work with whitening.

Is brushing with baking soda effective for whitening teeth?

Dr. Lim: I’ve heard different answers to this. What I do know is that baking soda can actually hurt your gums because of the powder size -- it’s too abrasive.

Are diet sodas as staining on the teeth as regular (non-diet) sodas?

Dr. Lim: From my understanding it’s the acid content, which is in both diet and regular.

Do some insurance plans cover teeth whitening?

Dr. Lim: I haven’t seen any that do. It’s considered more cosmetic and nowadays it’s so affordable. For example my office, I’m doing [the take-home trays] for like $99. It’s not something people have to invest a huge amount of money in anymore. The Zoom is ridiculously costly.

How soon after whitening do people need a subsequent application?

Dr. Lim: Typically what I see from patients is that they don’t normally need to whiten again until at least a year, usually longer, unless you’re overly aware of what’s going on with your teeth and you really want them to stay at a certain level. Typically a year to two years for a normal touch up. It’s something you can always go to your dental office and ask for more materials as long as your tray is intact, you could just touch it up.

Read more about the causes of teeth discoloration and types of teeth whitening procedures.

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