What is the best teeth whitening method?

By Dr. Lara T. Coseo

“Most dentists agree that the best teeth whitening method is the “at-home whitening” procedure done with custom trays and professional gel.”

Dr. Lara

With so many options for teeth whitening available today, it can be confusing and difficult to understand the difference between them. They all promise unbelievable results, but which ones actually work? Do you have to see a dentist to get the most noticeable whitening effect? After explaining the difference between the available options, we will go into detail on the method that produces the best and most predictable results.

Understanding Different Teeth Whitening Methods

It is easiest to understand the various categories and sub-categories of teeth whitening by first separating professional from over-the-counter. By “professional”, we mean teeth whitening procedures and products that require a dentist’s supervision. All true teeth whiteners must contain a peroxide chemical (either carbamide peroxide or hydrogen peroxide) as the main ingredient. Any teeth whitening product that does not contain a peroxide will not penetrate into the tooth and actually change its color.

Professional Teeth Whitening

Professional teeth whitening requires a dentist’s supervision and typically produces better results than over-the-counter whiteners. Because a dentist performs or oversees professional teeth whitening, it is both safer and more predictable.

In-Office Teeth Whitening

Procedures like ZOOM!, Boost, and other “power whitening” require a dental visit. During these procedures, a dental professional applies an extremely high concentration whitening gel to the teeth after protecting the gums with a gingival barrier. Often, these in-office teeth whiteners use a UV (ultraviolet) or LED (light emitting diode) light, which functions to heat the whitening gel and speed up the whitening process. Most patients experience three to four shades of color change with in-office whitening. This is the only type of teeth whitening in which the dentist is actually whitening your teeth for you. This procedure is wonderful for patients who have areas in the mouth that need protection from the harsh chemicals of the whitening gel, like root exposure from gum recession. The procedure takes about an hour to an hour and a half, and it costs anywhere from $500-1000.

with Professional Strength Gel

The most popular type of professional teeth whitening is at-home whitening using custom-fitted trays and professional-strength whitening gel. The dentist makes a flexible plastic “carrier” tray from an exact replica of your teeth. You then use the professional strength whitening gel (which is available in different concentrations to meet a variety of needs) to whiten at your own discretion. After the initial visits with the dentist to fabricate the custom trays and demonstrate the use of the gel, you can whiten as much or as little as you would like. The trays will last for many years, and you can purchase refill kits of the gel when you need more. The cost of this procedure ranges from $100-500, with some dental offices even offering it as a free gift when you undergo various dental treatments.

Over-the-Counter Teeth Whitening

Most people think that the biggest difference between professional and over-the-counter teeth whitening products is the strength of the gel. Originally, there were some limits on what concentration of peroxide manufacturers were able to use in OTC products.

The internet has changed that! Now you can purchase many OTC teeth whiteners with gels just as strong as those from the dentist. The most important difference is the method of application to the teeth. In order to get the best results in teeth whitening, the peroxide chemical must remain in contact with the enamel for a set period of time.

Gels in Generic Mouthpieces

Many OTC products use a generic-fit mouthpiece to apply the gel to the teeth. Because these lack the close fit against all of the teeth, you can get excess gel to pool in the bottom of the tray (on the upper) or ooze out onto your gums (on the lower). This may lead to slower or less noticeable results.

Whitening Strips

Whitening strips have the peroxide gel embedded into the strip. When applied to the teeth, they do hold the active ingredient in contact with the teeth and produce relatively good results. Some people find these strips difficult to apply or keep in place for the prescribed amount of time.

Whitening Toothpaste

Of all the teeth whitening methods we discuss here, only whitening toothpaste is not a true whitener. It does not contain any peroxides and even if it did, they would not stay in contact with tooth structure long enough to make a difference. Whitening toothpastes are a great tool to keep your smile bright. They contain tiny abrasive particles, which work to polish away superficial stains that collect on the outer surface of the enamel.

Teeth whitening pens

Another trend in over-the-counter teeth whitening is whitening pens or swabs. These involve the application of the whitening product to the teeth with a small applicator tip that is similar to a pen, a paintbrush or a cotton swab. Typically, these do contain a peroxide chemical as the active ingredient. They are quick to apply and require no carrier tray or strip, which is appealing to many. The results of this type of whitener depends not only on the user’s ability to apply the product evenly to the teeth, but also on the product’s ability to stay on the teeth without a carrier for enough time to produce a noticeable result.

Which teeth whitening method is best?

Most dentists agree that the “gold standard” in teeth whitening is at-home whitening with custom trays and professional gel. Here are the details why.

Advantages of professional home whitening.

A home whitening treatment prescribed by your dentist offers a number of advantages compared to other whitening methods.

Cheaper than in-office professional treatments.
High percentage of successful treatments.
Ease of touch-up and re-treatments.
Less post-treatment discomfort.
Minimal time in dentist’s chair.

Advantages of professional home whitening.

Most Accurate Placement of Whitening Gel.

The intimate fit of custom whitening trays keeps the gel in constant contact with the desired tooth surface for the entire time you whiten. Not only does this produce the best, most consistent whitening results; it also conserves the whitening gel. The close fit of the trays keeps the gel in place, preventing it from extruding out onto the gum tissue and causing irritation. Because your dentist makes the tray, he or she can customize it to protect areas of gum recession or other dental problems, allowing you to whiten only certain areas.

Most dramatic results

Custom tray whitening may take a little longer than in-office whitening, but it allows you to achieve much greater results. When there is significant staining, it takes consistent whitening over a long period of time to make a noticeable difference. With custom trays, you can whiten for as many days as you need to achieve your desired results.

Most predictable results

When used correctly, at-home teeth whitening creates very predictable results. Case studies show consistent whitening of teeth in a variety of pre-whitening shades.

Most versatile whitening method

Because the whitening trays are the perfect carrier of gel, you can use almost any type of whitening gel in them. Most dental offices offer a variety of concentrations of gel to meet different needs. Those with sensitive teeth will need to use a low concentration gel for longer sessions. Those with busy schedules may choose a high strength gel that they can wear for just 20 minutes while putting on makeup or taking a shower. Professional whitening gels often contain added ingredients to fight sensitivity and harden tooth enamel.

Most cost-effective whitening procedure.

As we mentioned earlier, the custom-fitted trays will last for many years. While your initial investment maybe a few hundred dollars, over the lifespan of your whitening, it will average out to very little. Refill kits of gel can be purchased from your dentist or online retailers. You can even use over-the-counter gels in your professional trays.

Easy maintenance

At-home whitening with custom trays allows you to keep your teeth white as long as possible. After an initial whitening period of using the gel daily for 10-14 days, you need only whiten as desired to maintain your smile. Heavy coffee, tea, and red wine drinkers or tobacco users may need to perform maintenance whitening more often than those without such habits.

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