The Cosmetic Dentistry Blog

I want to whiten my teeth but I’ve had many composite fillings over the years. Unfortunately, all of my teeth are of a yellowish shade by nature, so if I wanted to whiten them, wouldn’t I have to get the fillings replaced with whiter material and only then do the whitening? And what should I tackle first — should I wait to do whitening until after the canine situation is dealt with?
 - Diana in California

Diana,
You definitely want to do the tooth whitening first, and do the fillings later to match the whitened teeth. And you need to wait a couple of weeks after finishing the whitening so that your new whiter color stabilizes. Otherwise your fillings won’t match.

You can’t predict the shade result of bleaching beforehand.

A good cosmetic dentist will know this.
Dr. Hall

Hello Dr. Hall,
Can teeth be bleached to match the color of the eyeballs or is this unrealistic?
- Birte in Michigan

Dear Birte,
There seems to be no end to the creativity in these questions that I get. Thanks for a very creative question.

Whether or not you could get your teeth as white as your eyeballs depends on how white your eyeballs are. It’s possible, but there’s a limit to how white you can get teeth with bleaching.

But on the general question of matching a color with teeth bleaching–if you want to match some color, porcelain veneers is a better choice, because the results of bleaching are unpredictable. Bleaching will lighten the teeth, but how much depends on factors that are outside our control.

 That’s why when you’re having combination cosmetic dental treatments, it’s best to do the tooth bleaching first, then you match the other dental treatment to the bleached teeth. So if you have dark teeth but you only want to do six porcelain veneers, you bleach the teeth first, let the color stabilize (which takes a couple of weeks), and then veneer the front six so that they blend with the new color of the teeth further back. If you did the veneers first and the bleaching later, you wouldn’t be able to match the colors.
- Dr. Hall

Related information and links:
Read about teeth stains–the types of stains and how to treat them.
Ask Dr. Hall a question.
Find an expert cosmetic dentist.

Dr. Hall,
On the subject of teeth whitening, why can’t I just rinse with 3% hydrogen peroxide that I can buy in the drug store to achieve mild whitening?
- Cathy in Louisiana

Cathy,
Rinsing with peroxide might have a mild tooth whitening effect. But it will be very, very mild. The problem is that the whitening agent has to soak into your teeth, and in order to do that, it has to be in contact with your teeth for at least fifteen minutes. When you use the dentist-supervised at-home treatment, you wear the trays sometimes for a couple of hours or even overnight, which allows deep penetration into your teeth.

The discoloration in teeth is usually fairly deep. Your enamel is generally pretty translucent, and most of the color in your teeth comes from the dentin. So the object is to whiten the dentin.

Crest Whitestrips have a peroxide concentration of about 5 or 6%. The instructions are to wear the strip for thirty minutes a day for two weeks, and this produces a very mild whitening. If you rinse with 3% peroxide, your concentration is half that of the whitestrips, and if you rinse for one or two minutes, that will seem like an awfully long time.

I doubt you could go longer than that. So you can do the math and see how weak the effect of this technique will be: about one-fiftieth of the whitening power of Crest Whitestrips.

Dr. Hall.

Related information:
Read about Zoom whitening.
Read about tooth whitening relapse.

Dr. Hall,
My daughter just got her braces off and there were white spots on her teeth. Our family dentist suggested a Zoom whitening treatment for her, and we did that, but the spots haven’t gone away. Did she do something wrong?

Answer:
This is one of the problems with asking general dentists to do cosmetic dentistry. They just don’t know enough to do this right. Zoom whitening is a very effective treatment, but it isn’t for teeth that are uneven in color. Usually white spots are made worse by bleaching treatments, whether it is Zoom or the take-home tray tooth whitening.

There are several possible treatments available for your daughter’s white spots, depending on what exactly they are like. White spots after braces are usually caused by decalcification around the braces because of some oral hygiene problems the patient had while the braces were on. Tooth Mousse is a product that was developed specifically for this problem and actually helps remineralize these spots. There is another treatment called microabrasion that sometimes works, but it tends to make the teeth slightly creamier in color rather than whiter.

I myself would recommend direct dental bonding over the spots. The softened and decalcified enamel would be removed and replaced with composite. This enamel is actually suffering the early stages of tooth decay, so it has become defective and I feel that a direct repair is the way to go.
- Dr. Hall

Related information:
Alyssa’s white spots from her braces are turning brown and she is freaking out.
Tooth whitening.
Click here for referral to an expert cosmetic dentist.
Click here to ask Dr. Hall a question.

Dr. Hall:
Nice site. I happened on it looking for information about Lumineers.

My question pertains to tooth whitening. I have done many cases of tray-take home bleaching. I NEVER get white-white results. I do use Nite White. I disucss adjunct whitening toothpastes and certain habitual dietary controls. What is your secret (and technique) for white/white results?
- a dentist in California

Dear Dr. —
The secret to very white results isn’t whitening toothpaste or diet or anything other than the whitening procedure. It’s purely a function of the amount of time they whiten. Keep wearing the trays with the Nite White for as many hours of as many days as possible.
Even Zoom whitening won’t get teeth whiter than persistence and simple tray bleaching.
Dave

I have had white spots covering about half of my two front teeth for years since I was little. They make my smile look really white in pictures, but up close they are very distinct, expecially if I’m sick or tired. I like how they are so white but is there a way to get all of my teeth the same color as my white spots without Lumineers and without teeth whitening all of my teeth so my white spots get whiter… Is it possible to whiten my other teeth and not my white spots?
- Jessica

Jessica,
Yes, it is possible to whiten all your teeth but these two front ones. But while many dentists can do tooth bleaching, I believe this selective teeth bleaching needs an expert cosmetic dentist such as we list on our web site.

I would do this with the dentist-supervised at-home bleaching, where a custom tray is made for you. The dentist would just cut out the part of the tray around these two front teeth, which would prevent them from getting whitened.

There are various kinds of white spots that can be found on teeth. One type is an early sign of tooth decay. When the teeth are found to have white spots after braces are taken off, this is usually a beginning stage of decay. If this is the case, tooth bonding is the recommended solution. Or, they can be on the teeth since the teeth came in, which appears to be your case. Microabrasion can be used to treat these spots, but it leaves the teeth a little darker.
- Dr. Hall

Related information:
Click here for information about Zoom whitening.
Click here for referral to an expert cosmetic dentist.