Do Crest "whitestrips" whiten by stripping enamel off your teeth?

[MUN2005]

Or do they actually add something that whitens? Having an argument with somebody on the topic. She says they strip the outer layer of your teeth off, but I don't think they do...anyone know?

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[Big_Poppa DDS]

no, its some type of oxidation rxn.

 

[sunwoongc]

i thought that bleaching causes some roughening of the enamel so that the tooth refracts light differently, thus making the tooth look white. This is what i remember from learning last semester. Am i totally off?

steve

 

[aka-Jalopycat]

If you really want to whiten your teeth, get the opalescence gel from your dentist. It works great. It kinda makes your teeth hurt for about 24 hours, but it's well worth it! 🙂

 

[aka-Jalopycat]

Sorry, I just realized you weren't asking about how to whiten teeth. Oh well. I think it's oxidation that makes it work. At least that's how the gels are.

 

[DrJeff]

Yup, it's an oxidation rxn. The primary agent is carbamide peroxide which breaks down into the active ingredient, hydrogen peroxide which after oxidation is broken down into oxygen and water. This is the essential process by which all chemical bleaching (be it whitestrips, tray bleaching, or light activated bleaching) works. No enamel is "stripped" away in the process. Basically all three of these techniques will work, so just quicker than others. Basically the entire bleaching process is a concentration vs time vs results process (i.e. the higher the concentration of the bleaching agent, the less time it will take to get the results, the lower the concentration, the longer the time). Ultimately though with time, you'll be able to get the same final results with whitestrips as with a tray system (i.e. Opalescence, Nightwhite, Platinum, etc) as with a light activated system (i.e. Zoom, Brightsmile, etc). All bleaching systems can cause short term sensitivity, from the cases done in my office (we offer professional strenth whitestrips, Nightwhite, and Zoom) the levels of post bleaching sensitivity are greatest with the Zoom, than the Nightwhite, and almost zero with the whitestrips. Interestingly enough the post tx sensitivity last longer with the Nightwhite than with the Zoom, and is easily treated with topical flouride. Overall post bleaching sensitivity is about 20 to 25% of the patients that we treat in my office. Final results do very a bit based on starting shades. In general folks that in in the Vita A and B groups will have the best results, followed by the D group and the "toughest" to bleach have been the C groups (those gray based shades just don't get as dramatic result as the others 😡 ). Our results (and we keep extensive track of everyone in the office) have been an average results of 5.4 shades whiter on the Vita scale (that's based on over 350 patients with starting shades from B1 to C4).
Back to the whitestrips for a minute. We've been selling the professional strength kits (just under twice the carbamide peroxide levels as the standard over the counter whitestrips) since the beginning of March, and the feedback from our patients has been remarkable. They love them, they're getting good results, and most importantly they're telling their friends about it! The best thing about them for office morale is that Crest has a promotion where for every 12 cases that you buy (4 kits per case at a cost of $104 per case) Crest will give you a voucher for a free 3 day 2 night vacation at one of roughly 100 resorts across the US and Canada. My partner and I then turn around and give these vacations to our staff. The staff realizing this then promotes the product more, and we end up selling more of them (currently we're going through over a case a week). It's great, our patients are happy, our staff is happy, and as a result my partner and I are happy.

 

[al]

Hey dents

I'm curious on how long these whitening results generally last, assuming that good brushing habits are maintained? I mean, if one drinks coffee, grapejuice,pepsi etc, will the "whiteness" fade away rather quickly? are we talkin months, years, decades?

another random question, do you guys recommend a standard toothbrush, or those sonic/vibrating toothbrushes that I see on those late-night infomercials?

 

[Toots]

Another whitening question-
I have a crown and a maryland bridge - can I use whitestrips? And if not, what is my best option?

 

[Big_Poppa DDS]

any crowns, bridges, composites will not change color - you would have to bleach and then replace the restorations.

 

[DrJeff]

•••quote:•••Originally posted by al:
•Hey dents

I'm curious on how long these whitening results generally last, assuming that good brushing habits are maintained? I mean, if one drinks coffee, grapejuice,pepsi etc, will the "whiteness" fade away rather quickly? are we talkin months, years, decades?

another random question, do you guys recommend a standard toothbrush, or those sonic/vibrating toothbrushes that I see on those late-night infomercials?•••••How long will the bleaching results last??? 😕 In general, the best answer that I can tell you is the same one I tell my bleaching patients. It varies greatly from person to person. First off, if your daily diet involves alot of coffee, tea, red wine, and dark pigmented foods, you will see your results fade quicker than a diet not rich in those foods/drinks. If you're a smoker, then that dulling will accelerate even more. The greatest variable though isn't as much as it is one's perception of their tooth color. Some folks are quite paranoid/obsessed and will want to do a "touch up" bleaching every few months (even if no clinical shade change has occurred). Most folks are much more subdued in their color perception and may request a touch up every 3 to 5 years. Some folks will never request a touch up.

The rule of thumb that I tell my non smoking patients is that with a typical diet that the results will generally last a good 3 to 5 years before any appreciable (read as 3 to 5 shade) color change will occur. For smokers, I tell them 1 to 2 years is expected. What I also tell all my bleaching patients is that in the future if any touch up bleaching is needed the way that bleaching technology is advancing is that we'll likely have a far superior system that yields even greater results is a shorter amount of time by then.

 

[MUN2005]

Thanks for the great feedback guys! I still have another question though: Will my dentist give me the professional white strips just upon my request, or wil she have to do an assesment, etc. Or should I just go by the commercial ones first?

Thanks

 

[DrJeff]

That depends on a few things. First and foremost, does your dentist sell the professional strength whitestrips?? Not every office carries them yet. Then, are you a good candidate (i.e. no active decay, minimal, if any, composite/ceramic restoration especially in the anterior region since those materials won't bleach). Lastly, does your dentist believe in them, or will he/she try and steer you towards a different and/or more expensive/profitable system for their pockets.

If they steer you away from the professional whitestrips and you want to try them, buy the regular ones in the store. They will work, it will just take a couple of extra days to get the final results. When using them, just make sure that the strip extends all the way over the front surface of your teeth upto the gum line (I've had a few patients who have ended up with a couple of "stripes" at the gum line. Also another trick that I've found is that when you apply them, make what I call the "fish face" and really pucker your lips together, that will do a better job at getting full adherence of the strips to your teeth. Bleach away!

 

[sunwoongc]

Maybe this will help!!!!!

How does bleaching work?

The exact mechanism of action for the bleaching technique is not known. Bleaching agents have been shown to penetrate enamel and dentinal tissues when allowed sufficient time to diffuse through those structures. Some studies report that bleaching with peroxide removes the enamel matrix which create microscopic voids in the enamel. This serves to scatter light which increases the apparent lightness until the teeth remineralize and the color relapses. The active agent in lighteners carbamide peroxide (CH4N2O H202) breaks down to hydrogen peroxide and oxygen free radicals. These free radicals degrade stained teeth. Clinical Research Associates reported that home bleaching solutions removed some of the smear layer, but left the dentin tubules occluded. Thus, home bleaching kit does not open up dentinal tubules. Enamel is not affected adversely by most bleaching agents, but that contact with dentin should be avoided.

Due to the acidic pH of some home bleaches, tooth sensitivity during treatment is a possible side effect. Often this will continue until use of a fluoride containing dentifrice is initiated. Of note is the fact that one group reported that the use of fluoride during bleaching might actually impede the bleaching process.

Resources:
1. The Effects of Vital Bleaching Solutions on Dental Luting Agents by William Gordon Christensen, DDS, 1991

 

[MUN2005]

Thanks for the info, very interesting.