Whitening

About Teeth whitening, have you ever wondered why almost every hunk or babe in the TV series Baywatch had such glistening white teeth? Well, of course no one would have paid too much attention to Pamela Anderson’s teeth, but the worst kept secret in Hollywood is, they all had their teeth bleached. That pearly white, “starry” smile used to be called the Hollywood smile. And it used to cost thousands of US$. Not anymore. The Hollywood smile has descended to the realm of mere mortals. Not only is tooth whitening readily available in dental practices all over the developed world, the cost for the procedure, like the US$, had come tumbling down.

The Bleaching Conspiracy?
The moment tooth whitening became a mass market thing, something unfortunate happened. Marketing efforts by various manufacturers of dentrifices churned out an array of relatively cheap whitening gels, pastes and liquids which gave consistently poor results. One TV ad even said that with their product, nobody would ever need to pay their dentist hundreds of dollars for whiter teeth. Hardly any one of those products is still being sold in Singapore. Why were these products ineffective? Because the strength of peroxide (the active ingredient in bleaching gels) in them is too low. Meanwhile, at the dentist’s office, fanciful “laser whitening” procedures were performed. These procedures seemed to work very well, but within days, the teeth started yellowing again. In the end, they only worked marginally better than the OTC products but cost many times more.

Back in the good old days (20 years ago) dentists were taught that only non-vital, root canal treated teeth could be bleached. In those days, we would open up the pulp chambers of non-vital teeth, place hydrogen peroxide into the chamber and then, heat up the potent solution with a hot instrument. The whitening effect came fast and was very effective. Every science student can tell you that heating up hydrogen peroxide will cause it to decompose into oxygen and water. It’s the heat that speeds up the process and release whitening oxygen into the microscopic pores in the inside of the teeth.

Then, vital bleaching hit the market not long after I first started practising. Suppliers started telling us that even vital teeth which have not been root canal treated can be bleached with peroxide gel applied on the outer, non-porous surface of the tooth. It didn’t sound probable, but the “magic light” suspended our disbelief.

Fanciful light equipment like plasma arc lights, LED lamps, lasers etc burned holes through many a dentist’s pocket. It turned out that many dentists have either forgotten their basic sciences or somehow decided to go along with the suppliers’ marketing strategy. Light does not activate peroxide decomposition. Not plasma arc light and definitely not LED light which is cool. It’s heat that does it, so perhaps laser does work, but we can’t use heat on vital teeth or we’ll kill them. As far as bleaching is concerned, a safe, non-heat-generating light is a useless light.

Not only were some of these equipment bulky and expensive to rent, the hype generated by aggressive marketing tactics resulted in unrealistic expectations on the part of both dentists and their trusting patients who have paid about S$900 to S$1200 for mediocre results.

Tooth whitening with carbamide peroxide has been around for almost as long as I've been practising dentistry. However, very few dentists had their bleaching products flying off the shelves. I was curious enough to have tried out a wide range of products, encountered almost every kind of tooth discolouration and after countless complaints and praises, I more or less figured out some of the realities of tooth whitening. It’s not magic. It works for the majority of people but the degree of whitening varies from individual to individual. It doesn’t work for just anybody. Maybe that’s why not every lifeguard you see below is smiling. And the expensive, fanciful equipment are a big rip-off.