What takes place when your dentist performs professional teeth whitening treatments?

Professional teeth whitening: The procedure.

Your dentist has a large number of whitening products to choose from when they select a professional teeth whitening system. And while each of these systems may have their own unique characteristics, there is usually a standard set of steps that are performed when these types of products are used...

A) The dentist will evaluate the patient's pre-whitening treatment tooth shade.

Both the patient and dentist will want to be able to determine how effective the whitening treatment has been. In order to be able to make this comparison the dentist will need to document the pre-treatment shade of their patient's teeth.

The dentist will use an assortment of tooth-shaped porcelain tabs (each of which is a slightly different color) and compare each tab with their patient's teeth. The dentist will then determine which tab seems to match their patient's tooth color the best and then record this value in the patient's chart. In some instances the dentist may also choose to document the pre-treatment shade of their patient's teeth by taking a picture.

Before the teeth whitening process is performed the patient should have already had a professional dental cleaning. Both surface stain and tartar need to be removed from the patient's teeth before the bleaching treatment is performed. It is conceivable that a person may find that just having a dental cleaning has improved the appearance of their teeth enough that professional teeth whitening treatments are not needed.

Before the teeth whitening process is begun (and before determining the pre-treatment tooth color) the dentist will usually polish their patient's teeth with a compound such as flour of pumice so to insure that all surface staining, including any that might have formed since the dental cleaning, has been removed.

B) The dentist will isolate those teeth being whitened.

The peroxide bleaching agents that are used with professional teeth whitening systems are caustic and can irritate or damage soft oral tissues. So to protect these tissues, your dentist will need to isolate the teeth that will be bleached. They do this by way of placing a "dental dam."

One form of dental dam is one that is painted on. In this case a dental dam gel is applied around the teeth that will be treated. The gel is then cured thus creating a seal around each tooth that protects the gum tissue that lies underneath.

A cheek retractor is usually used in conjunction with a paint on dam so to help insure that the patient's lips and cheeks are held back out of the way. Gauze and cotton rolls may also be used to assist with tissue retraction. After the bleaching treatment has been completed the cheek retractors and cotton products are removed and then the dental dam material is simply peeled off.

• The Zoom! ® tooth whitening system.
  
• Opalescence ® tooth whitening system.
  
• The BriteSmile ® tooth whitening system.
  
• The LaserSmile ™ tooth whitening system.
  
• The Sapphire ™ Chairside system.
  
• The Beyond ™ Power whitening system.
  
• The LumaCool ™ tooth whitening system.
  
• NUPRO ® White Gold / Illumine ™ system.
  
• The Niveous ™ tooth whitening system.
  

Another form of dental dam barrier is a thin sheet of latex that dentists call a "rubber dam." Holes are punched in the latex (one for each tooth) and it is then slipped over the patient's teeth into position. The protruding teeth can be treated yet the latex sheet acts as a barrier to keep the bleaching agent away from the patient's gums and lips.

C) Eye protection and a bib covering are placed on the patient.

Because of the caustic nature of the peroxide bleaching compounds used during professional teeth whitening treatments eye protection is required. The unexpected can happen. During the bleaching process materials can be dropped or splashed. For these same reasons your dentist will probably place a protective bib over the upper portion of your body also.

Another reason eye protection is worn is because many professional teeth whitening systems make use of a light or laser to "activate" the bleaching agent. A laser or an intense bleaching light could cause eye damage.