What whitening really is
Whitening is not cleaning. Cleaning removes external deposits. Whitening changes the color of the tooth itself through chemical lightening of the tooth enamel. The active substance is hydrogen peroxide or carbamide peroxide in different concentrations, depending on the procedure.
Those who bleach without professional cleaning do not lighten the tooth but the deposits. That is the most common reason for unsatisfactory whitening results from drugstore products. Every serious whitening is therefore preceded by a dental hygiene session. Only on a cleaned tooth does the active substance work reliably.
Drugstore products versus dental treatment
In Switzerland whitening products for self-application are permitted with a maximum concentration of 0.1 percent hydrogen peroxide. That is medically a very low concentration with minimal effect. Strips, gels and pastes from the drugstore range deliver with correct application a very slight lightening of at most one shade level.
In dental practice we work with concentrations between 6 and 40 percent, depending on the procedure. These concentrations are only permitted in Switzerland under dental control and deliver lightenings of two to four shade levels. The decisive point is not the higher concentration but the controlled application with gum protection, findings check and individual adjustment.
In-office whitening, home whitening, internal whitening
In-office whitening
In a single session of one to two hours the active substance is applied to the tooth surface in high concentration. The gum is covered by a protective gel barrier. With some procedures the reaction is accelerated by light or laser, which, however, only marginally improves the effect. In-office whitening delivers the fastest result and is suitable for persons with tight time window or upcoming occasion.
Home whitening
We take impressions and fabricate individually thermoformed trays that fit the teeth precisely. You wear the trays at home overnight or for one hour during the day, filled with active gel. The treatment lasts ten to fourteen days. The end result is equivalent to in-office whitening, the effort for you is higher, the price lower.
Internal whitening
For a single dark-discolored tooth after a previous root canal treatment, surface whitening is not sufficient. In these cases the active substance is placed in the pulp chamber of the root-treated tooth and renewed across several sessions. The procedure is limited to individual teeth and delivers very good results with dark-discolored individual teeth.
When whitening does not work
Whitening works on healthy tooth enamel. It does not work on crowns, veneers, inlays or composite fillings. Those who apply whitening and have restorations in the front area risk a visible color difference between lightened own teeth and unchanged restorations. We discuss this in the assessment before whitening.
With tetracycline-induced discolorations from childhood, pronounced fluorosis or dentinogenic discolorations, whitening is often insufficient. In these cases we discuss veneers as an alternative aesthetic solution.
For patients with pronounced caries, exposed tooth necks or acute gum inflammation we postpone the whitening until the dental prerequisites are resolved. Those who bleach on inflamed gum risk intensified sensitivity and reduced effect.
Safety and side effects
Hydrogen peroxide and carbamide peroxide have been established in dentistry for decades and are considered safe with medically correct application. The most common side effect is a temporary sensitivity to cold and warm stimuli, which fades completely within 24 to 48 hours.
With contact with the gum a short-term white discoloration of the mucosa can occur, which also heals completely after a few days. We prevent this effect through careful gum protection before applying the active substance.
Long-term studies on multiply bleached patients have so far given no indications of structural damages to the tooth enamel. Prerequisite is application at dentally defensible intervals, usually not more often than annually or after individual indication.
How long the result lasts
One to three years, depending on lifestyle and oral hygiene. Strongly staining foods significantly reduce durability:
- Coffee and black tea
- Red wine and dark juice
- Berries and tomato sauces
- Tobacco in any form
Those who want to keep the result for a long time combine the whitening with annual dental hygiene and an adjusted brushing technique. A single refresh with home whitening trays every twelve to eighteen months keeps the result stable without a complete re-treatment being necessary.
What whitening costs
In Switzerland the costs move in the following bandwidths:
We bill according to SSO tariff. The costs depend on the procedure (in-office whitening, home whitening, internal whitening), the effort and material consumption. In-office whitening is usually more expensive than home whitening, internal whitening is billed per session.
Health insurance does not cover whitening because it is classified as a purely aesthetic treatment. You receive a written cost estimate from us before treatment begins.
When you should not have a whitening
During pregnancy and breastfeeding, because no sufficient study evidence on the safety of the active substances in this phase is available. For persons under 18 because the tooth enamel is not yet fully matured and the pulp cavity is larger than in adults. With acute caries or gum inflammation. With untreated root canals or open restorations.
In all other cases whitening is a safe and effective procedure with a well-documented history of effect and a clearly defined indication. Before treatment comes the findings. Those who bleach without findings lighten the wrong thing.