Chairside whitening 

Chairside whitening 

Chairside whitening, or professional teeth whitening, is the least invasive way to lighten and brighten your teeth. An experienced dental professional carries out the procedure in a sterile environment with the latest equipment and gives the best results compared to other whitening treatments.

When Do You Need Chairside Whitening?     

Surface stains on the teeth, or extrinsic stains, are successfully treated with chairside whitening.  These stains are caused by the deposition of dietary pigments in the dental plaque or pellicle (a thin transparent layer of salivary proteins). Frequent consumption of coffee, coke, tea, or red wine increases the risk of staining on the teeth. 

Over time, these stains penetrate the microscopic cracks and fissures of tooth enamel and become permanent. They can’t be removed through brushing and require whitening treatments. It may take 3-4 weeks to see the whitening and brightening effect. 

In-office whitening responds slowly to intrinsic stains (deep enamel stains). Brown, orange, and white stains due to fluoride and nicotine take 1-3 months to see the difference. Tetracycline stains (dark grey, brown, or blue) are most challenging to treat with in-office bleaching and often require crowning, macro or microabrasion. 

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What to expect?

  • Establish realistic expectations from the treatment. For instance, grey discoloration of teeth due to aging will not brighten the teeth as a 20-year-old because of the thicker yellow dentin reflecting from the enamel. Young people have thin dentin and, therefore, get significantly whiter and brighter teeth at the end of the treatment. 
  • White fillings will not whiten with the bleaching treatment and need replacement after the desired shade of natural teeth is attained.
  • In-office whitening may lead to sensitivity in teeth, so discuss with your dentist if you already have sensitivity in teeth. 

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SOPs followed before the procedure

The following SOPs are done before proceeding to chairside whitening:

Chairside whitening 
  • The x-ray of all the teeth is taken to evaluate any fillings, tooth decay, and gum recession.
  • The vitality of the front teeth is checked through electric pulp testing. 
  • You will be asked to fill out a consent form that contains all the information about the treatment and its complications.
  • The dentist may take your pictures before the treatment to compare later results.

Preparing the patient for chairside whitening 

A pre-treatment teeth shade is noted using a shade guide. After the shade determination, the scaling and polishing are done to remove the plaque and tartar from the teeth. 

Some dentists use an opaldam light-cured barrier, an adhesive barrier, to isolate the teeth from gums; others use a rubber dam for isolation. 

A high concentration of hydrogen peroxide (15-40%) is used during the procedure, and any accidental contact of peroxide with the gums may burn the tissues. The burned gums turn white but will resume their normal color after a couple of hours. 

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Chairside whitening Procedure 

There are some variations in the procedure among different dental practices. However, most whitening systems use three sets of a 15-minute application of hydrogen peroxide gel. A 0.5-1mm of gel is applied to the front teeth, and are exposed to LED light. Some whitening systems have chemically activated gels and don’t require light. The saliva is suctioned periodically to prevent saliva contamination. 

Every 15 minutes, the peroxide gel is rinsed, a fresh batch is applied, and the procedure is repeated. After completing the three sets, the teeth are thoroughly rinsed, and the shade is checked. The same method can be repeated in the following appointments until the desired results are obtained. 

Chairside whitening can be combined with at-home bleaching to enhance the effectiveness of treatment. 

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How Does Hydrogen Peroxide Work?

In-office bleaching uses 30-35% Hydrogen Peroxide, a bleaching agent. Light-activated systems require LED light to activate the gel.  

Hydrogen peroxide is an oxidizing agent. On exposure to light, the hydrogen peroxide dissociates into water and oxygen releasing the free radicals such as hydroxyl ions, perhydroxyl anions, perhydroxyl radicals, superoxide anions, and oxygen molecules. The free radicals bind to organic discolored molecules and break them apart.

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How long does chairside whitening last?

It is difficult to say how long in-office bleaching lasts. Generally, the longevity of the results relies on dietary and smoking habits. The frequency of consumption of chromogenic foods and drinks is directly related to discoloration of the teeth. 

For instance, a habitual coffee drinker taking 5-6 cups and one or two glasses of red wine daily will likely get tooth discoloration fast, within six months to 1 year. Also, smokers are likely to get the stains faster, depending upon the number of cigarettes smoked per day. For individuals with no such habits, the whitening treatment can last up to 3 years.

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Professional vs at-home whitening – which is better?

Chairside whitening is yet expensive but significantly gives faster results than at-home whitening treatment. In a study, at-home whitening carried out 6-8 hours daily for 5-7 days produces similar results with an hour in-office bleaching. 

How much does chairside whitening cost?

Chairside whitening is an expensive esthetic procedure and is, therefore, is not covered under insurrance. Generally, it costs between $500-$2000.

What are the side Effects of chairside whitening

The most common adverse effect of chairside whitening is tooth sensitivity, which affects almost 75% of individuals undergoing whitening treatments. The tooth sensitivity is most intense during the first 24 hours and probably goes away in 5-7 days. 

The pH of whitening gels varies from 3.8 to 11. The acidic gels are given in 3×15 minutes to decrease the demineralization effect of the acidic gel. The alkaline gel is given for 1×45 minutes. Whitening gels contain desensitizing agents, such as potassium nitrate and potassium fluoride, to make the treatment more comfortable. The desensitizing effects of potassium nitrate last up to 24 hours. Moreover, potassium fluoride remineralizes the teeth after peroxide exposure. 

You may be asked to take Advil 400 mg (ibuprofen) or naproxen 220 mg before the treatment to prevent post-treatment sensitivity due to peroxide penetration into pulpal tissues. 

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Chairside whitening is an effective, yet expensive method of whitening teeth. A high concentration of hydrogen peroxide (15-40%) is applied to the front teeth for a specified time. Tooth sensitivity is a common side effect of in-office bleaching due to high concentration of peroxide exposure.

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