eith N. ShrumDentistry

Understanding Teeth WhiteningWhat You Need To Know Before You Whiten Your Teeth

Compare The 7 Most Common Options

From Toothpaste To Laser Whitening

Find Out Which One Is Right For YOU...3441 Lebanon Road-Suite 105

Hermitage, TN 37076(615) 883-4600

www.KeithShrumDentistry.com

What Options Are Available?

Over the last several years, people have become very interested in whiter teeth. Let’s face it, first impressions are vastly important in this day and age. In fact, research intohuman behavior reveals that we judge the physical, mental and emotional reserves of a person based on our instinctual first impressions. When we first meet someone, their face makes a huge impression on us. A radiant smile automatically registers feelings of trust.

Few people still remember the commercial jingle of years ago, “You wonder where the yellow went when you brush your teeth with Pepsodent.” Toothpaste used to be promoted to whiten teeth. Then for years, toothpaste companies focused their advertising on preventing cavities. When you asked people what toothpaste they could use to get their teeth whiter, only a very few toothpastes like Pearl Drops, Topol, and maybe Ultrabrite came to mind. These only whitened by “sanding” the tooth surface with gritty abrasives. Yet today when you look at the toothpaste shelves in your local grocery or drug store, it seems everyone has a whitening toothpaste.

As more and more of our patients were becoming confused about whitening their teeth and asking us what works best, we felt we needed to put together a comprehensive look at the choices.

The following is a compilation of personal opinions and may not reflect the opinions of major product manufacturers.

Whitening Toothpastes:The Same Old Toothpaste In A Fancy New Box?

First, let’s look at whitening toothpaste. When examining most toothpaste’s lists of ingredients, you will find that there is little difference. You would think that if you bought a product labeled as a whitening toothpaste, the active ingredient would be a tooth-whitening chemical. Yet even in more costly toothpastes like Rembrandt, the only ingredient the FDA is allowing to be listed as active is the fluoride compound, which has nothing to do with whitening teeth. Everything else is listed as inactive ingredients. Many toothpastes with whitening claims on the box are no different than before. They are just in a new box.

So what is in there that is whitening teeth? For many it is sand which sounds better to be called silica or even better when called hydrated silica (wet sand). This common abrasive has been around for years. Some toothpastes also use alumina and/or titanium dioxide. However, Dentists have said for years that high abrasiveness is not good because you do not want to slowly sand away your teeth!

The new whitening ingredient is frequently a type of sodium phosphate. The thought in whitening is usually based on the idea of removing a protein coating that the saliva naturally places on your teeth. It is called the pellicle and is the main reason for the natural “slimy” feeling teeth have. Most food stains do not initially stick to the tooth but stick in this protein coating. So if you brush it away before the stain actually absorbs into the tooth, it brushes away the trapped stain, and therefore removes the stain. The pellicle reforms on the tooth in just a few hours and so no damage is done to the tooth.

There is no doubt that keeping food stains off of your teeth is very important in keeping your teeth white. However, at best, these toothpastes are not making your teeth any whiter than a hygienist could by polishing your teeth. In reality since these ingredients do not remove tartar, a cleaning at your Dentist’s office is going to be much more effective at making your teeth look better. Also, it is important to remember that tartar control toothpastes do not remove tartar, they just slow down how fast it builds up so they do not whiten your teeth at all.

The important message with whitening toothpastes is that while they may be helpful in maintaining white teeth, they are not going to make much difference in the color of yourteeth once stained. So what can you do?

Over-The-Counter Whitening Systems Beware Your Tooth Enamel & Gums!

These “systems” are basically toothpastes with a small amount of peroxide and possibly a weak acid like phosphoric acid, acetic acid, or citric acid. Long-term exposure of your teeth to these acids does dissolve little bits of enamel from your teeth. The concentration of peroxide in these products is only about 1 to 3 percent, so is no more effective than rinsing with hydrogen peroxide that you can buy in the store (usually 3 percent). Long term rinsing with peroxides may be harmful to your gums.

There are a number of different choices with gels, they are all over-the-counter and none are Dentist administered. While these will whiten teeth a couple of shades they have many drawbacks.

Because whitening only occurs when the solution is in contact with the tooth surface, gels work better than strips for crooked teeth or between teeth. The gel is however hard to administer due to the fact that saliva, food or drinks wash the product off the tooth surface.

You must let the gel dry on the tooth to be effective, which is very difficult. The other concern for most people is that they will typically only whiten the front couple of teeth on top and bottom because it is difficult to paint and dry the back teeth. Gels are typically used because of the low cost and the results are quite limited. Very minor results are expected for straight, in between teeth or crooked teeth. Caution is also recommended as gum irritation can occur if application is not exact.

It is the opinion of most Dentists that we have read or talked with that these products are a waste of money if you hope to have noticeable results.

There are two different products here, over-the-counter and Dentist administered. Strips you buy over-the-counter are mildly effective over the long run, but do not provide comparable results to Dentist administered strips. The Professional strength strips from a Dentist give you much better results in a lot shorter time because they contain bleach that is 3 times stronger than over the counter strips. In order to obtain the level of whitening provided by Dentist whitening strips, you will probably need to use four to six boxes of over-the-counter whitening strips. Again, because whitening only occurs where the bleach is in contact with the tooth surface the strips do not work well for crooked teeth or between teeth. The other concern for most people is that, due to their size, strips only whiten the front 4 teeth on top and bottom. Many people who have used whitening strips then purchase a tray whitening system to significantly whiten their teeth or correct any uniformity issues created by whitening strips.

Dentist administered strips will give you good results if you have straight teeth but limited results between teeth. Even the Professional strips will never give you the results of a DentistAdministered system.

TeeTh WhiTening gels: WhaT They Don’T Tell you is hoW harD They are To apply.

TeeTh WhiTening sTrips: if you have perfecTly sTraighT TeeTh

Dentist Administered Whitening Tray Systems:The Only Effective Whitening Tray Systems Available

Now we are getting into something that can make a difference for many people without costing you an arm and a leg. In the mid 1980’s carbamide peroxide, which had been used for years for minor gum irritations was found to whiten teeth if it stayed in contact with teeth long enough. Peroxide is the product an estimated 99% of Dentists use today to whiten teeth in one product or another.

Tray systems are available in 2 major groups, one is a customized take home tray system and the other utilizes in-office whitening plus customized take home trays for the deepest, most long lasting whitening. Both processes will generally provide whitening in 2 weeks or less.

Most people with typical stains can get impressive results with these products. The average fee for these products ranges from $350 to $750. Both of these systems provide quick results without an extremely high cost.

Although instructions on bleaching with these products vary, essentially what happens is a Dentist makes an impression of your teeth, which

allows a plaster duplicate, or model, of your teeth to be made. Your Dentist then takes the copy of your teeth ,creates reservoirs for the bleach, and with special equipment, warms and then vacuums a plastic-like sheet over the model of your teeth. You now have what is essentially a very thin mouthguard, which is custom made just for your teeth, this is used as a tray to hold the bleaching gel against your teeth. Your Dentist can adjust these after wearing to ensure a comfortable fit.

You wear the trays at night while you sleep. For those who stay committed to completion of this process, most will see significant difference in the color of their teeth. Most people get excellent results from this bleaching process. However, for some people, the reality is they get tired of wearing the trays and never complete the bleaching process so they never get the results they could. For these people in-office bleaching by itself is an option,however, the results are just not as good as Custom Tray Bleaching or Power Bleaching (custom tray bleaching plus in-office bleaching). You have to ask yourself, ‘Do I want “fast” or do I want “white”?’

The other reason for less than expected results is that some trays are uncomfortable to wear and people don’t realize they can have them adjusted, included in the original cost.

Our goal is to help you achieve the results you are looking for. We have chosen to use a combination of carbamide peroxide and hydrogen peroxide in our office. If you want to see whitening for the lowest cost, the peroxide type bleaches are your best option. Dentists have a choice of several companies to purchase this material from. The most common names are Rembrandt, Nite White, Opalescence, Contrast, White and Brite, Zoom and Pola. We have chosen Pola due to its advanced desensitizing agents, and faster results which in turn means shorter office visits.

It is interesting to note that this same bleach (carbamide peroxide) can be purchased by you over-the-counter. The over the counter versions sell in most places (and infomercials) for about $25 to $50. But do not be fooled into thinking that you get the same thing. For one thing, the bleach is about a one-third concentration of what the Dentist uses and it is runny which means it does not stay in the tray long so you have to apply it more often. Applying it often means most people haveto purchase a second or third bottle to be able to complete their bleaching.

Perhaps the worst part of these bleaches is the tray. To hold the bleach against your teeth, these companies give you a ‘boil and bite’ athletic mouthguard. This is a simple way for you to make a bleaching tray at home, the problem is it is about 5 times the mass of a Dentist made bleaching tray. This large mouthguard is just too bulky for most people to wear 2 to 3 hours a day, or especially for overnight use.

By biting into it you do not create the proper reservoir for the bleach so when you place the mouthguard in your mouth with bleach in it, almost all of the bleach is just pressed out when you bite into it. If you do not keep biting into it, the lower teeth open slightly so they do not get bleached well. If you do bite into it, your jaw muscles can get sore and can create pain or headaches for many. This is especially a problem if you have TMJ (jaw joint) problems. It also rubs on the gums causing gum irritation. Most people just are not willing to put up with the discomfort 2 to 3 hours a day for 4 to 6 weeks for minimal results.

Dentist Administered Whitening Tray Systems:The Only Effective Whitening Tray Systems Available

anoTher over-The-counTer Warning!

Laser Whitening:Not Really As Fast And Effective As Some Dentists Want you to believe

The newest type of whitening is laser bleaching. This process was approved by the FDA in February of 1996, so it is relatively new. Many thousands of people have had their teeth bleached with this process. Even though there are several chemical components to this system, the main bleach in this product is hydrogen peroxide, which has been used for over 29 years to safely bleach teeth. The difference is rather than a 1 to 3 percent solution as in over the counter hydrogen peroxide bleaches, this procedure uses up to 50% hydrogen peroxide.

Bleach this strong is very irritating to skin. So a major concern in being able to use bleach of this strength is way to protect the gums, cheek, lips, and tongue. This is done by covering and protecting everything pink in your mouth with special waxes and gels. Even with these precautions you will still likely have some discomfort from the bleach and lasers.

Many Dentist proclaim that laser bleaching will get you super fast - super white results. While the procedure is fairly short and you will see immediate results from your trip to the office, the majority of the whitening you will see is from dehydration of the teeth. The halogen light source or “laser” used to speed up the process dehydrates the surface of the tooth giving it a much

whiter appearance in a short period of time but as the teeth rehydrate the degree of whiteness is significantly reduced.

Most dentists that provide this type of whitening service will also provide whitening trays for you to take home and use for the week or two following the treatment to get optimum lasting results.

Because of the substantial increase in the cost of this procedure combined with the increased tooth sensitivity plus the fact that you will probably need to use trays anyway to obtain the results you want we have decided not to offer this type of bleaching at Keith Shrum Dentistry. We know we can get you sparkling results for a lot less money.

We have refined and improved the standard bleaching procedures by using our 20 years of bleaching experience. We have chosen bleaching programs that we feel represent thebest value to our patients. We selected from and combined options to take advantage of what each product does best. This means that the bleaching process will vary from person to person as we consider each of our patient’s needs. During your complete whitening process a Dentist will be monitoring your progress to assure your teeth and gums remain healthy and that you will get the results you are looking for.

all of our proceDures are cusTomizeD To your siTuaTion

Keith Shrum DentAL CARE

Our goal is to help you understand the whitening process, answer any questions you may have, help you feel as comfortable as possible on the day of your bleaching and assist you throughout the process.

Keith Shrum Dentistry has been achieving phenomenal results by taking over 20 years of personal experience with bleaching teeth, selecting the very best from 3 different bleaching techniques, and combining them to be able to consistently achieve more color change than most other bleaching techniques available today.

If you would like to compare our techniques to over-the-counter bleaching kits, we can show you photographic proof that our bleaching procedures will get teeth whiter while being cost effective. With all our dentist administered whitening programs, we provide a touch up kit as part of our whitening protocol. This will assist you in touch-ups and provide ongoing whitening. The average fee charged by Dentists in the Nashville area for a touch up kit is around $50… but one is included in our procedures at no extra charge.

If your teeth have not been cleaned recently we recommend that you have them cleaned first to remove any tartar buildup as your teeth will not bleach under the tartar. We also suggest a full x-ray of your teeth that is less than six months old before starting any bleaching program to ensure maximum results. If your Dentist has taken these x-rays for you in the last six months, you may be able to get them from your present Dentist.

The big question on everyone’s mind when considering teeth whitening is “will the results be worth the time and cost?”We have invested thousands of dollars and 20 years of experience to make sure the answer is a resounding “YES!” We also have hundreds of success stories that back up our claims. Our top priority is to be certain that you are very happy with your results. While results vary from person to person, everyone can benefit from this procedure…. Most with Astounding results. The goal of bleaching is to give you the whitest possible teeth as quickly, easily, and inexpensively as possible. The next page is an explanation of how to estimate your results.

so, hoW WhiTe can you make my TeeTh?

keiTh shrum DenTisTry - our experience Will geT you resulTs

This will depend on your teeth - everyone’s teeth are different. If your teeth are heavily stained from coffee or smoking, you will probably see a big change. If your teeth are not heavily stained, the change will not be as great. Changes up to 12 shades lighter are possible. Dentist measure teeth color by using a shade guide. This is essentially 9 - 12 tooth shaped colors of porcelain arranged from brightest to darkest. We will use this guide to measure the change that takes place. Here at Keith Shrum Dentistry, we even utilize a computerized color matching device to take any human error out of the before and after shade measurements. If your teeth are fairly white to begin with, they may achieve a whiter color than the whitest on the guide in one bleaching series but may not have changes as dramatic as someone with darker teeth.

If your teeth are moderately dark, they may require two sessions to get the teeth as white as you want them. Very dark teeth especially gray colors and tetracycline stains may require three to four sessions. Each time you bleach there will be a change but after four sessions, the amount of change starts to dramatically reduce.

The darker the teeth are before they are bleached, the more chance that the teeth will have some color variation remaining. Darkly colored teeth have major variations in the amount of calcium per cubic millimeter. These teeth may not totally blend to be a solid color, thus you will still have color variations. The best way to estimate your results is by examing photographs of stains similiar to yours.

Custom Tray Bleaching is a good option for most people. Generally, teeth can be whitened from 3 to 5 shades with this option, and sometimes more. Completion of this bleaching process as prescribed is satisfactory to many of our patients.

You now have a shade that is whiter than most people’s teeth.

However, it seems more and more people want their teeth to be the whitest possible. If that’s the case for you then Power Bleaching (a combination of in-office bleaching and Custom Tray Bleaching) is recommended. The average case usually needs only one in-office bleaching visit following Custom Tray Bleaching. Those people who are determined to have teeth whiter than most people’s teeth (Yes, we have bleached teeth whiter than the whitest on the shade guide) should choose Power Bleaching with two in-office visits (one prior to Custom Tray Whitening, and one after). This is the recommended method to whiten people with very dark teeth due to tetracycline stains, iron stains, and dead teeth (root canaled or nerve died). These extreme cases can also require 2, 3, or 4 rounds

Understanding Teeth Whitening

unDersTanDing TeeTh color:JuDge aheaD of Time The resulTs you can expecT

of Custom Tray Bleaching between the two in-office bleaching visits.

If your teeth are dark, don’t get discouraged. We are here to help you and we have achieved some fantastic results. Just be prepared for us both to work a little harder and longer to get to where you want to be. Your dentist will always be the best judge of what methods will work best with your teeth, in fact, bleaching is not the only way to get the white teeth you’ve always want-ed. Custom veneers and/or crowns are another option that some people will wish to consider.

Keith Shrum DentAL CARE

Understanding Teeth Whitening

Whitening Toothpaste

$3 to $15 Continuously None • Very limited little or no whitening.• May prevent tartar buildup• Some may actually cause tooth and gum damage if used over long periods.

Paint On Gels $5 to $15 6 to 8 weeks None • Some whitening expected - difficult to administer (saliva washes off product).• Caution suggested as gum irritation can occur if application is not exact.

Over the Counter Tape Strips

$50 to $75 6 to 8 weeks None • May whiten teeth up to 7 shades.• Does not work well for crooked teeth.• Will not whiten between teeth. Only for front 4 teeth on top and bottom.

Professional Tape Strips

$80 Up to 4 weeks Yes • Will get good results if you have good teeth.• Limited results between teeth.• Only for front 4 teeth on top and bottom.

Custom Tray Whitening

$250 Up to 2 weeks Yes • Trays fit teeth perfectly allowing for even distribution of whitening gel.• Can customize solution strength.• In most dental offices this is the most economical treatment that gets good results.

Power Whitening

$395 Generally 2 weeksCan take 6 to 8 weeks in extreme cases

Yes • Excellent results expected.• Custom Tray Whitening with either 1 or 2 in-office bleaching visits depending one the severity of the color/staining.• Custom strength solution depending on how well your teeth bleach and sensitivity.• Keith Shrum Dentistry’s most economical treatment that gets high quality results.

Laser Whitening

$750 to $1200 Usually an hour Yes • Not recommended by Keith Shrum Dentistry• May take 2 sittings for severe staining.• Uses special dental light to activate whitening solution.• May cause temporary burning of gums.• Includes custom take home trays for touch ups.• Initial color change due to dehydration, which may cause severe sensitivity.

Method COST LENGTH OF TREATMENT

GUARANTEE EXPECTED RESULTS

TeeTh WhiTening opTion charT

All bleaching results will fade over time and need to retouched up to keep them bright. Many people would like to have more dramatic changes than just whitening or would like teeth that stay white without the touch ups. Veneers are a great solution for these people, they also make teeth more uniform and proportionate to your other teeth and mouth size. Crowns are also a way to get those perfect teeth you’ve always wanted. These and other cosmetic solutions may be a viable choice for those of you that may have teeth that cannot be bleached. Only your dentist can give you the information you need to make the correct choice for you.

permanenT WhiTening

The next step is to either call our office for more information, or to schedule a FREE consultation to let the Dentist evaluate your situation. This evaluation will give you a good idea what you can expect, and we’ll be able to show you lots of photographs of past patients and their results.

Call Keith Shrum Dental Now!At 615-883-4600www.keithshrumdentistry.comFree Consultations Must Be Scheduled In Advance.Please Call For Availability.

© 2010 H-Cube Inc.All Rights Reserved. www.hcubemarketing.comThis report may not be reproduced or copied for any purpose.For Additional Copies, Contact Keith Shrum Dental at 615-883-4600

What to Do NoW…

Keith Shrum DentAL CARE

eith N. ShrumDentistry