Even with COVID-19 face masks and coverings concealing our mouths, you’ll be hard pressed to find anyone who doesn’t want a brighter, whiter smile. Professional teeth whitening is the gold standard for illuminating the smile, but there are a host of at-home whitening kits and products ranging from strips and trays to toothpastes and mouthwashes that promise similar benefits. So, what’s the difference between in-office whitening treatments and the ones you can find at the drugstore? We asked the experts.
Professional vs. At-Home Teeth Whitening
Just like over-the-counter skincare is less concentrated than its prescription counterparts, at-home teeth whitening products are not as potent as professional treatments. “In-office teeth whitening tends to be much stronger,” says Michael Apa, DDS, a celebrity dentist and founder of Apa Beauty.
Even so, the active ingredient in all teeth whitening treatments is peroxide, which can come in two forms: hydrogen and carbamide. “Peroxide is a natural occurring compound and safe to use in the mouth,” explains Stacy Spizuoco, DDS, a New York City-based cosmetic dentist with Onsite Dental and clinical instructor at Columbia University College of Dental Medicine. “The body has peroxidases, which are enzymes that can safely break down peroxide into water and oxygen.” Both types of peroxide offer similar bleaching benefits.
“Carbamide oxidizes and breaks down to hydrogen peroxide and urea,” she says. “This is a slow and limited reaction.” As a result, it is generally considered safer for at-home use and is found in kits like the Smile Brilliant Whitening System and Apa White Duo. Hydrogen peroxide, meanwhile, acts alone. “In-office teeth whitening is typically 35 percent hydrogen peroxide, whereas at-home is typically 10 percent hydrogen peroxide,” Dr. Apa shares.
Professional Teeth Whitening Treatments
In-office teeth whitening is a non-invasive treatment that uses a professional bleaching agent to whiten the teeth. There are two main types of professional whitening treatments — chairside and take-home trays. “In-office chairside whitening entails the dental professional placing a light setting material on your gums to protect them from the bleach,” Dr. Spizuoco explains. “They then apply the bleach and can leave it on for up to 60 minutes, sometimes using a light to activate the bleach.”
If you think back to old-school teeth whitening lights, you may associate them with tooth sensitivity. “Older lights generated heat, which made teeth more sensitive,” Dr. Apa says. That is less of a concern with newer technologies. “New lights like Zoom do not generate heat,” he adds. It should be noted that the light isn’t doing the bleaching. “It is just initiating the bleach,” he explains. “Other systems have liquid initiators that are mixed with the bleach and applied to the teeth.”
The other method is to fabricate take-home trays. “Molds of your teeth are taken to create custom trays that you put the bleach into,” Dr. Spizuoco says of this hybrid professional and at-home option. “These trays can be worn for as short as one hour or as long as overnight while you sleep.” Because dental professionals can use a higher percentage of bleach, teeth may be sensitive. Potassium nitrate and fluoride are often added to soothe the dental nerves, she says.
Professional teeth whitening treatments are efficient (most take less than an hour), and the results typically last six months to a year, depending on the patient. They can cost upwards of $1,000 per session.
To maximize the benefits, Dr. Apa recommends a few healthy lifestyle changes. “If you are really good about not smoking, not eating things that stain your teeth, or not letting things sit on your teeth for long periods of time, your results will have a much longer lifespan,” he says. Additionally, touch-ups are possible without a trip to the office. “Touch-ups are typically done with at-home bleach, where you are using either a custom tray or a strip,” Dr. Apa explains. “If the normal regimen for an at-home bleaching is 10 to 14 days, for example, a touch-up regimen is two to three days.”
At-Home Teeth Whitening Options
Speaking of at-home teeth whitening, the process requires a bit more patience. While in-office treatments are done in under an hour, at-home whiteners require a regimen. Over the course of several weeks, patients will see a noticeable difference in the brightness of their smile, but the results are not as dramatic. “The percentage of peroxide is usually lower in over-the-counter systems and, therefore, may not work as well,” Dr. Spizuoco says. “These methods can be messy and the bleach can get on your gums and cause sensitivity.”
As a reminder, the only active ingredients that bleach teeth are hydrogen peroxide and carbamide peroxide. If the OTC product doesn’t have either of those ingredients, then it is whitening, not bleaching, the teeth. “Whitening is stain removal, while bleaching is actually changing the internal surface of the tooth structure to make it seem whiter,” Dr. Apa clarifies. “Stain removal products are more abrasive and should be used in smaller doses.” (More on that below!)
If you are ready to give at-home teeth whitening a try, here’s what you need to know about three of the most common treatment options:
1. Whitening Strips
Most whitestrips work by coating the teeth with a gel that contains hydrogen peroxide or carbamide peroxide. The concentration of hydrogen peroxide and carbamide peroxide is, needless to say, much lower than an in-office treatment. Users press the strips against the teeth and leave them for five to 30 minutes, depending on the brand. Most people report seeing initial results after three days and full results in about 21 days. Whitening strips are considered an affordable option — priced between $30 to $50 per kit — and usually include two to three weeks worth of treatments.
2. Whitening Trays
Similar to whitening strips, whitening trays use a peroxide-based bleaching gel. Instead of applying the gel via strips, you wear a gel-filled, mouthguard-like tray for several hours at a time. Most people see results in seven to 14 treatments, depending on the whitening kit system. Overall, whitening trays deliver the strongest results of the whitening solutions, but they also require the biggest time commitment.
3. Whitening Toothpastes
Toothpastes with whitening claims usually contain polishing beads and/or whitening agents to remove stains from the teeth. Some over-the-counter toothpastes might also be formulated with a low dose of hydrogen peroxide. While these products may not cause as much tooth or gum sensitivity as strips and trays, those with polishing agents can be overused. “I don’t recommend using them every single day,” Dr. Apa says. “I would use it two or three times a week and alternate with something less abrasive.” Dr. Spizuoco recommends Sensodyne whitening toothpaste because it “has potassium nitrate and fluoride in it to combat sensitivity.”
Nothing can rival the results of professional teeth whitening, and, at this, point, you probably recognize that there is no such thing as a one-size-fits-all treatment. “It's difficult to give everyone the same treatment, which is why I recommend seeing a dental professional,” Dr. Spizuoco says. “We can customize a treatment plan just for you based on your level of sensitivity.”
Once you've successfully brightened your teeth, it’s important to preserve the results. “I recommend avoiding coffee, tea, red wine, soy sauce, curry, tomato sauce, smoking, kale, spinach, and basically anything that will stain your white shirt,” she explains. “Using an electric toothbrush with a whitening toothpaste can help remove these stains before they get a chance to set in.”
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