There are a few methods of dental bleaching (also known as tooth whitening). In our practice, we prefer overnight bleaching.  The procedure is designed for patients who want to improve the esthetics of their smile in a simple way.  It is a simple, well-assessed method, proven to cause no damage to the tooth or tooth pulp, no negative changes in the tooth structure and no risk of cracking or brittleness.

In our practice, we offer overnight bleaching with OPALESCENCE preparation, used since the 1990’s.  The patients perform the procedure at home, by placing special mouthpiece trays, fitted to their dentition and containing the bleaching gel, on their teeth.  The OPALESCENCE gel applied into the trays can be used in various concentrations: 10%, 15% or 20%.  Indications to use a specific concentration are dependent on the intensity of teeth color. The lowest concentration is usually applied in patients with hypersensitive teeth, who may experience considerable discomfort after the procedure. Hypersensitivity after the procedure varies from one individual to another and may appear during the dental bleaching cycle every morning, immediately after removal of the trays with the bleaching agent. It is caused by dehydration of the teeth, which are separated throughout the night from the oral mucosa that normally moisturizes them. Hypersensitivity disappears after a few hours; however, some patients require breaks in the bleaching process, or sensitivity-abolishing medications.

The preparation for bleaching involves detailed examination of the patient.  The patient must not undergo bleaching if caries or tooth structure defects are detected.  They should be prepared and safeguarded before the procedure.  Tartar and plaque deposits should also be removed to enable taking alginate impressions for preparation of customized dental trays.

The overall bleaching process takes from a week to 14 days.  The patients are instructed to place the dental trays containing appropriate amounts of the bleaching agent on the dental arches after brushing their teeth every evening. Although the bleaching process lasts from 2 to 6 hours, the trays should remain on the teeth all night.  The Gauss curve shows that the highest intensity of the bleaching process is reached ca. 3-3.5 h after the moment of application.  However, removal of the trays in the middle of the night throughout a fortnight or so of the bleaching cycle would interfere with normal sleep and might affect the patient’s health.

It is important for the patient to come for control visits every day, or every second day, because inappropriate application of the OPALESCENCE gel may result in severe irritation of the gums.  Bleaching should be supervised by a dental hygienist, who will check whether the bleaching process has started, whether or not the patient applies the gel correctly and in an appropriate amount, or whether hypersensitivity is not too severe.

Additionally, it is obviously important for the patient to comply during the procedure and preferably also for a week after its completion with so-called white diet, involving avoidance of all food products which may affect the color of the teeth and interfere with the bleaching process.  Such products include red wine, fruit, blackberries, strong tea and coffee.  Coffee should be drunk with large amount of milk.

Bleaching with overnight tray application guarantees improvement of tooth color by 2 to 3 tones, which persists for up to 2 years.  Food products eaten during that time may affect the color and structure of the teeth, but they will always remain brighter after bleaching.

However, it should be remembered that the shade of fillings present in the teeth will not be affected by bleaching.  Therefore, all fillings, even the tight ones, will require replacement with new color-matching ones after bleaching.

Bleaching should be taken into consideration when esthetic reconstruction of teeth is planned,  when the color and shape of teeth is to be improved, e.g. with composite reconstruction, veneers or crowns.  A decision whether to bleach the teeth or not should be made before the reconstructive procedures are performed, because when they are completed and the color of veneers and crowns has been selected, porcelain would differ in color from the rest of the teeth after bleaching.