Question:
My dentist had me use a nighttime whitening system (Nite Brite, or
something like that) for ten nights to bleach my teeth. I followed the
instructions to the letter. Prior to the bleaching, my teeth were darker
than I liked, but generally a pretty uniform color, with no signs of
fluorosis, no patchy discoloration of any kind, no enamel defects
observable. Now, ten days after the last application of the bleaching gel,
I have patchy white spots on my teeth. It's pretty obvious - and upsetting
to me, really, since some people have commented to me about it in a pretty
rude way. My dentist says he's never seen anything like this or heard of
it, and he's getting in touch with the company and asking around among his
colleagues to see what they have to say, and he'll get back to me. But I'm
wondering - anyone here have any ideas? thoughts on how to fix it?
Answer:
Gordon Christensen a dental materials guy gave an informative piece
about it in today's DentalTown. I will post here in a few minutes
ADVERTISMENTS IN DENTAL JOURNALS AND MAGAZINES
As I thumbed through a current ?cosmetic? magazine, I noted the
presence of ads for several light enhanced in-office bleaching
devices, touting their superiority to other bleaching techniques. It
must not matter to some manufacturers that it has been proven and
published that the tested bleaching lights do not effect a greater
tooth color change than the bleach solution alone. I find it amusing
that one manufacturer actually advertised that his product could be
used with or without the light. Dentists are not without guilt in this
situation. Recently, I talked to a practitioner in a course who
blatantly told me that he knew the lights did not improve the
bleaching, but he thought that patients accepted bleaching fees better
if bleaching lights were used. At some time in the future,
bleach-light combinations may be found that will allow faster and
better tooth lightening than the bleach alone. We are still waiting.
Consider the paint-on over-the-counter bleaching that is more evenly
distributed.
That wasn't the issue, I'm certain. I mean, there's one tooth that has a
round unbleached spot in the center, another tooth which has unbleached
edges...and I was very careful to make sure the gel was evenly covering
the teeth!
A few things could be happening. By any chance, did you ever have braces?
Sometimes the tooth colored composite used as adhesive for the brackets is
not completely removed after treatment. This results in a thin layer of
material in the shape of a small circle or oval in the middle of the labial
surface of the teeth. These areas will not bleach until all the composite is
completely removed. Another possibility is that you may have composite
restorations in these areas (they will not bleach). Still another
possibility that comes to mind is that the bleaching tray may be coming into
tight contact with the teeth in some areas. Also, there is the possibility
that in your case, ten days is too short a time to bleach your teeth well.
It is normal for some areas to bleach faster than others. I have found in my
practice that the incisal edges of lower anterior teeth bleach faster. I
don't know if this happens to other dentists. Another thing to check is if
you had areas of decalcification or other anomalies in the enamel of those
teeth.
Nothing wrong with it. I've heard reports recently that laser
bleaching may be less effective on certain types of stains. I would
guess though that since all commonly used external bleaching techniques
use carbamyl peroxide that the effects would be similar.
What you are paying for with the Brite Smile is the convenience and
speed.
