THURSDAY, Aug. 19, 2004 (HealthDayNews) -- Products and procedures that bring a gleam back to aging teeth are literally white-hot these days, with everyone seeking that perfect Julia Roberts smile. But what works best?
In many cases, experts say, that may depend on how much you want to pay.
"For the brightest smile, quickest, you'd want power bleaching in your dentist's office, and you'd back that up with tray bleaching at home," said Dr. Jeff Morley, a San Francisco cosmetic dentist and spokesman for the American Dental Association.
In "power bleaching," which usually achieves impressive results in just one or two half-hour sessions, the dentist applies a strong bleaching agent to the teeth. A special light is usually passed over the teeth to help activate the bleaching agent.
The procedure doesn't come cheap, however. "I would expect a price range somewhere between $500 to $1,000 per session," Morley said. "But it's the fastest way to get those kinds of results."
Another dentist-based treatment involves custom-fitted, take-home trays that patients can use to soak their teeth in bleaching solutions for periods of time. While not as immediately effective as dental chair power bleaching, "trays are a lot cheaper," Morley said, with prices ranging from $150 to $450 per set.
Tray products are also available at drug stores, but Morley doesn't recommend them, because "they don't usually fit as well."
Two other whitening products can be picked up at the local drug store: rub-on gels, or tooth-whitening strips.
The strips "are a good, inexpensive [around $25 for a two-week supply] approach that will work for some people," Morley said. With strips, consumers apply a peroxide-soaked plastic strip to the outside of the lower and upper front teeth for half-hour periods.
"If someone is interested in the whitening process, and they just want to try it out and don't want to spend a lot of money on it, then maybe the strips would be a good first choice for them," Morley said.
He's not so enthusiastic about rub-on peroxide gels or pastes, however. "On the one hand, the concentration of the whitening material isn't what you'd get from a dentist, and on the other hand, it simply doesn't stay on your teeth very well, so it doesn't work," he said.
Earlier this year, a University of Florida study sponsored by the Procter & Gamble Co. compared the tooth-whitening power of Crest Whitestrips Supreme -- containing 14 percent hydrogen peroxide -- to that of the Excel 3 Nite White gel system, which consists of a 16 percent carbamide peroxide gel delivered in a custom tray. Both are prescription-only products available from dentists. Crest Whitestrips Supreme is a Procter & Gamble product.
Both products were used on the upper teeth only, with one group of healthy adults using the strips for three weeks as directed, while another group used the tray system for a typical nine-day period.
Co-researcher Dr. Ingvar Magnusson said in a statement that his team "found the strip containing the 14 percent hydrogen peroxide got better results than the carbamide peroxide product in the tray, in terms of bleaching, and also we had fewer side effects, such as gum irritation and tooth sensitivity, with the strip."
Side effects are common and occur with almost every bleaching technique available, Morley pointed out. "My advice, for anybody, is if their gums or teeth get sensitive, just stop using the product. If you're using an over-the-counter product and you're having trouble with it, call your dentist and ask what's going on."
Tooth sensitivity linked to whitening doesn't affect everyone, and usually passes soon after treatments end. Still, sensitivity can be quite painful in the short-term.
Alan Mozes, 39, of New York City, recently went to his dentist for "power bleaching." While both he and his dentist were pleased with the results, Mozes said he was surprised by the amount of discomfort he suffered immediately after the procedure.
"It's not particularly painful while you're doing it," he said, "but then moments of pain occurred intermittently over about the next 12 hours. You'd be walking down the street and it feels like all of a sudden someone zaps your gums with pain."
The vast majority of people don't seem to mind a little discomfort if whitening restores their pearly whites. Morley does have one important caution for those contemplating the use of any whitening product, however.
"Tooth whiteners do not bleach out caps, bonding, porcelain veneers," he said. "So if you have discolored restorations in the front where it shows, then you really need to be talking with your dentist as to what needs to be done."
More information
To learn more about tooth-whitening options, visit the American Dental Association.
