Which Teeth-Whitening Treatment Is Right for You?

The Run-Down

With several teeth-whitening treatment options to choose from, how does one pick? If you’re looking for better results than a whitening toothpaste or rinse can provide, then over-the-counter whitening strips found at most drugstores, custom-fit trays from your dentist and in-office professional teeth-whitening sessions are your three choices.  While all consist of mostly the same two substances – carbamide peroxide and hydrogen peroxide – the primary difference is that bleaching solutions found in each treatment contain different concentration levels.

“It’s the same material, three ways to do it,” says Michael Rayburn, DDS, of Rayburn Dentistry in Newnan, GA. The concentration of materials in OTC whitening strips is less than anything provided by a dentist because there is no professional supervision. “I can give whitening that is more concentrated and more effective over a longer period of time,” Dr. Rayburn says.

Custom trays that are fitted with dental impressions by your dentist have a concentration of whitening agents between 10 to 20 percent, according to Chris Campbell, DMD, of Palmetto Dental Associates in Lexington, SC.  And in-office laser whitening, often referred to as power bleaching, ranges from 30 to 35 percent.

Both dentists recommend custom trays to their patients first and foremost. Rayburn says the high-intensity light in a laser treatment does not make a lasting difference in whitening compared to the custom trays. “The way that we typically do custom trays is we make you a custom tray fit precisely with teeth,” he says. “It’s the least invasive and most cost-effective way.”

OTC bleaching treatments are obviously the most convenient solution. However, they do not come with the additional protective materials like the professionally-dispensed trays. In the dentist’s office, patients are given gel or rubber shields before whitening treatments to protect oral cavities and gums from any negative bleaching effects. Plus, dentists can give patients exams and take into account their medical past to determine whether or not bleaching is a good option in the first place. Dr. Campbell says people who have multiple crowns or fillings on front teeth should not consider bleaching, simply because it will be ineffective.

Both Rayburn and Campbell caution that while whitening can never really be dangerous, sensitivity can be an issue. Rayburn tells many of his patients who are bleaching to avoid consumption of highly acidic substances, such as orange or grapefruit juice. “Some people are more sensitive than others,” he says. “So if you’re having a dentist supervise it, they can tell you to quit doing it for a week or use a lower concentration.”

Campbell says the sensitivity bleaching causes can usually be reversed – but not always. “In theory, if your teeth are sensitive and you continue to bleach and bleach and bleach, then it can be irreversible.” He says there is a larger chance of people damaging gums and teeth when there is a higher concentration of the whitening solution.

Money & Time Spent on Teeth-Whitening Treatments

While trays cost around $350, laser whitening ranges from $600 to $1,000. “The cost difference is not worth it,” says Campbell. “You could have just started with take-home trays and have an extra few hundred dollars.”

However, many people report dramatic results from a simple 30-60-minute laser treatment session. Patients are sent home with a conditioning gel after a laser treatment, which is essentially even more bleach to achieve the whitening effect.

Rayburn says it takes about 20 minutes to make impressions for his patients’ custom trays, and another 10 to explain the process to them. Take-home trays are usually used at night while people are sleeping, according to Campbell, and they can be used for varied lengths of time. “You can see some effect in as little as two to three nights,” Campbell says. “Then people will bleach anywhere from two weeks to multiple months.” 

And what about the cheapest option — the whitening strips you can find on a shelf in the drugstore? Campbell says Crest Whitestrips are more likely to cater to adolescents or people whose teeth are not done rearranging and/or need to have braces. “Because once a tray is made to custom fit, if teeth move, then it won’t fit anymore,” says Campbell.

However, do not be fooled by the low cost of OTC options (they can range from about $30 to $70 per pack). It has to be done at least twice in order to see a result comparable to custom trays or laser whitening.  And strips only come in one size, so they are limited to whitening the areas they touch.

“You’re out of luck if it doesn’t fit your smile,” Rayburn says. “Provided it fits right, it’ll work, but you’ll have to do it more than one time.”

Ultimate Teeth-Whitening Treatment Results

Hands down, laser treatments produce the quickest and most noticeable difference in teeth whitening. “The biggest bang is the first treatment,” Rayburn says. But these instant results are the effect of dehydrated teeth, according to both Rayburn and Campbell. This causes teeth to appear much whiter, much faster.

“Most of the immediate improvement with in-office bleaching is a result of teeth being dried out, so the patient looks at it and thinks it looks great,” Campbell says. “But two weeks later, you don’t have that same level.”

In a study of 36 Canadian volunteers aged 19 to 58, researchers at Leeds Dental Institute of the University of Leeds found the subjects who received a combination of custom trays and in-office bleaching for two weeks experienced a more significant change in shade immediately.

However, within one week after the treatment, the color of their teeth regressed to the same shade as the volunteers in the group using only custom trays for the two-week period.

And be warned – whitening can sometimes turn excessive and produce an artificial look to a person’s grin. “Sometimes teeth can be over-whitened and bleached,” Campbell says. “It begins to look almost unnatural and translucent.”

In the grand scheme of things, the decision to go with one teeth-whitening treatment over another should be based on how much time you are willing to wait for results and the amount of money you’re willing to dole out. Because at the end of the day (and after some persistence, in the case of OTC treatments), each option can produce a very similar whitening effect, which will ultimately result in a whiter, brighter smile you can be proud of.