By Diane Griffith, Staff Writer, myOptumHealth

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Between the toothpastes and whiteners you've seen in stores and the bleaching treatments available at your dentist's office, you may wonder which, if any, are right for you.

The American Dental Association (ADA) recommends that you talk to your dentist before making any decision about whitening your teeth. It may not be for you. People with sensitive teeth, grayish discolorations, prior bonding or certain types of fillings in their front teeth are not good candidates for bleaching. If you fit one of those descriptions, talk to your dentist about other options.

If your dentist recommends bleaching, then - depending on your needs, your pocketbook and your dentist's advice - there are several choices available:

• Laser bleaching
• In-office bleaching
• At-home bleaching
• Whitening toothpastes

If you have any cavities, your dentist will fill them before bleaching. Otherwise, the whitener can penetrate cavities and cause pain.

Laser bleaching

Lasers are used to enhance the action of whitening agents. Laser bleaching can be costly - approximately $1,000 - and usually isn't covered by insurance. The FDA has approved lasers to be used in bleaching. However, the ADA states that studies have not been done to prove the safety or effectiveness of laser whitening.

In-office bleaching

In-office bleaching allows your dentist to supervise your progress. The ADA has given its Seal of Acceptance to a number of in-office bleaching products. The Seal lets you know that the product has met ADA safety and effectiveness standards.

Your dentist will first apply a protective gel to prevent gum irritation. Afterwards, a bleaching agent will be applied and a special light may be used to activate the whitener.

The cost of in-office bleaching is not usually covered by insurance plans, but is about half the price of laser bleaching. Typically, you will visit your dentist one to three times and each visit will last about 30 to 90 minutes.

At-home whiteners

You can buy at-home whiteners from your dentist or over-the-counter. These whiteners contain peroxide and usually come in a gel that you place inside a mouth guard. You will wear this for several hours a day for two weeks, or overnight for one to two weeks.

The advantage of buying the kit from your dentist is that he or she can custom-fit your mouthpiece so that bleach won't leak out and irritate your gums. Only certain at-home whiteners that are available in dentist's offices carry the ADA Seal of Acceptance at this time. The ADA recommends that if you choose to use a bleaching product you should only do so after consultation with a dentist.

Toothpastes

Whitening toothpastes improve the appearance of your teeth by removing stains with polishes, chemicals and other non-bleaching agents. Look for the ADA Seal of Acceptance when buying a whitening toothpaste.

Causes of discoloration

Yellowing and staining are usually caused by tobacco, coffee, tea and aging. Discoloration can also be caused by too much fluoride in childhood and certain medications. Tooth whitening works best on teeth that have been stained by food, drinks and aging.

Effects of whitening

Whitening is successful about 90 percent of the time. Over-the-counter home use products and dentist-supervised at-home products usually contain a lower strength-bleaching agent. In-office, professionally applied tooth whitening products are generally higher strength. In general, a higher strength bleaching agent works better, although all work if used over time.

Your teeth will usually lighten about two shades, but the results aren't permanent. If you continue eating and drinking the products that cause staining, you will need to re-bleach sooner. If you drink coffee, tea or soda, the Academy of General Dentistry (AGD) recommends drinking them through a straw to prevent discoloration of the front upper teeth.

Children's teeth

Since children have more sensitive teeth than adults, the AGD does not recommend whitening until after age 14 - when tooth pulp is fully formed.

View the original Is teeth whitening for you? article on myOptumHealth.com 

SOURCES:

• Academy of General Dentistry. Teens: Want a brighter smile? Visit the dentist, not the shopping mall. Accessed: 10/01/2009

• American Dental Association. Tooth whitening treatments. Accessed: 10/01/2009