The public has become more aware of advances in cosmetic dentistry, including both the availability and variety of whitening agents on the market. As a result, parents and media request more information on dental whitening for children/adolescents. A negative self-image due to tooth discoloration could have serious consequences on adolescents and can be a consideration for whitening.
The pretreatment examination by a dentist can help identify the pathology that may be causing tooth discoloration as well as establishing the baseline shade where progress can be evaluated and monitored. The two most common types of whitening offered by dental professionals are 1.) in-office whitening which is applied by a dental professional 2.) fabricating custom made trays where dispensed bleaching agents can be placed. Custom trays ensure great fit and fewer adverse gingival effects. Over the counter products include gels, whitening strips, toothpastes, mints, chewing gum and mouth rinses. While not as effective, these agents offer patient convenience and lower costs.
Agents used by dental professionals to whiten teeth:
1. Carbamide peroxide (10 percent to 38 percent) **most common
2. Hydrogen peroxide (3 percent to 13 percent)
These agents work by an oxidative process to remove intrinsic stain, whereas most toothpastes, rinses, and chewing gums work against extrinsic stain.
The two most common side effects with bleaching: gingival irritation and tooth sensitivity, both of which cease after discontinuance of treatment. The American Academy of Pediatric Dentistry encourages judicious use of bleaching with constant monitoring in the adolescent population.