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Dr. Philips in the News…
Put your best smile forward with new whiteners

Most people find their teeth lose their lustre with age no matter how often they brush. Unfortunately, it’s other daily habits that may be the cause. Smoking, drinking coffee and eating certain color-dense foods such as blueberries will contribute to the gradual darkening of your teeth. Bleaching teeth with a peroxide gel breaks down stains and brings back the teeth’s natural whiteness, In the past, a trip to the dentist’s office was the easiest way to get whiter teeth. Now, several over-the- counter whiteners are available, making the smile you’ve always wanted more accessible and less expensive.

Whitening toothpastes
One of the most popular whitening products on the market is the American-made Rembrandt Whitening Toothpaste (available in most drugstores for about $10), which uses Citroxain to whiten teeth and reduce plaque and tartar. Some of the more recent products are Aquafresh Whitening with Triclene ($2) and White Step ($6), endorsed until recently by actress Heather Locklear. Because neither contains peroxides or bleaches, they’re safe for daily use.

Three-step procedures
Similar to a method performed by dentists (see box), over-the-counter three-step procedures are growing in popularity. Natural White, available at your drugstore for about $20, includes the material to create your own bleaching tray, a horseshoe-shaped piece of malleable plastic that retains your teeth’s impression. You fill the tray with the specified amount of bleach gel and hold it in your mouth for two to three minutes, once a day for a maximum of three weeks, depending on the severity of the staining. Then, you cleanse your mouth with the oral rinse. However, Dr. Ed Philips, a cosmetic dentist in Toronto, warns that this tray, unlike the tray a dentist creates, can distribute the bleach to your gum line as well. "Depending on the sensitivity of the tissue, it may cause irritation." Natural White also has another product that includes a pre-rinse to clean your mouth, bleach gel (which you apply directly to the teeth with a cotton swab) and a final polishing step. It costs about $10.

The percentage of the active ingredient in over-the-counter versions of whitening products may not be as high as your dentist’s products, however, and therefore you may not get the expected results. Unlike the gel distributed by dentists, many products may only contain about six percent carbamide peroxide-too small an amount to provide lasting results, says Dr. Philips. Regardless of which type of whitener you intend to use, the Canadian Dental Association advises that, because few tests have been done with over-the- counter products, anyone who is thinking of using a teeth whitener should consult a dentist before making any decisions. Your dentist will be able to discuss with you what product is best for your situation and inform you of any risks.

Dentist-assisted teeth whitening
Cosmetic dentists Ed Philips and Sol Weiss of Toronto practise one of the most common tooth-bleaching methods, called Opalescence or Nite Whites. After taking an impression of your teeth, the dentist makes a specially fitted mouth tray for you to take home. You’ll also receive a gel containing approximately 10 to 16 percent carbamide peroxide which you squeeze into the tray and apply directly to your teeth. The product only needs to be used for up to a few weeks, before you go to bed. According to Dr. Weiss, "Sixty percent of the bleaching occurs within the first week, the other 40 percent in the next week or two." Opalescence will only work on natural tooth enamel so if you’ve had veneers or bonding done on your teeth, it may not be as effective. Patients with active gum disease may not be good candidates because the tissues may be sensitive to the peroxide in the gel. Expect to pay about $500 for the treatment.

Both dentists agree that take-home bleaching doesn’t work on some patients whose stains require a stronger percentage of carbamide peroxide. These patients usually have naturally dark pigments in their teeth or tetracycline stains, both of which require in-office bleaching. Tetracycline stains-permanent yellow or gray bands across the teeth-occur in people whose mothers took tetracycline during pregnancy and in people who were given tetracycline as babies less than 1 year old. In this case, dentists "power bleach" your teeth, painting them with 15 percent carbamide peroxide and then using a light to activate the bleaching process. Prices start at about $400, depending on the extent of your stains and on the number of teeth you want whitened.

With the dentist’s method, teeth will eventually return to their original pearly lustre. This doesn’t imply that touch-ups aren’t necessary, though, say Drs. Philips and Weiss. They recommend patients use a whitening toothpaste to maintain their brightened teeth. As stains begin to redevelop, patients may return for more of the gel treatment every one or two years. Because they have already paid for the tray, the price is substantially lower at about $50.