General Tips for Teeth Whitening
I recently had a discussion with a co-worker who felt it was wrong that I was suggesting applying a whitening product with a QTip directly to the teeth. Sometimes patients ask for suggestions during their hygiene appointment as to how to deal with too much solution in the tray, leading to gingival irritation. I suggest putting less in the tray, changing the duration of time, or decreasing the percentage of the solution if they are really sensitive. My question is, am I indeed “wrong” for suggesting they apply the solution with a QTip as an alternative method of application? Thank you for your time.
Tooth sensitivity and gingival sensitivity are the two most challenging situations with bleaching. It sounds like you are doing a lot of the correct things to reduce sensitivity. To answer your question completely, it would be helpful to know what concentration and type material you are using, but here are some general tips:
- Use the lowest concentration of carbamide peroxide (different from hydrogen peroxide), which is 10% CP. That is equivalent to about 3.5 % hydrogen peroxide.
- The higher the concentration of material you use, the more you have the trim the tray to avoid gingival irritation, and the more tooth sensitivity you will have. However, with 10% CP, which is an oral antiseptic meant to go on the tissue, you can use a non-scalloped tray and allow tissue contact.
- It does not take much material to bleach teeth, but the tray is important to isolating the material from the saliva. If you place the material on the teeth with a QTip, then you should immediately place the tray over the teeth. The bleaching material does not remain on the teeth without the tray long enough to be effective.
In my experience, the best material for tooth sensitivity is 5% potassium nitrate, which can be found in most desensitizing toothpastes. It should be used in the tray for 10-30 minutes as needed. Sometimes gingival irritation, especially in females, is related to the flavors in the bleaching material. Banana flavor has been cross-linked to latex allergies. I’ve also noticed that mint flavor can cause irritation. Some materials also may have gluten, which can cause gingival irritation along with certain flavors. Trying multiple flavors might be helpful.