Teeth whitening procedures are performed to reduce the discoloration and staining of teeth and have become the most popular cosmetic dental procedures today according to the American Academy of Cosmetic Dentistry (AACD).

The demand for teeth whitening products has increased by more than 300 percent over the past five years. Women are more likely to have a teeth whitening procedure, but men are quickly realizing the advantages of seeking a brighter smile. According to the American Academy of Cosmetic Dentistry, between one-fourth to one-third of teeth whitening patients are men.

Teeth whitening is the most popular cosmetic dental procedure among patients between the ages of 20-50. This age group represents a majority of the American workforce. People in this age group have become increasingly interested not only in looking and feeling better, but also in using cosmetic procedures to enhance their careers by presenting a more attractive image.

In-office teeth whitening procedures performed by a cosmetic dentist have become increasingly popular because patients want faster results compared to the slower results achieved by the variety of over-the-counter products (such as toothpastes and whitening kits). Usually, whitening the teeth two to three shades makes a significant difference in a smile.

It is important to note that not all of the teeth are the same natural color.

Dentists use a Vita shade guide, which determines the degree of discoloration and staining of your teeth. Depending on the severity of the discoloration of your teeth, you and your dentist will discuss to what degree your teeth can be whitened.

Causes of Discoloration

The most common causes of discoloration are drinking coffee, tea, and cola, as well as smoking cigarettes and taking some medications. Teeth can also be stained simply through the aging process or by chemical damage.

Research has shown that genetics and disease also play a role in the discoloration of teeth. We recommend that you inform your dentist of any medical condition you may have that may contribute to the discoloration of your teeth.

Types of Teeth Whitening Procedures

Chemical whitening, mild acid whitening, abrasive teeth brightening, and laser teeth whitening are different techniques used to whiten teeth. While all procedures are effective, there are advantages and disadvantages to each procedure. During the consultation, your dentist will recommend the most appropriate teeth whitening procedure depending on the structure, sensitivity, and degree of discoloration of your teeth.

Procedures Performed at the Dentist’s Office

In-Office Laser Bleaching

If you decide to have your teeth whitened by a cosmetic dentist, you will likely undergo a laser bleaching technique such as BriteSmile. During laser bleaching, a translucent bleaching gel is applied to the teeth. A special activating light is then used to activate the crystals in the gel, which absorb energy from the light. These crystals penetrate the teeth enamel to increase the lightening effect on the teeth. The degree of discoloration determines the length of the procedure, but, on average, this procedure takes one to two hours.

Pros: The procedure can be done in one office visit.

Cons: The sudden change of color is likely to be immediately noticed by other people, and can be an expensive procedure.

If needed, an at-home bleaching kit may be offered as a follow-up.

Custom Fit Tray Bleaching

Custom-fit tray bleaching is the most common whitening procedure because it is easier and costs less than laser bleaching. Your dentist will take an impression (mold) of your mouth so that he/she can make a custom fitted plastic tray that you will take home with you.

A small amount of bleaching gel is placed in the custom-fit tray. The tray is worn over your teeth between one to two hours each day, and typically full results may be seen after one to two weeks.

If you have severe discoloration or internal teeth staining prior to the use of a custom-fit tray bleaching kit, your dentist may recommend this procedure in conjunction with in-office laser bleaching.

Pros: A gradual whitening of your teeth is less noticeable by other people. Lower cost than in-office laser bleaching.

Cons: This procedure may require multiple visits to the dentist’s office, results may vary depending on how often you wear the trays, and your teeth may experience increased sensitivity as a result of using the whitening gel.

Costs of Different Whitening Procedures

During the initial consultation for teeth whitening, your cosmetic dentist will explain to you what to expect from the whitening procedure. The result of any given procedure varies from person to person. The result will usually depend upon the structure of your teeth and the type of teeth whitening procedure that will be performed.

Dental insurance does not cover the cost of teeth whitening. Therefore, the price of teeth whitening is influenced by these main factors:

1) the number of in-office treatments you may require.

2) the type of procedure you are having done.

The following chart provides information on the common procedures for teeth whitening. All whitening procedures fall either into one of these two types of procedures:

Gel / Tray 4 to 12 Months Sensitive Gums / Teeth 50 Hours 4 to 5 $400
Laser 12 to 18 Months Minor Discomfort 2 to 3 Hours 7 to 8 $600 – 1,000

Pros and Cons of Teeth Whitening


  • Teeth whitening procedures produce whiter teeth, a brighter smile, and can drastically improve your appearance.
  • Whiter teeth are a sign of good hygiene and a healthy lifestyle.
  • A brighter smile tends to minimize the appearance of facial wrinkles.
  • Research indicates that bleaching is completely effective in more than 78% of people.


  • Some people are sensitive to chemicals and can experience sore gums or teeth.
  • Mouth trays may cause discomfort, but a dentist can usually adjust the mouth tray to minimize any discomfort that may be caused by a bad fit.
  • Laser Bleaching procedures tend to be more expensive than Tray/Gel Bleaching procedures.
  • The longevity of your results may vary depending on your dental habits.

Ask a Dentist, Dental Q & A – Teeth Whitening 

Teeth whitening is a safe, fast and easy process that is effective for almost everyone. There are certain dental or health problems that may disqualify an individual from getting this procedure. Dentists evaluate each patient’s teeth and smile to determine whether whitening is right for the patient. In these cases a dentist may recommend a different cosmetic procedure, which may better meet a patient’s expectations. Prior to any procedure, a dentist conducts a thorough exam of an individual’s oral health. He/She examines the gums and takes x-rays during the initial visit. If an individual qualifies for the teeth whitening procedure, he/she can schedule an appointment for the teeth whitening procedure.

How long does it take for a procedure?
This depends on which whitening procedure a patient chooses:

Laser teeth whitening takes a maximum of one and a half hours.

The procedure itself takes 45-50 minutes. A patient should expect to be in the dentist’s chair for 45-50 minutes. The patient is recommended to allow an addition 30-40 minutes to make payments and talk with the dentists regarding post procedure maintenance. During this time the dentist explains the precautions to take to avoid any stress to the gums and teeth.

Custom Tray – The dentist takes an impression of the teeth and then provides a custom fit tray and the bleaching products to the patient to use at home. Depending on the condition of the teeth, a dentist recommends the number of hours and days the patient should use the tray. The dentist may suggest the patient to have the tray on for two or three hours a day for up to four weeks.

How many dental visits does it require?
In-Office Teeth Whitening procedure requires only one visit.

At Home Teeth Whitening procedure – It requires a maximum of three visits. The third visit may not necessary, but if there are any concerns, a patient should see his/her dentist.

The dentist takes an impression of the patient’s teeth and on the following visit provides all the products, tools, and the custom tray to take home. If the patient wants to see the dentist afterwards, he/she can go to the office for a follow-up, but the 3rd visit may not be necessary.

What are the various things I should keep in mind to get prepared for the procedure?
On the day of the teeth whitening appointment, it is highly recommended that a patient cleans his/her teeth thoroughly. Even though, the dentist will check and clean the teeth prior to the procedure, it can save time to be prepared.

What does the dentist need to know about the patient?
The dentist should be informed of any and all medical conditions. This is necessary to avoid any complications that may occur during or after the procedure.

What should i expect during the procedure?
Tools used for In-office laser bleaching – Laser light, a rubber shield, gel

In-office laser bleaching – The dentist examines the teeth and if the teeth are clean, he applies a polish to the teeth. To protect the gums from the effects of the bleaching, the dentist will apply either a gel to the gum tissue or use a rubber shield (which slides over the teeth) prior to treatment. The rubber shield not only protects the gums, but also pushes the lips away, so the laser only hits the teeth. After applying a carbon peroxide jelly (tastes like mint) on the teeth the dentist shines a light on the teeth for 3 cycles. Each cycle last approximately 15 minutes.

The procedure is safe and painless. While a patient is comfortably relaxing and watching TV, listening to your favorite music, or snoozing, the dentist transforms the teeth to great white color in just 50 minutes.

Does the dentist use a laboratory for the procedure and is the cost of lab included in cost of the procedure?
The laser tooth whitening does not require a lab. The custom trays are made in the office as well and the total cost is included in the procedure.

What do most people experience after the procedure?
The laser teeth whitening process is normally painless. Some people may experience little tooth sensitivity because the bleach dehydrates the teeth. It is best to avoid very cold or hot drinks for the first 24 hours. A very small percentage of people may experience a minor, dull ache following the procedure and dentist recommend taking Advil or Tylenol to ease the pain.

Are there any prescriptions provided after the procedure?
Usually Advil or Tylenol is recommended to ease the minor aches or pains that a patient may experience following the procedure.

What medical conditions would disqualify a person from getting a certain procedure?
It is very important that a patient informs of his/her medical condition to the dentist. It is not recommended for individuals who have braces, ill health, just completed gum surgery, have bad gums or decayed or sensitive teeth, exposed roots, jaw joint problems, colitis, ulcers, periodontal disease or allergies to any of the ingredients used for teeth whitening.

How long do the results last?
Teeth whitening provides instant gratification, is painless, and has been able to achieve dramatic results in most patients. Laser teeth whitening results can last for about two years assuming good hygiene and reasonable exposure to staining foods and beverages. The results may vary depending on the type of stain, thickness of enamel, your age and personal habits. People should avoid foods and drinks that can cause discoloration, such as red wine, coffee, and smoking. Everything should be taken in moderation.

Things to keep in mind:

a. Custom tray whitening – The dentist provides a gel to protect the gums from getting in contact with the bleaching product. It is important not to over fill the tray with the whitening jelly, which can cause some gum irritation. Even though, it goes away after few days it is safe to follow the dentist’s instructions.

b. While results may vary, whitening procedures are generally not designed for caps, veneers or bonds. Depending on the patient’s dental condition, a dentist may recommend to perform teeth whitening procedure prior to putting a crown or a cap. Usually a temporary crown or a cap is put on to the tooth during the teeth whitening procedure. The permanent crown or a cap is placed which matches the color of the teeth after the whitening procedure.


American Academy of Cosmetic Dentistry (AACD)

Tulsa World (Oklahoma), December 9, 2004 Thursday, Final Home Edition: Living, Family; Health Matters: More men smiling about cosmetic dentistry Pg. D8

Christopher A. Jordan, DDS.