Our society has become increasingly concerned with appearances. It seems as if people will go to any length to improve their looks. In addition, the public has become more aware of advances in cosmetic dentistry. Dental whitening is an effective and safe way to improve your smile, however it is not an appropriate procedure for every patient. When we consider dental whitening for children there are many factors that must be evaluated.
Indications for dental whitening for individual permanent teeth may include darkening resulting from a traumatic injury, discoloration of enamel due to trauma or infection of its corresponding baby tooth or intrinsic stain due to medications such as tetracycline. Full arch whitening during the mixed dentition, which is when children have a mixture of permanent and baby teeth, is usually not advised. Many parents become concerned about the color of the permanent teeth when they erupt. They often are darker or more yellow that the baby teeth which are usually “pearly white”. This is normal and is due to the increase thickness of enamel of the new teeth. Once a child has the full complement of permanent teeth their smile appears to be whiter.
Whitening procedures are not for every child and the decision to bleach must be made on an individual basis. The following criteria must be met:
- There can be no remaining baby teeth except in cases where permanent teeth are missing
- All orthodontic treatment must be completed
- The child must not have any sensitivity or tooth pain
- All cavities must be restored
- Oral hygiene must be excellent
- The child must be able to cooperate during a long procedure
Dental whitening can be accomplished by either an in-office or a home use technique. The in-office procedure requires about one hour of chair time and utilizes a higher concentration of hydrogen peroxide (or carbamide peroxide) than the home use materials. For this reason, the patient may experience a temporary tooth sensitivity and gum irritation, but will see faster results. The home bleaching technique will be slower and require daily use of a tray or brush-on bleach, but will cause less sensitivity. Your
dentist will recommend the best technique for your child. It is important that you consult your child’s dentist before considering any dental whitening, including over the counter products. In addition, it is not advisable to allow any unlicensed individual to perform any bleaching procedures.