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Bleaching – Tooth Whitening Explained

Bleaching refers to the professional whitening of teeth using chemical agents. It is a common cosmetic dental procedure performed in clinics or at home.

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Things worth knowing about "Bleaching"

Bleaching refers to the professional whitening of teeth using chemical agents. It is a common cosmetic dental procedure performed in clinics or at home.

What is Bleaching?

Bleaching (also referred to as tooth whitening or dental bleaching) is a cosmetic procedure used to lighten discoloured or stained teeth. It can be performed professionally by a dentist or as a home treatment. The process uses chemical agents, typically based on hydrogen peroxide or carbamide peroxide, which penetrate the tooth structure and break down pigmented molecules responsible for discolouration.

Types of Bleaching

Professional In-Office Bleaching

In-office bleaching is performed directly in the dental practice. High-concentration bleaching agents (up to 35 % hydrogen peroxide) are applied to the teeth. A special light or laser source is often used to accelerate the process. The treatment typically takes 60 to 90 minutes and delivers immediately visible results.

Home Bleaching

With home bleaching, the patient receives custom-made trays and a bleaching gel of lower concentration (usually 10–22 % carbamide peroxide). The trays are worn daily for several hours or overnight, usually for a period of two to four weeks.

Over-the-Counter Products

Commercially available products such as whitening strips, toothpastes, or gels contain significantly lower concentrations of active ingredients and produce more limited results. In the EU, over-the-counter products may contain a maximum of 0.1 % hydrogen peroxide.

Mechanism of Action

The peroxides used in bleaching penetrate the enamel and dentine layers of the tooth, releasing oxygen radicals. These radicals oxidise the colour-causing molecules (chromogens) responsible for staining, rendering them colourless. As a result, the teeth appear lighter and whiter.

Indications

Bleaching is suitable for:

  • Age-related discolouration of the tooth enamel
  • Staining caused by coffee, tea, red wine, or tobacco
  • Mild to moderate intrinsic discolouration
  • Desire for a visually brighter smile

Contraindications

Bleaching is not recommended for:

  • Pregnant or breastfeeding women
  • Children and adolescents under 18 years of age
  • Individuals with severe gum disease or heavily damaged enamel
  • Patients with hypersensitive teeth (without prior dental assessment)

Side Effects

The most common side effects of bleaching include:

  • Tooth sensitivity: Temporary hypersensitivity to cold and warm stimuli
  • Gum irritation: Particularly when the product is applied incorrectly
  • Enamel changes: Possible with very frequent use

These side effects are generally temporary and resolve after the treatment is completed.

Results and Long-Term Effects

The results of bleaching last between six months and several years, depending on dietary and smoking habits. Regular touch-up treatments can prolong the effect. Crowns, fillings, and implants cannot be whitened and may need to be colour-matched after bleaching.

References

  1. Watts, A. & Addy, M. (2001): Tooth discolouration and staining: a review of the literature. British Dental Journal, 190(6), 309–316.
  2. Joiner, A. (2006): The bleaching of teeth: A review of the literature. Journal of Dentistry, 34(7), 412–419.
  3. American Dental Association (ADA) (2023): Tooth Whitening/Bleaching: Treatment Considerations for Dentists and Their Patients. Chicago: ADA.

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