‘Should I whiten my teeth before I get dentures?’ is a common question on the lips of people about to have new dentures fitted. After all, having new dentures fitted is like getting a whole new look. And you want your new smile to be as good as it can be – right?
With your focus firmly on having a new look, you’ve probably examined your natural teeth and decided they could be whiter. Perhaps the odd coffee or red wine has dulled your smile somewhat. Or maybe you’re a smoker, or your teeth have been stained by excessive fluoride or antibiotics? Perhaps you were simply born with less than white tooth enamel. There are many reasons teeth are not white. It is also worth noting that decayed teeth will not respond to tooth whiteners.
Perhaps you’re concerned that matching your new dentures to your less than dazzling white teeth, will spoil the whole ‘new look’ effect. And if your prosthetist matches your denture teeth to your natural ones then you’ll be stuck with that colour.
All are perfectly acceptable lines of logic. But are they valid?
About tooth whitening
The process of whitening your teeth depends on the reason they aren’t white in the first place. You can choose between using over the counter whitening products, take-home kits from your dentist which include a custom tray for overnight application, or ‘in-house’ whitening treatments applied by your dentist. They vary in terms of their strength, efficacy and cost.
‘The active ingredient in most whitening products is hydrogen peroxide (H2O2) which is delivered as hydrogen peroxide or carbamide peroxide’ [ref]. Bleaching agents like hydrogen peroxide and carbamide peroxide-based products are generally safe when manufacturer’s instructions are followed. The strength of these agents vary according to whether they are applied by an oral health specialist or by you at home. While activated charcoal products claim to whiten teeth, there isn’t sufficient clinical data to substantiate their safety and efficacy (ref). Further, concern about the highly abrasive nature of activated charcoal potentially causing excessive wear of dental enamel, outweighs the prospect of whiter teeth (ref).
About your expectations
Like anything you do, your expectations play a large part in whether you’re satisfied with your results. If you think that anything less than a blinding white smile is unacceptable, you may be disappointed. As mentioned earlier, much depends on why your teeth aren’t white to begin.
How white is white enough when it comes to teeth?
A useful measure of natural whiteness is for your teeth to be a shade lighter than the whites of your eyes. Smokers should expect their results to be temporary if they continue to smoke. Similarly, continuing to consume tooth-staining foods and beverages will eventually dull your teeth again.
Are you a candidate for teeth whitening before getting dentures?
If you’re thinking of whitening your teeth so that you can choose a whiter denture teeth, then it’s worth considering a few factors.
Perhaps you’re young with good dentition and enamel with little or no work done in the ‘smile line’. You may have lost teeth as a result of an accident. In this case, the new denture may replace just one, two, or maybe three natural teeth. Therefore, whitening your teeth before getting your denture could be beneficial.
If, on the other hand, you’ve had a lot of fillings, crowns, or other extensive work done, as is the case for many older people, then whitening your teeth will only work on the natural teeth you have left. A greater contrast between your natural teeth and the dental work will then be very apparent. In some cases, the composite materials could even be compromised
If you are committed to having whiter teeth despite the obstacles, revising or re-doing all the old dental work that’s visible when you smile is an option. This way the new dental work will match the bleached or whitened natural teeth.
What are the consequences of going down this track?
Each time you have a filling removed, the dentist must drill a little more of the natural tooth enamel away to remove old filling material and get purchase for the new filling. Therefore, you are losing more of your natural tooth. This can further weaken the tooth structure, especially if the tooth needs more work in the future.
The consequences of teeth whitening for your existing dental work
Moreover, new studies have shown that ‘aggressive bleaching can chemically react with composite restorations, glass ionomer cements, sealants, and ceramic crowns, thus reducing their stability’ [ref]. So you need to carefully weigh up the benefits of having whiter teeth with the possibility of compromising dental work you’ve already had done.
Tooth and gum sensitivity arising from tooth whitening materials
One researcher explains ‘risks commonly reported with tooth whitening include increased tooth sensitivity and mild gingival [gum] irritation. The degree of these side effects is directly related to the concentration of the peroxide bleach component, duration of the treatment, and the non-bleach composition of the product used’ [ref].
Another researcher cautions that results of teeth whitening are unstable and vary according to the technique and concentration of the product. Therefore, adverse effects accumulate as repeated bleaching treatments are required [ref]. Given these complexities, it seems prudent to consult with an expert.
Talk to your oral health specialist before whitening your teeth
Determining the cause for your teeth discolouration is essential. Understanding the consequences and assessing the value of teeth whitening will avoid disappointment with results. Different products and different strengths of those products are used to address external and internal causes of discolouration. Speaking to an oral health expert who is familiar with your particular circumstances can not only equip you to make an informed decision but possibly also allay any concerns you have.
If you decide to proceed, your oral health specialist can also advise on making a choice of various take-home whitening kits or in house treatment. In either case, there is the issue of how much is too much? In fact, while some very aggressive regimens can damage the tooth through dehydration and demineralization, this negative effect can be overlooked in the pleasure of making your teeth temporarily appear whiter [ref]. Asking your oral health specialist about your exposure to additional risks like tooth erosion, tooth mineral degradation, increased susceptibility to demineralization, and pulpal damage, before you proceed, can prevent expensive restoration work in the future.
A timely word of warning
Misusing teeth whitening products under the premise of ‘if the recommended strength produces results, then using more must be better’ is unwise to say the least. Take care to follow instructions. Leaving the product on for longer than is advised may cause harm to your teeth, gums and existing dental work.
In some cases, repeating the whitening process at regular intervals may be necessary. Not only is this an ongoing expense and may also compound the negative effects discussed above.
Maintaining your sparkling smile
Keeping your smile white requires maintenance. One way is to avoid staining in the first place. This might mean giving up smoking and avoiding certain foods like:
- Black teas and coffee
- White and red wine
- Sports drinks
- Carbonated beverages (dark and light-coloured)
- Berries and other strongly-coloured foods
- Sauces (soy, tomato, curries)
A final word on whitening your teeth
It’s natural to want a bright white smile. After all, it’s no less than you deserve. But before you jump in, talk to your oral health expert about the teeth whitening process. They are best placed to advise on your particular situation, your existing dental work and gum health. If you choose to go down the whitening track, be informed about the possible risks. Focusing solely on the expected results could be expensive.