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An Enlightening Experience

An Enlightening ExperienceIn search of a brighter smile? Tufts' Dr. Gerard Kugel breaks down the differences between various teeth-whitening procedures.

Medford/Somerville, Mass. [08.23.07] There are many ways to give your pearly whites a boost these days, with a variety of tooth-whitening solutions available through your dentist and your local pharmacy. But which ones work best? According to Tufts' Dr. Gerard Kugel, an expert in clinical research and esthetic dentistry, some methods brighten smiles more than others.

"If you go to your pharmacy, it's almost funny to look at the whitening section," Kugel, a professor at Tufts School of Dental Medicine, told NECN's Healthweek. "There are so many products out there."

One popular method, he explained, is tooth-whitening strips, which are available both over-the-counter and through dentists. To brighten their smile, people wear these thin strips on the teeth for about 30 minutes each day. According to Kugel, "Yes, they work."

"Peroxide is peroxide," he told the television program. "I always say it's not rocket science, bleaching. Carbamide peroxide, hydrogen peroxide will whiten teeth, so it's the delivery system that's a little unique with this product."

Trays, which are fit to an individual's mouth, are another option for folks interested in whitening their teeth. These require a trip to the dentist, however.

"The mold is done at your dentist's office," Kugel told NECN. The dentist takes an impression of your teeth, he explained, and then provides you with a tray that you can take home, line with whitening solution and insert in your mouth.

"They [users] load the tray with the peroxide and then they need to use this for at least two hours a day," he told the television program. "Some people have trouble with that, so one of the advantages to some of the other products with shorter durations is that they're easier to use."

Through some dentists, people can also get a high-cost laser whitening treatment. According to Kugel, while the promise of bright teeth from costly procedures can be appealing, the laser method may not be the best way to improve your smile.

"A lot of the lasers-and they're not really lasers, most of them are lights-supposedly speed up the [whitening] process," Kugel told NECN. "What I feel is happening is that you're dehydrating the teeth, making them look whiter because you dry them out."

He explained that most offices that provide laser treatments also offer patients a tray system to touch up their teeth. Kugel said, "Those lights may activate or speed up the process a little bit, but our studies have indicated that they're not very effective."

Likewise, toothpastes that claim to whiten teeth don't work very well, according to Kugel.

"The toothpaste, in my experience and in some of the work we've done, is not very effective," he told NECN. "They'll get stain off teeth, which makes them look whiter." He added that they probably don't end up whiter than they would normally be, however.

Staining can be an issue no matter what solution you choose, Kugel explained to NECN. "If you run out and you're drinking three cups of tea a day, well, your teeth will stain and that can make the teeth look darker," he told the news program.

Because teeth can stain, Kugel suggests revisiting the whitening process down the road no matter what solution you initially choose.

"I recommend to my patients probably every two years you want to re-whiten," he told NECN. "The rule of thumb is if it took you five days to be as white as you want to be, then it may be one day to re-whiten."

Whether you are whitening for the first time or touching up your teeth, Kugel explained to NECN that the key to achieving maximum brightness is using a product correctly.

"Evidence shows and the literature says 90 percent of people will get white," he told NECN. "My experience is that people will get white if they're compliant. Our experience is some people say that won't get white, but if you actually ask them did they follow through with the directions of the products, the answer is no."

No matter which product people use to whiten their teeth, Kugel says that sensitivity may occur when you are going through the process.

"Sometimes teeth dehydrate a little bit when you bleach," he told NECN. "That could cause the sensitivity, but it's not uncommon."

He explained that about half of the people who participate in the studies at the School of Dental Medicine experience some degree of sensitivity. But most will continue with the study, he said.

"People will experience a lot of pain to look good," Kugel told NECN.

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