Professional teeth whitening is something that many consider to brighten their smile. It can be efficient, safe, and an effective choice for most individuals who are good candidates for the procedure ^[1] Prior to having professional whitening treatments a thorough discussion with your dental professional is strongly encouraged to produce the best results and the least incidences of potential side effects.

Prior to whitening:

A through professional exam is necessary prior to proceeding with in-office whitening procedures.^[2] Your dentist will also review any areas of your teeth that the whitening gel will not penetrate: such as areas that have porcelain or bonded restorations, areas exposed to tetracycline antibiotics during tooth formation, or areas that is dark due to trauma.^[2]Although almost everyone wants a bright white smile, what’s important is to make sure your mouth is healthy first.Whitening when cavities, exposed roots, or if there is active gum inflammation could lead to discomfort and increased risks of tooth sensitivity. Whitening substances can not penetrate hard calculus buildup or plaque therefore it is recommended that prior to whitening you visit your dental hygienist first. Whitening can be a great way to brighten your smile if proper precautions are taken.

In-office whitening

In-office professional whitening treatments a dental professional will apply a whitening agent to your teeth. Typically the whitening agent is left on for 15-to 30 minute increments ^[1] The entire appointment usually is no longer than an hour and a half.^[1]

Types of in-office whitening treatments:

• A high concentration hydrogen peroxide gel applied by a syringe
• A hydrogen periodic gel combined with a high-intensity light. The light is applied by a lamp or laser like device that sits directly outside your mouth facing your teeth.

The Process:

• A dental professional will use a tooth shade chart to determine the current shade of your teeth. They will discuss with you how many shades lighter your smile may become after whitening.^[1]
• A dental professional will then polish your teeth and remove any plaque and stains from your teeth. ^[1]
• A dental professional will use tools to keep your mouth open. To ensure the whitening agent doesn’t touch any fleshy parts of your mouth like your gums, cheeks or tongue, a barrier will be placed around all delicate areas^[1]
• A dental professional will then apply the whitening agent to your teeth incrementally and might use light activation throughout the treatment.^[1]
• Once the whitening process is complete, the barriers will be removed and your mouth is gently rinsed. A dental professional may apply fluoride or a desensitizing gel treatment, which will help mitigate any potential sensitivity you might experience.^[1]
• A dental professional will discuss with you regarding if your teeth have reached your desired shade and will provide you with aftercare instructions. Following these instructions are key to allowing the whitening agents to sink into the pores of the teeth and prevent shade rebound. After whitening, your teeth are dehydrated. This makes them extra susceptible to liquid and food stains. Lifestyle habits you’ll need to practice for the next day include not eating brightly colored foods and resisting coffee and red wine.^[1]
• Custom fit take-home bleach trays may be made as a follow up treatment, so that you can maintain your new bright smile at home and prevent future staining.^[1]

Take-Home trays

Professional in-office whitening deliver fast results whereas take home trays require more time whitening in order achieve the desired results.^[2] These trays may also be used as a follow up treatment after in-office whitening to maintain the results, or the treatment that your dental professional distributes to you instead of in-office whitening.^[2] You will receive whitening gel to use with the trays that will whiten your teeth.

Cost:In-office professional whitening may range in costs from $800-$1000.(3) Custom take-home trays may often range in cost from $300 to $600.(3) Most dental insurance companies considered teeth whitening to be a cosmetic procedure and choose not to provide a benefit for it to the patient.^[3]

Time: In-office whitening is usually completed in one or two appointments. Each session usually totals 60 to 90 minutes long and is done in increments of time^[2] Custom fit trays can be worn to touch up the results after treatment. If the trays are being worn to whiten the teeth instead of doing in-office whitening, then the time period the wearer must wear the trays can be from a few days to a few weeks.

Longevity: Whitening treatments last longer when you follow a good oral care routine and avoid ingesting products that cause a lot of staining.^[2] Foods and beverages that contribute to staining are coffee, red wine, and soda.^[2] Using take-home trays can maintain the brightness and help to remove certain stains that can occur overtime.

Common Concerns:One common concern regarding whitening is tooth sensitivity. If you normally experience tooth sensitivity it is important that you relay that information to your dental professional. This will help them to determine which treatment and whitening gels will work best for you. To reduce the risk of sensitivity associated with tooth whitening, you may be provided with desensitizing gels or fluoride gels to use either alone or with custom fit trays prior to and after whitening treatments.^[3] Prior to an in-office treatment you might be advised to use a nonsteroidal anti-inflammatory drugs to help reduce tooth sensitivity during the treatment.^[3] Many locations such as salons, kiosks, and spas are now offering whitening services^[4]The law varies regarding the legalities of non dental professionals administering the treatment.^[4] The concern for many dental professionals is that the patient may be unaware of any cavities, gum inflammation, or exposed roots present in their mouths leading to sensitivity. The patient may also be unaware if the procedure is being done legally in a nondental establishment or not. It is strongly recommended that an individual that is interested in professional whitening services contact their dental office and have an examination so as to answer all possible questions and concerns.^[4] We love to help our patients achieve a bright smile however we also want to help them have great results with the least number of side effects as possible.

Kari Carter-Cherelus

Kari Carter-Cherelus RDH, DA is a registered Dental Hygienist, writer, consultant, coach, international keynote speaker, with 23 years of experience in dentistry. She is passionate about helping others recover from burnout, improving organization’s work culture, and helping her clients to improve their mindset. She authored the book The Ultimate Guide For Dental Hygienist Burnout, and has written for RDH Graduate, RDH Magazine, and Inside Dental Hygiene.

View My Profile Contact Kari

1. Professional Teeth Whitening: Everything You Need to Know. Willardsen, Joseph. (2022, June 27).https://www.forbes.com/health/body/professional-teeth-whitening-guide/
2. Professional Teeth Whitening:Everything You Need to Know. Shinde, Emily. (2022, Jun 27). ://www.forbes.com/health/body/professional-teeth-whitening-guide/
3. ADA. Whitening.://www.ada.org/resources/research/science-and-research-institute/oral-health-topics/whitening
4. Unregulated teeth whitening dangers. (2012, March 21). https://www.dentalproductsreport.com/view/unregulated-teeth-whitening-dangers

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There are many beliefs and psychological reasons for whitening teeth as a social prerogative, including confidence, self-esteem, and quality of life. When we smile, our lips curve into a unique shape that can lighten the mood of any situation. It is a simple gesture that can express love, joy, appreciation, and other positive emotions. However, if the teeth are discolored, one may not want to smile as often for fear of embarrassment or judgment. Dissatisfaction with tooth appearance and color is associated with an increased desire for treatments that improve dental aesthetics, including tooth whitening.^[1]

Society has been obsessed with the aesthetics of whiter teeth, and the number of products available has increased due to popularity and technological advances. We all strive for white teeth, but it can be challenging to maintain natural tooth color, especially with the amount of staining that occurs from food, drinks, and smoking. Fortunately, below are a few tips on teeth whitening that can help you understand what to expect from teeth whitening products and procedures and how to maintain a beautiful white smile.

What defines our natural tooth color?

White teeth are often seen as a sign of beauty and good health, but getting and maintaining white teeth can be difficult. Everyone’s teeth are slightly different in color, ranging from yellow to gray. Certain minerals cause this natural tooth color in the enamel, and some people may be more prone to staining than others.

Natural enamel is a white color with some translucency. However, due to continuous chemical and mechanical wear of enamel with increasing age (erosion, etc.), the enamel will become thinner and more translucent, i.e., the dentin will become more visible, and the overall tooth color will become darker.^[2] Researchers have revealed the association of increased age with darker, yellow teeth.^[3]

Tooth color is affected by intrinsic and extrinsic factors. Extrinsic factors like smoking or wine and intrinsic factors such as tetracycline staining, teeth vitality, age, and congenital defects are known to affect tooth color.^[3]

Can your teeth be as white as a Kleenex?

Enamel naturally has a white hue, and the underlying layer, dentin, is yellow. If the enamel is thin due to erosion or grinding, the teeth can appear more yellow. Some sources reveal that extremely white teeth look unnatural and distracting. To achieve teeth as white as Kleenex, if that is your goal, a more permanent procedure such as veneers or crowns is necessary. However, achieving a naturally white smile with the guidance of your dental professionals is best to avoid unnecessary expenses and damage to the teeth.

Whitening options & expectations

Numerous over-the-counter (OTC) oral health products contain whitening agents, including mouthwashes, toothpastes, floss, and at-home whitening kits. The two types of whitening agents are typically hydrogen peroxide or carbamide peroxide. A 10% carbamide gel has been approved by the American Dental Association for home bleaching.^[4] Whitening mouthwashes contain a low concentration of hydrogen peroxide (1.5%) and have generally been shown to be ineffective in improving tooth color, even after up to 30 days of exposure.^[5]

Whitening strips, introduced in the 1980s, typically contain 5-14 % hydrogen peroxide, and in-office whitening is performed under the supervision of a dentist. The in-office whitening procedure typically involves the application of high concentrations of hydrogen peroxide (35-40%) for 15–20-minute periods over a 45-60-minute clinical session.^[5]

Whitening toothpaste typically contains higher amounts of abrasives and detergents than standard toothpaste, to remove tougher stains. Whitening toothpaste does not contain bleach (sodium hypochlorite) but some contain low concentrations of carbamide peroxide or hydrogen peroxide that help lighten tooth color. Whitening toothpastes typically can lighten tooth color by about one or two shades.^[6]

Tips to achieve optimal results

1. Dental restorations such as crowns, veneers, and tooth-colored (composite) fillings will not whiten like a natural tooth.
2. Limit your consumption of foods and drinks known to stain teeth, such as coffee, tea, and red wine, especially following any whitening procedure.
3. Brush and clean between your teeth at least twice daily and visit the dentist regularly.
4. Talk with your dental professional to find the right whitening product.
5. Quit smoking.
6. Rinse with water or use a straw when drinking dark-colored beverages.
7. Avoid dark-colored food and beverages for 24-48 hours after whitening.
8. Follow the manufacturer’s instructions on any whitening product.

By following these tips for maintaining white teeth, you should be able to maintain a bright, healthy smile!

Lacy Walker

LACY WALKER, RDH, BS, CDA, FAAOSH - dental hygienist, speaker, owner of Shared Hygiene, LLC, & writer w/ 25 years of experience in the dental field working in a psychiatric hospital, cosmetic, restorative, DSO, and periodontal practices. Lacy is the CE Director for A Tale of Two Hygienists podcast & Public Relations Chair for the AADH. She has a passion for the oral-systemic connection & is published in DACE, RDH Magazine, & DrBicuspid. Lacy is an approved provider of CE credits through AADH.

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1. Newton, J., Subramanian, S., Westland, S., Gupta, A., Luo, W., & Joiner, A. (2021). The impact of tooth colour on the perceptions of age and social judgements. Journal of Dentistry, 112, 103771. https://doi.org/10.1016/j.jdent.2021.103771
2. Epple, M., Meyer, F., & Enax, J. (2019). A Critical Review of Modern Concepts for Teeth Whitening. Dentistry Journal, 7(3). https://doi.org/10.3390/dj7030079
3. Haralur, S. B. (2015). Effect of Age on Tooth Shade, Skin Color and Skin-Tooth Color Interrelationship in Saudi Arabian Subpopulation. Journal of International Oral Health : JIOH, 7(8), 33-36. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4588786/
4. Epple, M., Meyer, F., & Enax, J. (2019). A Critical Review of Modern Concepts for Teeth Whitening. Dentistry Journal, 7(3). https://doi.org/10.3390/dj7030079
5. Irusa, K., Alrahaem, I. A., Ngoc, C. N., & Donovan, T. (2022). Tooth whitening procedures: A narrative review. Dentistry Review, 2(3), 100055. https://doi.org/10.1016/j.dentre.2022.100055
6. Carey, C. M. (2014). Tooth Whitening: What We Now Know. The journal of evidence-based dental practice, 14 Suppl, 70. https://doi.org/10.1016/j.jebdp.2014.02.006

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Has the new year brought new advances in whitening or are the tried and true options still the best? Read on to find out.

In-office teeth whitening options

The most common type of in-office teeth whitening is the application of a professional strength whitening gel. With this method, check retractors are placed to hold the lips and cheeks away from the teeth. Then, a special material is placed onto the gums to protect them. In some cases, a high-intensity light is then placed close to your mouth to help increase the effect of the whitening gel. While this method of whitening is fast and effective, it is also pricier than some other options, often costing several hundred dollars. Furthermore, tooth sensitivity can be more severe with this type of whitening than with other options.

Over the counter teeth whitening

There are numerous over the counter products for tooth whitening, including toothpastes, strips, non-custom-fit trays, light activated whitening trays, paint on gels in the form of pens and even gels applied with a small spatula. While many of these options produce results, they also come with drawbacks. For instance, paint-on products can be cumbersome to apply. Furthermore, whitening strips and non-custom-fit trays apply peroxide gel not only to the teeth, but to the gums as well. While peroxide gel is perfectly safe when applied to the teeth, it causes irritation, burning, and even sloughing when applied to gums.

What to avoid

There are safe ways to whiten your teeth, and then there are methods that are downright harmful. Avoid DIY whitening techniques, especially those that include mixing together ingredients from your kitchen. One common example on the internet includes mixing lemon juice with an abrasive like salt, and using this concoction to brush your teeth. This is incredibly harmful to your teeth! Lemons are very acidic and eat away at your enamel, causing permanent damage. It’s also best to avoid ultra-abrasive whitening toothpastes. Always look for the American Dental Association’s seal of approval on toothpaste packaging, which ensures the paste you have chosen is safe and effective ^[1].

Why custom-fit whitening trays are still the best option

Even though there are more whitening options available than ever, the best choice is still custom-fit whitening trays. They are crafted in order to fit you and only you! They are designed to protect your gums from the peroxide gel by keeping it from squishing up over your gums to keep you comfortable. This method of whitening also causes less tooth sensitivity than in-office whitening. There are even options available for sensitive teeth, such as the addition of a desensitizing toothpaste or gel. Custom-fit trays are safe, effective, and more comfortable than the other options out there.

Pro tips for whitening your teeth

Brush your teeth gently with a toothbrush dampened with water before bleaching. This will remove any plaque that could get in the way without adding any barrier between the gel and your teeth. Apply a very small amount of whitening gel into the trays. The gel should not squish up onto your gums. If it does, you’ve used too much. After removing the trays, clean them well and brush your teeth with toothpaste. Try to avoid staining foods and drinks for two or three days after whitening to protect your newly white smile. Lastly, whitening on a regular basis after you have achieved your desired shade (once per month if you are prone to staining, or less often if you aren’t) will help to keep your smile stunning!

Rachel Stroble

Rachel Stroble is a researcher, professor of dental hygiene at Rose State College in Oklahoma, and registered dental hygienist with 10 years of experience in dentistry. She supports education in the classroom with her own students, in the professional community through the development and presentation of continuing education courses, and you may have seen her articles in RDH Magazine, Today’s RDH, and the Oklahoma Dental Association Journal.

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1. American Dental Association. (n.d.) ADA Seal of Acceptance. https://www.ada.org/resources/research/science-and-research-institute/ada-seal-of-acceptance

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Dental patients have increasingly desired a more attractive smile to help boost their confidence that is whiter or brighter. This desire has especially increased with the rise of virtual meetings as individuals’ teeth are more noticeable on screen. Over the past few decades there has been a steady influx of whitening products on the market, yet there still remains only two main options to whiten your teeth.

What are my options?

Your options are to either have professionally administered (in-office) teeth whitening services or self administer at-home whitening products. Several popular in-office treatments use heat and/or light to speed up the treatment and to intensify the whitening process.^[1] In-office treatments tend to deliver the most dramatic results in the least amount of time, therefore they are more costly.^[1] Self administered at-home teeth whitening products can include custom fitted trays that you use to apply whitening gels to, strips, rinses, chewing gums, or paint-on films.^[2] This method usually delivers results within a few days to a few weeks and can be less costly yet more time consuming.

Teeth whitening & tooth sensitivity

Most dental patients are interested in having a brighter smile, however they may be wary of treatment as they may have heard that whitening products can cause tooth sensitivity.^[1] Whitening products use peroxide based (carbamide or hydrogen peroxides) whitening agents in varying percentages to lift the stains from the pores of the teeth.^[1] There is a risk of temporary tooth sensitivity with whitening treatments. This risk is possibly due to the pulp (nerve of the tooth) becoming exposed to peroxide during the procedure resulting in inflammation. When a tooth’s pulp is irritated it can cause pain to the individual.^[1][3] Tooth sensitivity is more common with the use of higher concentrations of peroxides in the whitening products and leaving the product on for longer lengths of time.^[2] Some patients feel sensitivity during treatment immediately during the initial procedure (in-office treatments), or within two to three days after starting treatment (at-home treatments).^[2] Tooth sensitivity usually resolves within four days post-treatment.^[2]

Handling sensitivity while whitening

There are several approaches one can explore to help prevent and treat sensitivity prior to using treatments, as well afterwards to help speed up ones recovery.^[2] Prior to using whitening treatments, some have found that using nonsteroidal anti-inflammatory drugs and the pretreatment of 5% potassium nitrate and 2% sodium fluoride or desensitizing gels can help reduce dental sensitivity.^[2]

• Never whiten your teeth longer that the time that is recommended on the products instructions or provided by your dentist.^[3]
• If you experience sensitivity with at-home whitening try to shorten the application time or give your teeth breaks between treatments by skipping days instead of consecutively whitening.^[3]
• Limit foods and drinks that are either very hot or cold during treatment to minimize your symptoms.^[3]
• Use a whitening product that contains a lower amount of peroxide.^[3]
• Use fluoride rinses, desensitizing gels, and/or sensitivity toothpaste prior to and during treatment.^[3]
• Use a soft bristled toothbrush.^[3]
• Stay in contact with your dentist if problems arise so that the sensitivity can be mitigated.^[3] Your dentist can apply desensitizing products in the office if necessary.

Homecare is important

After whitening your teeth you can extend the benefits and reduce stains by practicing good dental homecare habits such as brushing at least at twice a day and flossing daily^[4]. Try to avoid foods and drinks that have the potential to cause staining especially after initially whitening. Examples of stain causing products are teas, coffee, carbonated beverages, sports drinks, sauces, and berries. If you do consume these products, brushing your teeth 30-60 minutes afterwards or rinsing your teeth with water can reduce staining.^[4] If a brighter smile is what you desire it is within reach following these tips.

Due to the risks of tooth sensitivity it is advised that you consult your dentist first to discuss options that would work best for you. Your dental professional can help determine if you are a candidate for whitening treatments and determine what your best treatment options are. Some patients regularly have teeth sensitivity without having whitening procedures done. They may need to take extra precautions as it can make their teeth especially uncomfortable.^[1] It is important to follow the instructions when doing at-home treatments so as to reduce the risk of burning or temporarily bleaching the gum tissue.^[1]

Kari Carter-Cherelus

Kari Carter-Cherelus RDH, DA is a registered Dental Hygienist, writer, consultant, coach, international keynote speaker, with 23 years of experience in dentistry. She is passionate about helping others recover from burnout, improving organization’s work culture, and helping her clients to improve their mindset. She authored the book The Ultimate Guide For Dental Hygienist Burnout, and has written for RDH Graduate, RDH Magazine, and Inside Dental Hygiene.

View My Profile Contact Kari

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Teeth whitening is a popular cosmetic procedure that can improve the appearance of your smile. There are many reasons why you might want to whiten your teeth. Maybe you’ve just noticed that your teeth have lost their luster over time. Or perhaps you’re getting ready for a big event like a wedding or job interview. Whatever the reason, there are several ways to achieve whiter teeth.

However, it is important to remember that it can also influence your oral pH level. The whitening process uses chemical agents like hydrogen peroxide and carbamide peroxide to oxidize the molecules in the enamel that cause discoloration. These agents are effective in whitening teeth but can also slightly decrease the mouth’s pH level.

Oral pH is Important

The mouth can become an acidic environment, which can lead to tooth decay and other problems. The pH scale ranges from 0 to 14, with 7 being neutral, and the pH balance in the mouth should be slightly alkaline. A balanced pH helps maintain healthy teeth and gums by preventing cavities and reducing gum disease risk. When the pH falls below 5.2, enamel demineralization and root resorption have been reported.^[1][2]

According to a study that measured the pH of 26 whitening products, the pH of these products ranged from 3.67 (highly acidic) to 11.13 (highly basic). ^[1][2] To keep your mouth’s pH level balanced, it is essential to practice good oral hygiene habits, such as brushing and cleaning in between the teeth twice a day and using an alcohol-free mouthwash.

Teeth whitening alters oral pH

Whitening teeth can help improve the look of your smile and boost your confidence, but it’s important to speak to your dentist before using any whitening products. The bleaching agents’ pH is a factor that can directly influence the whitening process. Teeth whitening products can lower the pH, leading to enamel erosion and increased tooth sensitivity.

The pH of some whitening products is acidic primarily to increase the shelf life, and manufacturers have paid attention to the acidity of bleaching gels because low oral pH can produce various harmful effects on the structure and properties of the tooth.^[3] The effectiveness of dental bleaching is influenced by several factors, such as the bleaching system used, bleaching agent concentration, application time, and light application.^[4]

Safely use teeth whitening products

When teeth whitening products are used incorrectly, they can strip away the natural protective layers on your teeth, making them more vulnerable to acids and bacteria. This increase in the mouth’s acidity can cause cavities, enamel erosion, and tooth sensitivity. To help minimize this risk, following the directions on the whitening product you are using is important, in addition to discussing with your dentist any potential risks before starting any whitening treatment.

If you experience sensitivity, your dentist may suggest using a potassium nitrate product. Potassium nitrate helps those with sensitive teeth by blocking the pain signal resulting in less pain and sensitivity, and can be found in over-the-counter and prescription dental products.

If you have active periodontal disease or gingivitis, it is highly recommended to treat the infection first before proceeding with any whitening procedure, as it can irritate your gums further. Maintaining oral pH balance, healthy gums, and choosing a tooth whitening product for your needs under the direction of a dentist are some of the key components of a healthy, beautiful-looking smile.

Lacy Walker

LACY WALKER, RDH, BS, CDA, FAAOSH - dental hygienist, speaker, owner of Shared Hygiene, LLC, & writer w/ 25 years of experience in the dental field working in a psychiatric hospital, cosmetic, restorative, DSO, and periodontal practices. Lacy is the CE Director for A Tale of Two Hygienists podcast & Public Relations Chair for the AADH. She has a passion for the oral-systemic connection & is published in DACE, RDH Magazine, & DrBicuspid. Lacy is an approved provider of CE credits through AADH.

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1. Price, R.B. (2000) Download pdf | the ph of tooth whitening products – researchgate. https://www.researchgate.net/publication/12282985_The_PH_of_tooth_whitening_products
2. Price, R., Sedarous, M. and Hiltz, G.S. (2000) The pH of Tooth-Whitening Products, The pH of tooth-whitening products. Available at: https://www.cda-adc.ca/jcda/vol-66/issue-8/421.html
3. WIJETUNGA, C.L. et al. (2021) Effect of ph of bleaching agent on tooth bleaching action in vitro, Dental Materials Journal. The Japanese Society for Dental Materials and Devices. https://www.jstage.jst.go.jp/article/dmj/40/3/40_2020-191/_pdf
4. Soares, A. F., Soares Bombonatti, J. F., Alencar, M. S., Consolmagno, E. C., Honório, H. M., & Lia Mondelli, R. F. (2016). Influence of pH, bleaching agents, and acid etching on surface wear of bovine enamel. Journal of Applied Oral Science, 24(1), 24-30. https://doi.org/10.1590/1678-775720150281

The post The little-known secret to teeth whitening – low pH appeared first on Smile Brilliant.

What is a sinus infection?

The sinuses are four paired spaces in the head that are connected by narrow channels.^[2] The sinuses produce thin mucus that drains out of the channels of the nose, helping to keep the nose free from bacteria and viruses. A sinus infection (sinusitis) is when the sinuses which are normally filled with air become inflamed, blocked, and filled with fluid.^[2] This fluid can harbor bacteria and viruses that can cause a sinus infection.^[2] Sinus infections are caused by both bacteria, viruses, or allergies.

What type of sinus problems do kids usually have?

Children are most commonly diagnosed with viral sinusitis, a viral upper respiratory infection.^1] The most common bacteria that causes childhood sinus infections are streptococcus pneumonia, haemophilus influenzae, or moraxella catarrhalis.^[3] Children are more susceptible to infections in their nose, ears, and sinuses during their early years of life.^[2]

What are the symptoms in children?

It can be difficult to distinguish if one has a sinus infection, a cold, or allergies as some of the symptoms of each illness are the same.^[2] A cold can transform into a sinus infection and seasonal allergies can be a precursor to a sinus infection. Children’s symptoms can present as cold-like symptoms.

Symptoms:

• A cold that last more than 10-14 days.^[2]
• A fever.^[2]
• Post nasal drip at times accompanied with a sore throat, cough, bad breath, nausea, and vomiting.^[2]
• Headache.^[2]
• Stuffy nose.^[3]
• Irritability or tiredness.^[2]
• Swelling around the eyes.^[2]

The Different Types of Sinus Infections:

Acute Bacterial Sinusitis: A sudden onset of cold symptoms such as a runny nose, congestive nose, and facial pain that persists for longer than 10 days and doesn’t get worse. At times symptoms might seem to improve only to return with even worse symptoms than what was initial experienced.^[1][2] It is important to continue to treat your child with all medicines that the doctor recommends and to finish the antibiotic therapy.^[1]

Chronic Sinusitis: This occurs when there is nasal congestion, drainage, facial pain or pressure, and a decreased sense of smell that lasts for at least 12 weeks. Usually the infection has cleared however there is prolonged inflammation that is making the suffer uncomfortable.^[1][2] Children that suffer from two or more symptoms of sinus infections within a 12 week period of time coupled with sinus pressure, may have chronic sinusitis.^[1] If your child has more than four to six sinus infections per year, you should see an ENT specialist so that they can determine what testing and treatment is needed.^[1][3]

Subacute Sinusitis: When the symptoms of a sinus infection that last for four to twelve weeks it is called subacute sinusitis.^[2]

Treatment for sinusitis:

• An acute bacterial sinus infection responds best to antibiotics and decongestants.^[2]
• Nasal steroid sprays, drops, or gentle sprays help to relieve nasal nasal congestion and stuffiness.^[1]
• Nasal sprays, drops, or other medicines that contain antihistamines and decongestants may be prescribed. These will help to loosen and get rid of the mucus.^[3]
• Allergy shot may be prescribed if the child has nasal allergies to help reduce their sensitivity to pollen, dust mites, or mold.^[3]
• Referral to an ENT specialist for needed test, treatment, and at times surgery.^[3]

Prevention:

To help prevent sinus infections use a humidifier in dry environments as this will stop dry air from irritating the sinuses.^[3] Have your child use nasal saline washes to keep their nose as moist as possible.^[3] Keep your child away from things that stimulate their allergic response system such as dust, pollen, smoke, mold, dust mites, and animal dander.^[3] Practice good hand washing techniques to limit the spread of germs.^[3] Stay up do date with immunizations. Avoid contact with people who are sick.^[3]

Current research suggests that the use of oral probiotics may help prevent chronic inflammation of the sinuses. Probiotics are live microorganisms that when administered in significant amounts can offer benefits to our bodies and reduce infections.^[5] Probiotics can be taken orally or through nasal sprays.^[5] Talk with your child doctor or an ENT to see if they recommend the usage of probiotics for your child. It is important to see your child’s doctor as a sinus infection can lead to other life threatening conditions if it is not treated properly and progresses.

Kari Carter-Cherelus

Kari Carter-Cherelus RDH, DA is a registered Dental Hygienist, writer, consultant, coach, international keynote speaker, with 23 years of experience in dentistry. She is passionate about helping others recover from burnout, improving organization’s work culture, and helping her clients to improve their mindset. She authored the book The Ultimate Guide For Dental Hygienist Burnout, and has written for RDH Graduate, RDH Magazine, and Inside Dental Hygiene.

View My Profile Contact Kari

1. ENT Health. Pediatric Sinusitis. https://www.enthealth.org/conditions/pediatric-sinusitis/
2. Cleveland Clinic. Sinus Infection. (2020, June 4). (Sinusitis) https://my.clevelandclinic.org/health/diseases/17701-sinusitis
3. Standford Medicine. Sinusitis in Children. https://www.stanfordchildrens.org/en/topic/default?id=sinusitis-in-children-90-P02063
4. Sinusitis (Sinus Infection). https://kidshealth.org/en/parents/sinusitis.html
5. Medical News Today. Friendly nasa bacteria may protect against sinusitis. Kingsland, James. (2020, June 20). https://www.medicalnewstoday.com/articles/friendly-nasal-bacteria-may-protect-against-sinusitis

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For centuries, white teeth have been seen as a sign of wealth, beauty, and privilege. Whether you’re looking for a more youthful look or want to boost your confidence, teeth whitening can make a big difference. Teeth whitening is one of the most popular cosmetic dental procedures, but it’s important to seek professional help to avoid damage to your teeth and gums.

Oral health conditions to consider before proceeding with any whitening procedure are periodontal disease, crowding, medical history, and current restorations such as fillings, crowns, and veneers.

Understanding over-the-counter teeth whitening strips

Whitening strips are a popular way to improve your smile and confidence, but it’s essential to do it safely. They are easy to use and relatively affordable. Additionally, various formulas are available to target different needs, such as sensitive teeth or deep stains. Whitening strips consist of plastic holders typically containing 5–15% hydrogen peroxide, developed with the main idea of avoiding the customized trays used in an at-home dental bleaching technique.^[1]

How do whitening strips work?

There are numerous whitening products on the market, and the formulations and ingredients have evolved over the years. Tooth whitening agents aim to remove stains and discolorations. The success of tooth whitening depends on the type of stain present, which can be categorized as extrinsic staining, intrinsic staining, and internalized discoloration^[2]

Whitening strips deliver a thin layer of peroxide gel on plastic strips shaped to fit onto the buccal surfaces of the teeth. ^[3] Carbamide and hydrogen peroxide are the most broadly used whitening agents. A typical set of instructions is to apply the strips twice daily for 30 minutes for 14 days. ^[3]

Is it possible to cause permanent damage with prolonged over-whitening?

Prolonged over-whitening can cause damage to the enamel structure and cause sensitivity to the teeth and irritation to the gums. This depends partly on how many whitening products are used in conjunction with the whitening strips.The degree of these side effects is directly related to the concentration of the peroxide bleach component, the duration of the treatment, and the non-bleach composition of the product used. ^[3] Aggressive bleaching can chemically react with composite restorations, glass ionomer cements, sealants, and ceramic crowns, thus reducing their stability. ^[3]

Disadvantages of whitening strips

Whitening strips are a popular at-home teeth whitening option; however, some temporary risks include sensitivity, damage to your enamel, or irritation to the gums if misused. An ingredient that can aid in the reduction of sensitivity caused by teeth whitening is products containing potassium nitrate.

Whitening strips may not lighten crowns, veneers, or composite (tooth-colored) fillings. A study that investigated the application of carbamide peroxide and hydrogen peroxide whitening agents resulted in clinically unacceptable color change for all resin composites. ^[4]

Advantages of whitening strips

Research has shown time and again that having a beautiful smile is linked to your self-confidence and can also increase your happiness in life. ^[5] Whitening strips are affordable and easy to use at home or on the go. Although whitening strips are not as powerful as custom teeth whitening procedures, they can still impact lightening teeth. Whitening strips are easily accessible over the counter, online, at supermarkets, and pharmacies and are also gentler on the teeth and gums. Whitening strips are an excellent choice for those looking for a quick and convenient way to achieve brighter teeth. However, follow the instructions on your whitening product and talk to your dentist if you have any concerns.

Lacy Walker

LACY WALKER, RDH, BS, CDA, FAAOSH - dental hygienist, speaker, owner of Shared Hygiene, LLC, & writer w/ 25 years of experience in the dental field working in a psychiatric hospital, cosmetic, restorative, DSO, and periodontal practices. Lacy is the CE Director for A Tale of Two Hygienists podcast & Public Relations Chair for the AADH. She has a passion for the oral-systemic connection & is published in DACE, RDH Magazine, & DrBicuspid. Lacy is an approved provider of CE credits through AADH.

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References

1. de Freitas, M. R., de Carvalho, M. M., Liporoni, P. C., Fort, A. C., Moura, R. D., & Zanatta, R. F. (2021). Effectiveness and Adverse Effects of Over-the-Counter Whitening Products on Dental Tissues. Frontiers in Dental Medicine, 2. https://doi.org/10.3389/fdmed.2021.687507
2. Naidu, A. S., Bennani, V., Brunton, J. M. A. P., & Brunton, P. (2020). Over-the-Counter Tooth Whitening Agents: A Review of Literature. Brazilian dental journal, 31(3), 221–235. https://doi.org/10.1590/0103-6440202003227
3. Carey, C. M. (2014). Tooth Whitening: What We Now Know. The journal of evidence-based dental practice, 14 Suppl, 70. https://doi.org/10.1016/j.jebdp.2014.02.006
4. Kurtulmus-Yilmaz, S., Cengiz, E., Ulusoy, N., Ozak, S. T., & Yuksel, E. (2013). The effect of home-bleaching application on the color and translucency of five resin composites. Journal of dentistry, 41 Suppl 5, e70–e75. https://doi.org/10.1016/j.jdent.2012.12.007
5. Rye, D. G. (2017, June 13). Studies prove your smile has a direct impact on your self-confidence. Your Dental Health Resource. Retrieved December 13, 2022, from https://yourdentalhealthresource.com/studies-prove-your-smile-has-a-direct-impact-on-your-self-confidence/

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When shopping for toothpaste, it’s hard not to be a little skeptical of all the claims on the box. Things like “whiter teeth in 2 hours!”, and “remove years of stains with 1 tube” sound incredible, after all who doesn’t want whiter teeth? But can you really whiten your teeth with just a whitening toothpaste? Let’s investigate.

How Exactly Does Whitening Toothpaste Work?

First things first, can stains be removed with toothpaste? Yes, depending on the stain. If the staining is extrinsic (outside the tooth), and caused by things like wine, coffee, or smoking, these stains can for the most part be removed. If the staining is intrinsic (within the tooth), they cannot.

There are a couple of ways a whitening toothpaste can whiten the teeth. The first is with an abrasive agent like hydrated silica^[1]. This abrasive is gritty and works to scrub and buff the stains off the tooth. Another is with hydrogen peroxide or carbamide peroxide (very similar to hydrogen peroxide, just a little more diluted). Hydrogen peroxide differs from hydrated silica in that it penetrates the tooth ^[2] causing an actual bleaching effect. While hydrogen peroxide is effective, there is debate whether the 1 wt.% regulated amount of peroxide in toothpaste^[2] is enough to penetrate the tooth as the average person only brushes about a minute a day (it should be two). A small tip when brushing is to skip rinsing afterward. This allows the beneficial ingredients in the toothpaste to be more readily absorbed by the teeth.

Do I Use Whitening Toothpaste for Maintenance or for Stain Removal?

While whitening toothpaste can remove some surface staining, it is best used for maintenance as the whitening effects are fairly minimal. The best options for whitening teeth are bleaching trays which will offer a much more concentrated delivery of peroxide in a shorter amount of time. You can achieve a whiter smile more effectively with bleaching trays once every few months than you can by using a whitening toothpaste every day. That being said, whitening toothpastes are still a great option for maintenance as too much bleaching can make teeth sensitive. If teeth are sensitive, a desensitizing gel is a great option to have on hand to soothe teeth and reduce any pain or sensitivity.

Do I Need to Brush Harder When Using Whitening Toothpaste?

Absolutely not. While it’s easy to think brushing harder will lead to whiter teeth and more stain removal, aggressive brushing is never the answer as it’s harmful to the tooth and surrounding tissues. However, one should still be on top of their homecare if they hope to attain a brighter smile. Tartar and plaque retain a lot of stain and can cause the teeth to have a dingy appearance.

Whitening toothpastes are a great addition to an oral homecare routine. They are gentle enough for daily use and help maintain a bright smile!

Esmy Ornelas

Esmy Ornelas is a registered Dental Hygienist, writer, educator, and consultant with 10 years of experience in dentistry. She is passionate about education, empowering hygienists to advance their careers in and out of the operatory, and about community. She has written for RDH Magazine, the RDH Graduate, and is a full-time professor of Dental Hygiene and Assisting at Rose State College in Oklahoma.

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References

1. Collins, L. Z., Naeeni, M., & Platten, S. M. (2008). Instant tooth whitening from a silica toothpaste containing blue covarine. Journal of dentistry, 36 Suppl 1, S21–S25. https://doi.org/10.1016/j.jdent.2008.02.006
2. Epple, M., Meyer, F., & Enax, J. (2019). A Critical Review of Modern Concepts for Teeth Whitening. Dentistry journal, 7(3), 79. https://doi.org/10.3390/dj7030079

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Find out what causes tooth sensitivity and how to stop the daily pain & discomfort.

Having sensitive teeth is an uncomfortable problem that you might notice after having something cold such as ice cream or hot, such as a bowl of hot soup.^[2] Although this discomfort at times can alert us to a potential cavity, it might be an indication that we might need to make some changes in our oral hygiene home care routine.^[2]

What are some common causes of sensitive teeth?

Although some people are more prone to having sensitive teeth due to having thinner enamel, there are many factors that can lead to the development of your teeth becoming sensitive. The enamel is the hard protective outer layer of the tooth. If it becomes worn down then the next layer, dentin which is much softer becomes exposed, this exposure can lead to tooth sensitivity.^[3] Some other factors that contribute to tooth sensitivity are:

• Brushing too hard can cause the enamel to wear away overtime, leaving the teeth exposed. This often happens where the teeth and gum meet at the gum line.^[3]
• Grinding or clenching your teeth may wear down surfaces of your teeth.^[1]
• Gum Recession is usually developed as a result of periodontal disease. It occurs when the gum tissue pulls away from your teeth, exposing the roots of your teeth which will lead to increased sensitivity.^[1]
• Cracked teeth, tooth decay, or worn down fillings can leave the dentin exposed and open to harmful bacteria.
• Acidic foods and medical conditions such as GERD or Bulimia can contribute to tooth erosion. The excess acid can coat the teeth and wear down the layers of the teeth overtime. Consume acidic foods less often and see your physician if you have a contributory medical condition.^[1][3]
• Your teeth might feel temporarily sensitive following certain dental procedures such as teeth bleaching or restorative treatments like fillings or crowns.^[2] This sensitivity usually diminishes in four to six weeks. If you have discomfort after a procedure make sure to inform your dentist so that they can determine if this normal or is a concern needing additional treatment.^[1]

How is tooth sensitivity treated?

• If your tooth sensitivity is mild, you can try over-the-counter sensitivity treatments such as toothpastes labeled specifically for sensitive teeth. Sensitivity toothpastes contain ingredients such as Potassium Nitrate that will help desensitize your teeth overtime and help block the discomfort of the tooth sensitivity you have been experiencing.^[2]
• Gently brush with a soft toothbrush, using a medium or hard toothbrush is not recommended as it contributes to wearing away the enamel of your teeth quickly.^[2]
• If you grind or clench your teeth, discuss this with your dentist to see if a night guard or corrective treatment is advised.
• Use a non-alcoholic mouthwash that contains fluoride or xylitol. These ingredients help prevent cavities and help desensitize uncomfortable areas.
• If you plan to do in-office or at-home dental bleaching, discuss this with your dental professionals prior. They may recommend certain desensitizing products to be used prior to the treatment and after to help prevent or alleviate any discomfort.^[3]
• Visit your dental office regularly. If you have sensitivity don’t ignore these symptoms, they could be indicators that immediate treatment might be necessary. Your dental professionals can help with sensitive areas by applying fluoride gels, prescription-grade desensitizing agents in-office, and might prescribe you prescription strength treatments to use at home.^[1][3]

Tooth sensitivity can definitively be a pain, pun intended. However thankfully as discussed there are several options that can help it to be treated and successfully managed.

Kari Carter-Cherelus

Kari Carter-Cherelus RDH, DA is a registered Dental Hygienist, writer, consultant, coach, international keynote speaker, with 23 years of experience in dentistry. She is passionate about helping others recover from burnout, improving organization’s work culture, and helping her clients to improve their mindset. She authored the book The Ultimate Guide For Dental Hygienist Burnout, and has written for RDH Graduate, RDH Magazine, and Inside Dental Hygiene.

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References

1. Cleveland Clinic. Teeth Sensitivity.(2022).
   https://my.clevelandclinic.org/health/symptoms/10954-teeth-sensitivity
2. 2. Frank, Christine. (2018, September 29). Why Are My Teeth So Sensitive? https://www.healthline.com/health/sensitive-teeth
3. Oral Health Foundation.Sensitive Teeth. https://www.dentalhealth.org/sensitive-teeth

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Erin Stelbrink

Erin Stelbrink is a Registered Dental Hygienist with 5+ years of experience as a licensed hygienist and oral health care professional. She holds a passion for researching and acquiring awareness of the latest technologies and methods for providing valuable health care service and clinical treatment. Have more questions? Email Erin at erin@smilebrilliant.com

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