Laser teeth whitening

The benefits

Contraindications

• Pregnancy and breastfeeding: as a precaution, whitening is postponed.
• Under eighteen years of age: European regulations reserve products containing 0.1% to 6% hydrogen peroxide for adults.
• Untreated cavities, cracks or defective restorations: to be treated first, otherwise pain and penetration of the gel into the tooth may follow.
• Unstabilised gum disease: periodontal treatment comes first.
• Marked dentine hypersensitivity or extensive gum recession: the aesthetic benefit is weighed against the discomfort expected.
• Long-standing internal staining — non-vital tooth, trauma, tetracyclines, fluorosis: the response to external whitening is weak or nil, and the treatment route is a different one.
• Visible restorations on the front teeth: crowns, veneers and composites do not lighten, and the contrast with the neighbouring teeth will increase.
• Expecting a change of shape: whitening changes the shade, never the shape or the alignment.

The treatment process

1. 1

   Examination, shade record and search for the cause

   Examination of the teeth and gums, record of the starting shade with a shade guide, photographs, X-rays if needed. The cause of the staining is investigated: external, internal, or linked to an existing restoration. It is this examination that determines whether whitening can reach the staining.

2. 2

   Prior cleaning and necessary treatment

   Scaling and polishing are carried out before any application. Cavities are treated and defective restorations replaced: a gel that penetrates through a crack or a loosened filling causes sharp pain. An inflamed gum is treated before the session.

3. 3

   Protection of the gum and application of the gel

   The gum is isolated by a protective barrier applied over the whole treated area. The peroxide gel is placed on the visible surfaces of the teeth. The concentration and the application time are chosen according to the starting shade and the sensitivity found at the examination.

4. 4

   Activation, rinsing and desensitisation

   The gel is activated by lamp or laser in several short passes, then rinsed off. A desensitising gel is applied at the end of the session. The shade obtained is recorded with the same shade guide as at the start, which makes it possible to measure the actual gain rather than estimate it.

5. 5

   Check of the shade and maintenance at home

   A check-up is scheduled later, as the shade stabilises over one to two weeks. Dietary advice for the first few days is given in writing. Maintenance is then carried out with a tray at home, once or twice a year, rather than with new chairside sessions.