Making the great white hope of a smile come true

Tantri Yuliandini, The Jakarta Post, Jakarta

A smile is the friendliest gesture, more welcoming than a handshake or even a hug. It lights up a person's face and engenders comfortable, secure feelings in others.

But before you flash your megawatt smile, make sure those pearly whites are just that.

No matter how well you take care of your teeth, they will stain naturally over the years, due to aging, staining substances such as coffee, tea, red wine and tobacco, excessive fluoride, and the deterioration of a tooth's nerve.

Luckily, many options are available today to return the brilliant white to your teeth, including off-the-shelf whitening toothpastes.

But while whitening toothpastes can be abrasive and need a long period of time to bring back a shade or two of whiteness, cosmetic dentistry can do a lot more in a shorter time.

Several cosmetic dentistry options include at-home bleaching and laser teeth whitening, which will g generally lighten four to five shades teeth that are stained by coffee, tea, or smoking. While teeth that are discolored due to pigmentation within the teeth will lighten two or three shades.

By far the most popular teeth whitening system here is the at- home bleaching or mouth tray method.

After the initial check up for cavities, the teeth will be cleaned to remove plaque and custom fitted with a mouth tray. A peroxide-based teeth bleaching gel is put in the mouth tray, and the tray worn over the teeth for up to two hours daily or overnight.

Most of the bleaching is then done at home, and a dentist regularly checks to make sure the gums are not being irritated or damaged.

The treatment, costing about Rp 1.5 million (about US$159), takes about two to four weeks to acquire the desired shade of whiteness.

However, for about 15 percent to 20 percent of patients, the method may cause heightened teeth and gum sensitivity but it usually goes away as the treatment progresses.

Another method is laser teeth whitening performed by a cosmetic dentist.

After the teeth are cleaned of plaque, a peroxide-based gel is applied to the teeth and laser is used to activate the gel and initiate the whitening process.

Laser teeth whitening is more effective against difficult stains, like the tetracycluse, and more reliable against stains caused by coffee, tobacco and from the natural aging process.

The actual laser bleaching time takes about 30 seconds per tooth for an average whitening of two to three shades, consisting of one to two hours for the whole process, from set-up and isolation, pre-treatment and post-treatment. Treating difficult stains, such as from tetracycline, will take closer to two hours.

Another method, and relatively new to Indonesia, is the BriteSmile. Similar to the method used for laser bleaching, a hydrogen peroxide whitening gel is applied to the teeth and activated by a special blue light.

After an initial checkup, the dentist prepares the patient by placing a barrier material over the gums and masking cream over exposed lips. Then a thin layer of proprietary whitening gel is applied onto the teeth.

However, instead of the 22 percent to 35 percent hydrogen peroxide usually used in both mouth tray and laser bleaching methods, BriteSmile uses only 15 percent, therefore reducing the risk of tooth sensitivity and gum irritation, BriteSmile International's vice president for Asia Pacific Leow Kee Peng said in a media conference recently.

"The wavelength of the proprietary blue light is matched to the gel chemistry so that it will emit little or no heat," he added.

Developed by John Warner, a former National Aeronautics and Space Administration (NASA) scientist and member of the Hubble Space Telescope development program, BriteSmile claims to be able to improve teeth whiteness up to 10 shades.

While not fully guaranteeing maximum whiteness for tetracycline staining, whiteness of about two or three shades is usually expected.

However, tooth whitening treatments -- whether laser bleaching, BriteSmile, or others -- have no effect on the artificial materials used for bonds, veneers or capped teeth.

The whole BriteSmile treatment takes about one hour and can last up to two to three years without special maintenance, but a special gel pen, toothpaste and mouthwash can help make it last longer.

Pregnant women, nursing women and children under 14 years old are not advised to use the treatment because there are no studies as yet on any effects on these three types of patients.

"People often worry about pain, but this process has very little (risk of) sensitivity," Leow said, explaining that while there is higher risk of sensitivity among Asians compared to Caucasians, the pain is usually bearable.

Renie Nirmala, 30, who was treated at the newly opened BriteSmile Teeth Whitening Spa at Dharmawangsa Square Citywalk, said that she experienced little sensitivity and only mild jaw discomfort during the whole process.

Besides the Spa, BriteSmile is also available at 15 dental clinics in Jakarta, Bandung and Denpasar. Treatment costs a not insignificant Rp 5.9 million ($626) at the Spa, and between Rp 6 million to Rp 10 million at the dentist.

"It's a small price to pay," Renie assured, showing off her white smile to emphasize the point.