Professional Teeth Whitening in Miami

Professional whitening lightens natural teeth without changing their shape. At Vizcaya Dental Arts we prefer a slow course in custom trays worn at night, using the KöR system, over a single strong in-office session, because the slower course causes less sensitivity, which means patients complete it, and in most cases ends up whiter. Whitening does not change crowns, veneers, fillings or bonding, and it comes before any new dental work on the front teeth.

Start with a healthy mouth

Whitening is cosmetic, so everything else comes first. Before you start we examine your teeth and gums, because bleaching gel on a cavity, a leaking filling or inflamed gums causes pain and solves nothing.

• Decay is treated.
• Gum problems are brought under control.
• If your teeth are already sensitive, we work on that before whitening rather than during it.
• A good cleaning beforehand removes the surface stain that whitening would otherwise have to work through.

How whitening works

Whitening gels are based on a peroxide that passes through the enamel and breaks up the pigment molecules that have accumulated in the tooth over the years, from food, drink, tobacco and age. It works on natural tooth structure only, from the inside out, which is why surface cleaning is a different thing and why crowns and fillings are unaffected. The result depends on how long the gel is in contact with the tooth, which is the reason a low concentration overnight can outperform a strong gel applied for an hour.

Why we prefer custom trays at night

Our preferred system is KöR, chosen for its results and for how little sensitivity it causes in our patients. The gel is a lower concentration than fast in-office treatments, worn in thin custom-fitted clear trays while you sleep. A lower concentration over more hours does the work gradually, and because it is comfortable, people complete the course.

The alternative, a strong gel applied for an hour in the chair, produces a quick change and often enough sensitivity that the patient cannot continue. For most people the slower route ends up whiter, and we rarely suggest a single in-office session on its own.

Whitening before other cosmetic work

If you are considering bonding, veneers or a new crown on a front tooth, whitening comes first. Restorations are matched to the color of the teeth around them and do not change afterward, so the shade has to be settled before anything is made. We finish the whitening course, wait a couple of weeks for the color to stabilize, and only then match the new work. The same logic applies to Invisalign: straighten first, whiten next, then add shape only where it is still needed. Our cosmetic dentistry page walks through that order.

What the course involves

1. 1
   Step 1 of 5 Examination and shade

   We check teeth and gums, note existing crowns and fillings, record your starting shade and talk about what is realistic for your teeth.

2. 2
   Step 2 of 5 Custom trays

   Impressions or a digital scan of both arches, and thin trays are made to fit your teeth exactly, which keeps the gel on the teeth and off the gums.

3. 3
   Step 3 of 5 Two weeks of nights

   You load the trays with gel and wear them overnight, every night that is comfortable. We recommend whitening upper and lower teeth together; if you are wearing one tray you may as well wear two.

4. 4
   Step 4 of 5 Check and extend if needed

   We compare the shade with your starting point. Darker teeth often benefit from continuing to four, six or occasionally eight weeks, with our supervision.

5. 5
   Step 5 of 5 Maintenance

   Keep the trays and the remaining gel. One or two nights a month, following the product directions, holds the shade.

Managing sensitivity

Use a sensitivity toothpaste for a week or two before you start and throughout the course; it makes a noticeable difference. If a night leaves your teeth tender, skip a night or two and resume. A gentler pace reaches the same shade. Patients who start with sensitive teeth are not the best candidates until the sensitivity is addressed, and we tell you if we think you should wait.

What will change color, and what will not

Only natural tooth structure whitens.

• Crowns, veneers, bonding and fillings stay the color they are.
• If a filling or crown is already lighter than your teeth, whitening may bring your teeth closer to it, which is welcome.
• If it matches your teeth now, it will look dark against them once they lighten, and it may need to be replaced to match.

We go through every visible restoration with you before you start, so there are no surprises and so any replacement can be planned for after the new shade has settled.

Response also varies between people. Younger teeth generally whiten faster and further; older teeth are more resistant, though we see good results at every age. Teeth that are gray or stained from within, as with tetracycline, may lighten but not as far as you would like, and those are the cases where we talk about veneers as the next step.

Coffee, strips and other advice you may have heard

Do I have to give up coffee and tea? In our view, no. Manufacturers often recommend a white diet during whitening, but we are not aware of good evidence that daytime coffee undoes a gel worn at night, and the clinical studies that have looked at it have not found a meaningful difference. Follow your product’s instructions, and know that whatever stains your teeth will stain them again over time, which is what maintenance is for.

Are strips any good? Reputable strips from a well-known manufacturer are effective. In our experience they cause more sensitivity than custom trays and work best for younger patients and teeth that are not very dark. When the teeth are darker, or the goal is more than a shade or two, the trays do more.

What about products online? Buy whitening products from a manufacturer you can identify, with clear ingredients and directions. We are cautious about products that do not say where or by whom they were made, and we suggest the same caution.

Keeping the shade

After the initial course, one or two nights a month with the trays and the remaining gel, used within its expiry and stored as directed, keeps the shade more or less indefinitely. The trays themselves last for years. What shortens their life is tooth movement: if your teeth shift, the trays stop fitting. Patients who wear an orthodontic retainer at night rarely have that problem, because the retainer keeps the teeth where they were. If you have no retainer and the trays feel tight after a year or two, we make new ones.

Frequently asked questions

How white will my teeth get?

Most patients see a clear change within two weeks of nightly wear, and darker teeth keep improving over an extended course of four to eight weeks. How far your teeth go depends on the cause of the color and how your enamel responds; younger teeth tend to whiten faster. We will give you an honest expectation at the consultation rather than a promised shade.

Does whitening hurt?

Any whitening can cause some sensitivity. We choose a lower-concentration gel worn overnight precisely because it causes less, and we recommend a sensitivity toothpaste before and during the course. If a night is uncomfortable, you skip a night; nobody has to push through pain.

How long does whitening last?

The shade holds as long as you maintain it. Teeth pick up stain again from food, drink and time, so we recommend a maintenance night with the trays about once or twice a month. Patients who do that keep their shade indefinitely.

Is whitening safe for my teeth?

Professional whitening on healthy teeth, with a product from a reputable manufacturer and used as directed, is safe. It does not weaken enamel. The things that make it unsafe are untreated decay or gum disease, which is why we examine you first, and products of unknown origin.

Can I whiten if I have crowns or fillings on my front teeth?

You can, but they will not change color. If they are lighter than your teeth today, whitening may bring your teeth closer to them. If they match now, they will look darker afterward and may need replacing to match the new shade. We go through this before you start.

Are whitening strips any good?

Reputable strips work, especially for younger patients whose teeth are not very dark, and we would not talk you out of them. They tend to cause more sensitivity, and they reach a limit sooner. When the teeth are darker or you want a bigger change, custom trays worn at night do more.

Sources

Professional guidelines and peer-reviewed reviews this page draws on.

1. Carey CM. Tooth whitening: what we now know. Journal of Evidence-Based Dental Practice. 2014;14(Suppl):70-76. DOI