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Is it better to whiten the teeth utilizing an accelerator light?


Published by
SmileLabs, LLC
Written by
Zachary Hilgers, DDS (Retired)
October 13th, 2009
© All Rights Reserved

ABSTRACT

It has often been asked  as to whether or not the use of our bright blue accelerator light was necessary. More simply put, "Do teeth whitening lights work?". This paper reviews the efficacy of the use of a strong blue light source in addition to the usual procedure of vital teeth bleaching or teeth whitening with a peroxide-based gel placed in direct contact with the dental hard tissues. This is the type of system that SmileLABS™ uses. A research of the current literature and scientific papers will show whether or not the additional use of a strong source of blue light causes the treated teeth to become whiter than those bleached without a light. It will also examine any possible further benefits obtained by using the light in addition to whitening the teeth.

INTRODUCTION

Currently, cosmetic teeth whitening or teeth bleaching is performed, either in a dental office or by an independent entrepreneur, by placing a peroxide-based bleaching gel into direct contact with the dental hard tissues. This contact of bleach to teeth is facilitated either by painting the gel directly onto the teeth or by use of a custom made whitening tray loaded with bleaching gel that is placed into the mouth to carry the gel and keep it held in constant contact with the outer surface of the teeth. It has been shown that these two methods will result in noticeable whitening of the teeth, with the finished degree of whitening being based on both the relative strength and concentration of the peroxide-based gel and the amount of time that the active gel is left in contact with the surface of the teeth. If the concentration was low, a longer amount of time of contact with the bleach was needed to achieve a satisfactory result. This meant that for the patient a number of daily treatments were needed either in the dental office or at the patient’s home for the teeth to become satisfactorily white.

Making the bleach concentration stronger, on the other hand, would speed the color change, but would often lead to increasingly painful tooth sensitivity, which was a very non-desirable result for both the patient and practitioner. So, experience showed that a good result could be obtained at home if the patient used either a medium peroxide concentration of bleaching gel coupled with a regimen of spacing the treatments into an hour per day for a number days to a week, or to all-night bleaching with a low peroxide concentration gel every night for a 7-21 day course of treatment. These two variations of the teeth bleaching processes have been used for many years with a good and predictable outcome for the patient who actually correctly completes the treatment regimen.

The only downside was that results were not immediately obtained, but were gained incrementally over a number of days or weeks. Since this type of treatment was done unsupervised at home, strict compliance with treatment guidelines was many times hard, if not impossible to maintain, and results and patient satisfaction with the treatment were many times negative.

Therefore, many a practitioner hoped for a way that could combine the shortest course of treatment, coupled with the ability to be able to supervise the entire treatment to a satisfactory conclusion, that was both easy and pain free from sensitivity to the patient.

This hope resulted in what is now known as Chairside Power Bleaching, the system used by SmileLABS™. By combining a higher concentration of peroxide gel with the use of a strong, safe wavelength of light as an accelerator or catalyst to the teeth bleaching reaction, a much shorter time of contact between gel and tooth resulted that increased the bleaching efficiency of the gel and shortened treatment time by a very large factor, while keeping the process mostly free from sensitivity and achieved the patient’s desire of whiter teeth in minutes instead of days. The question is now whether that combination of gel and light really works.

EVIDENCE

In an in vitro study conducted on non-vital extracted teeth, K. Luk, L. Tam, et al showed that color changes were “significantly affected by an interaction of the bleach and light” used. In their article published by the Journal of the American Dental Association they found that the application of light greatly “improved the whitening efficacy of some bleach materials…” This study also pointed out that the wavelength of light used had a direct bearing on the increase in temperature inside the tooth, which, if it was too high, could result in increased risk for internal tooth nerve (pulp) damage which might result in pulpal inflammation or death, thus necessitating possible future root canal treatment therapy. The wavelength of light associated with the least rise in internal temperature and that speeded up the chemical bleaching reaction was at around 480 to 520 nanometers, or the color of visible light spectrum blue/green.[i]

In a more recent  in vivo study published 2009 in the Journal of Dentistry, JC Ontiveros, et al., found that when using a supplementary light there were “significantly greater bleaching-dependent changes (i.e. the teeth got whiter) in color compared to treatment without light when assessed using instrumental (intraoral spectrophotometer) measurement methods. The same was determined for the visual method with Vita Bleachguide 3-D Master shade guide.[ii]

Back in 2002, when Chairside Power Bleaching first started, a comparison trial of the whitening effects of the first light-enhanced Zoom! ™ Chairside system was studied against Opalescence™ Xtra Boost, which did not use an accelerator light. The Zoom! gel was 25% peroxide and the Opalescence used 38% peroxide. At the end of the trial, both systems were shown to improve teeth shades by between 6 to 9 shades whiter. However, the light-enhanced system, even with its lower peroxide concentration, was shown to be 11 to 22 percent whiter than the higher concentrated non-light-activated gel.[iii]

In a study of wavelength specific lasers used in dentistry, DN Dederich, et al., reported in the 2004 JADA, the best wavelength of light used to facilitate power bleaching was in the 457 to 502 nanometer visible blue light spectrum because of its significant aid in bleaching the teeth while it did not produce the internal tooth heating that other wavelengths of light might cause. They definitely also were against the use of infrared wavelengths that tend to heat the tooth, such as those employed by a CO2 laser.[iv]

In the cover story to the February 2003 JADA, J Goodson, M Travares, et al showed that by using a light and a “relatively low–concentration peroxide (15 percent) for a treatment period of one hour, we were able to achieve a high level of tooth whitening that persisted for a minimum of six months with minor transient tooth sensitivity.” The light that was used was a short-arc gas plasma lamp emitting in the blue-green visible light spectrum at 400-505 nanometers.[v]

Lastly, as an interesting side note to the effects of accelerator light use during vital teeth bleaching, a study mentioned in the News section of the may 2005 issue of the JADA states that using a blue light to help whiten teeth may help fight periodontal (gum and Jawbone) disease. JADA reported that researchers at the Forsythe Institute had shown that as many as 500-600 different types of harmful bacteria found in oral plaque known as “black-pigmented bacteria” (BPB) were eliminated during teeth bleaching when a visible light spectrum blue light is used to enhance the bleaching effect. They also found that when the amount of BPB was reduced, the proportion of potentially helpful bacteria increased. This suggests that the use of bleaching lights might one day help “restore a healthy bacterial balance in the mouth.”[vi]

CONCLUSION

Recent research on the use of a bright light while performing vital tooth bleaching has shown that it improves the final desired result of whiter teeth than when one doesn’t use a light. The studies have shown that using a light in the visible blue light spectrum results in the greatest whiteness level achieved as opposed to using other visible or invisible wavelengths.

They also show that they can shorten the time needed to achieve a whiter smile by allowing the clinician to use a higher than normal concentration of peroxide in the gel during a shorter treatment time, with positive results taking place in minutes as opposed to days or weeks. Using the right light and gel combination results in fewer incidences of sensitivity, which all patients and clinicians desire as part of a positive bleaching experience and result.

So, with all these factors being considered, the SmileLABS™ Cosmetic Teeth Whitening system, which incorporates a relatively medium strength peroxide gel and a cool LED blue light in the visible spectrum with a wavelength of 490-520 nanometers, is a perfect combination to get teeth whitened very fast without sensitivity. And lastly, it appears that there is a here-to-fore unknown benefit that results in the bright blue light helping in combating gum disease, which causes many adults to lose teeth. Therefore, one might have the added benefit of helping keep their teeth longer and have them become a lot whiter when using our SmileLABS™ bright blue cold LED accelerator light while bleaching.

 

Cited References


[i] Kuk K, Tam L, Hubert M. Effect of light energy on peroxide tooth bleaching. J Am Dent Assoc. 2004; (135): 194-201

[ii] Ontiveros JC, Paravina RD. Color change of vital teeth exposed to bleaching performed with and without supplementary light. J Dent. 2009 Nov;(37): 840-847

[iii] Gallagher A, Maggio B, Bowman J, Borden L, Mason S, Felix H. Clinical study to compare two in-office (chairside) whitening systems. J Clin Dent. 2002; 13(6):219-224

[iv] Dederich DN, Bushick RD. Lasers in dentistry: Separating science from hype. J Am Dent Assoc. 2004 Feb; (135):204-212

[v] Tavares M, Stultz J, Newman M, Smith V, Kent R, Carpino E, Goodson J. Light augments tooth whitening with peroxide. J Am Dent Assoc. 2003 Feb; (134):167-175.

[vi] No authors listed. NEWS: Blue light may fight bacteria associated with periodontitis. J Am Dent Assoc. 2005 May; (136): 584

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