All about teeth whitening – procedure, methods, costs

What is tooth whitening?

Tooth whitening summarizes different methods to whiten teeth, i.e. to (re)create a radiant smile and white teeth. The term comes from the word bleaching from English and means bleaching.

All methods of tooth bleaching have in common that hydrogen peroxide and carbamide peroxide are used. These two substances dissolve color pigments contained in the tooth substance by oxidation. 

When can people think about teeth whitening?

Tooth bleaching is popular when the natural tooth is dark or yellowish in color. Discolored / yellow teeth are caused by frequent consumption of coffee, tea, red wine and nicotine.

Important prerequisites for whitening are healthy teeth and gums. If the teeth have untreated caries, leaking fillings, defects in the enamel or fractures, the bleaching agent in the. tooth and damage the tooth or tooth nerve.

In general, it is advisable to consult a dentist before whitening to avoid damage to the gums and teeth, and to have a professional teeth cleaning.

In addition, children and adolescents should refrain from tooth whitening, as their tooth structure is not yet mature and therefore there is an increased risk that the whitening will damage the tooth root.

There are other groups of people who should generally avoid bleaching: Pregnant women, breastfeeding women and people who have intolerances to the ingredients of the bleaching agents. 

What are the procedures?

Self-application: Whitening toothpaste and home remedies

Dentists advise against whitening toothpaste and home remedies (e.g. baking soda, oil pulling with coconut oil), as the discoloration on the teeth is partially ground out by these approaches, which attacks the enamel. Due to the damage to the enamel, new color pigments can then be deposited more easily in the teeth and thus, in the longer term, these agents can even lead to a stronger discoloration of the teeth.

In addition, the whitening effect of such remedies is generally weaker than that of professional bleaching approaches; for example, the maximum concentration of peroxides in over-the-counter remedies is 10%, whereas in professional bleaching products it is around 30%. 

Professional teeth whitening: In-Office and Power Bleaching

This is a professional teeth whitening procedure in which the bleaching agent is applied exclusively by a dentist in the dental office. Depending on the initial color of the teeth and the target shade, several appointments may be necessary for bleaching. The whitening agent takes effect for about 20-30 minutes, covering the gums for protection.

In some cases, power bleaching is distinguished from in-office bleaching. Here, in addition to conventional in-office bleaching, a light-assisted procedure is used to whiten the teeth.

Mixed variant: Home bleaching

In home bleaching, the patient receives a custom-fitted plastic tray from the dentist with bleaching gel filled in. The patient wears the splint at home usually for 1-2 hours over 2 weeks, depending on the desired degree of whitening.

Internal bleaching or walking bleach method (for root-treated teeth)

This is a special bleaching method for root-treated teeth, in which the bleaching agent is introduced directly into the tooth and left there for a certain period of time (usually a week). For this purpose, the root-treated tooth must be opened and provisionally closed during application.

What is the procedure for in-office teeth whitening?

Step 1: Professional teeth cleaning and check-up at the dentist’s office

Only healthy and clean teeth can be whitened again. Therefore, before professional teeth whitening, professional teeth cleaning is mandatory, ideally, a check-up at the dentist should also be performed.

Before the actual bleaching, a shade determination of the teeth is usually performed.

Step 2: Protection of the gums

Before applying the bleaching agent, the dentist applies a mouth opener and applies liquid plastic between the teeth and gums to prevent the bleaching agent from coming into contact with the gums. 

Sometimes the gums are also protected from the bleaching agent by a plastic film with small holes through which the teeth are put, or both methods are used.

The isolation of the gums from the teeth is also called a rubber dam.

Step 3: Bleaching process

After the rubber dam is in place, the tooth surface is cleaned once again. The bleaching agent is then applied and left on the teeth for a certain amount of time (usually between 20 and 30 minutes), depending on the desired degree of whitening and the strength of the bleaching agent. 

In some cases, the bleaching effect is enhanced by light.

Step 4: Rinse off

Finally, the teeth are carefully rinsed with water to remove the bleaching agent without leaving any residue and to rehydrate the teeth, which are partially dehydrated by the bleaching process. The rubber dam is then removed.

Step 5: Repetition (depending on the desired degree of lightening)

Depending on the degree of whitening desired, the above process is repeated in additional appointments to help the patient achieve the desired white teeth.

What do I have to pay attention to in the period after bleaching?

For 2-3 days after whitening, you should refrain from consuming foods with strong color, for example, coffee, red wine, curry and acidic fruits.

What are the advantages of professional teeth whitening?

White smile: As described above, professional teeth whitening is more effective than Seblst application due to the higher level of hydrogen peroxide concentration.

Higher treatment safety: Bleaching in the dental office is considered harmless as long as there is no previous damage to the teeth or gums. Professional teeth cleaning and dental check-up before bleaching increases the safety of the treatment, because it can be excluded that there is any previous damage to the teeth, which could cause permanent damage to the teeth by bleaching. 

What are the risks and side effects of teeth whitening?

Hypersensitivity immediately after bleaching: Teeth may be hypersensitive immediately after bleaching. This is because the ingredients of the whitening substances dry out the teeth. The hypersensitivity usually subsides about 24 hours after whitening, by which time the saliva has naturally rewetted the teeth. 

Gum and tongue irritation: Gums and tongue can be irritated by the bleaching medium, this is especially true for the self-user methods, but also for home bleaching with the help of a tray. Dentists minimize the risk of gums and tongue coming into contact with the bleaching agent by taking special safety measures (rubber dam). 

What costs should I expect for teeth whitening?

In Switzerland

In Switzerland, the following costs can be expected:

• In-Office Power Bleaching: CHF 300 – 800 (depending on the number of sessions)
• Home bleaching with splint per jaw: CHF 280 – 600 (depending on duration)

In other European countries

For Swiss people, whitening treatment in other European countries is not worthwhile as an end in itself for whiter teeth, as the treatment costs are relatively low compared to other dental treatments – however, it can make sense to have whitening performed if you are having treatment abroad anyway. 

The following table provides an overview of whitening costs in various popular destinations for dental treatment abroad:

Country	In-Office Power Bleaching	Home bleaching with splint per jaw
Switzerland	CHF 300 – 800	CHF 280 – 600
Germany	EUR 300 – 800	EUR 200 – 400
Austria	EUR 300 – 700	EUR 180 – 400
Greece	EUR 200 – 600	EUR 180 – 300
Czech Republic	EUR 150 – 400	EUR 150 – 300
Hungary	EUR 150 – 400	EUR 100 – 300

Sources: Various dental practice websites and price comparison sites.

Does the supplementary insurance cover the cost of tooth bleaching?

Bleaching is considered a non-medically prescribed treatment and is therefore usually excluded from the coverage of supplementary (dental) insurance, so patients usually have to bear the costs of bleaching entirely themselves.

More common questions about teeth whitening

How long will my teeth stay white?

As a result of professional bleaching you will have beautiful white teeth and for a period of 3 to.5 years. Self-performed home whitening methods have a much shorter holding time. 

With proper care and reduction of foods and stimulants that contribute to staining (e.g. coffee, red wine, cigarettes), you can help yourself to enjoy your radiant smile for as long as possible.

How can discoloration be prevented?

The be-all and end-all for the prevention of discoloration is thorough and regular dental care. This can also remove superficial discolorations in the long term. An electric toothbrush can help achieve a more even result when brushing teeth.

It is also important to note that acidic foods make teeth particularly vulnerable to attack, as the acid dissolves minerals from the teeth. Therefore, after consuming such foods (e.g. juices, wine, fruits), wait at least half an hour before cleaning the teeth, otherwise the tooth cleaning may further attack the teeth and thus contribute to discoloration. After about 30 minutes, the saliva has neutralized the acid from the food. 

Will my teeth be damaged during bleaching?

Professionally performed bleaching is considered harmless to the teeth.

However, caution is advised with self-application bleaching, i.e. whitening toothpaste and home remedies for whitening teeth: self-application remedies sometimes grind particles out of the teeth, which tends to increase discoloration and damage the teeth in the medium term. 

What happens if I had a root canal treatment and want to whiten my teeth?

To bleach teeth that have undergone root canal treatment, the dentist must open the tooth and introduce a special bleaching agent into the upper part of the root canal from the inside. The dentist then closes the canal provisionally. The bleaching agent is usually changed once a week until the desired shade is achieved and the tooth can be permanently sealed again.

Can I whiten my teeth if I have crowns, bridges or veneers?

Bleaching products only affect natural teeth and cannot change the color of artificial teeth such as crowns, bridges and veneers. Therefore, dentures may be distinguishable from natural teeth in terms of color after whitening if the dentures are located in the visible area of the teeth.

Can I whiten my teeth despite braces?

In principle, bleaching is only possible after completion of the orthodontic treatment. Experts recommend waiting at least 1-2 months between braces removal and whitening, as the tooth may be weakened by the braces’ brackets.

However, care should be taken to ensure that the patient has reached the necessary age for bleaching (18 years), as in children and adolescents the tooth structure is not yet mature and therefore there is an increased risk that bleaching will damage the tooth root.

How white can my teeth become through whitening?

Dentists state as a guideline that teeth become two to three shades whiter than the original color of the teeth through bleaching. The degree of whitening depends on the patient’s individual predisposition.

What are the alternatives to teeth whitening?

Professional teeth cleaning alone can have a visible effect in the form of whiter teeth.

Veneers are considered the most sensible alternative to bleaching. They are wafer-thin and opaque plastic or ceramic shells that are permanently attached to the visible front teeth using a special plastic. Thus, in addition to discoloration, crooked or chipped teeth can be corrected.

Home remedies, as already mentioned, cannot be considered as real alternatives to bleaching, because although they can sometimes show limited effectiveness on teeth whitening, most of them attack the enamel through abrasion or acid development and are therefore harmful in the medium term.

Last update: December 16, 2022