Patients continue to desire whiter teeth and demand for tooth whitening continues to grow. Options available include in-office tooth whitening with or without a lamp, office-dispensed home-use products, and a variety of over-the-counter products. In addition to being a procedure that patients want, tooth whitening is a great practice builder. Patients should be carefully assessed before starting a tooth whitening treatment; this includes examinations for erosion, caries, abrasion and defective restorations. The type of stain and its cause must be determined in order to make a determination of the likely success and speed of tooth whitening. Educating patients on their options, what is involved in a tooth whitening procedure, management of potential sensitivity, and what they will need to do are important components in the decision to whiten teeth and the likelihood of patient compliance and success. With good case selection, tooth whitening is straightforward, effective and a welcome adjunctive treatment.

The demand for tooth whitening continues to increase in the US. Whitening is available as an in-office treatment, as a take-home treatment utilizing custom fabricated trays or with many over the counter products. There has been considerable advancement in whitening technology since its inception, making the results more predictable and reducing the incidence of post-op sensitivity. The primary types of tooth discoloration are intrinsic and extrinsic. Extrinsic stains can become intrinsic by seeping into the interior of the tooth through pits, fissures and surface irregularities. Extrinsic discoloration is effectively removed during a prophylaxis. Intrinsic discoloration is improved with the use of peroxide containing whitening agents. This course discusses clinician responsibilities, ethical considerations, mechanism of action,side effects and management of patient expectations with tooth whitening procedures. Cosmetic dental procedures have been developed over a relatively short period of time, with virtually continuous refinements to materials and procedures.

 Tooth whitening removes intrinsic and extrinsic staining. Many tooth-whitening options are currently available, including in-office treatments and home-use products that can be office-dispensed or purchased over the counter. Each type of treatment has its own advantages and disadvantages. Management of potential side effects such as tooth sensitivity and gingival irritation must be considered and managed if necessary. Tooth whitening is safe, effective and desired by patients in our esthetically conscious society.