Tooth Whitening

Most effective tooth whitening procedures

In-house tooth whitening at Designer Smiles®, followed by home tray whitening system, or

Two visits of In-house tooth whitening at Designer Smiles We at Designer Smiles are happy to suggest the most appropriate treatments, based on the best risk-benefit, and cost-benefit ratios for your situation. We listen, evaluate and discuss bleaching with you. We also educate you by helping you to acknowledge unrealistic expectations.

Meeting your expectations

Bleaching and tooth whitening results depend on several factors:

Dentist’s skill

Individual variation in teeth form, surface and colour

Patient’s habits: diet, smoking etc

One cannot promise the patient an exact final shade

We also discuss all modalities of bleaching, advantages, disadvantages and other options

Before and after photos with shade guide are generally required for obtaining your informed consent. 92.5% of patients consulting Designer Smiles have expressed satisfaction with our tooth whitening procedures. Long-term studies on tooth whitening have shown:

After 1½ years: 75% of all patients are happy

After 3 years: 65% of all patients are happy.

Therefore, we help patients understand the possibilities available to them.

Five years after One Visit Tooth Whitening

Monthly home tray whitening gel can be supplemented with yearly in-house tooth whitening system as well at Designer Smiles. Over-the-counter products (OTC) have considerable amounts of acid which can affect the surface enamel of the tooth, while professionally delivered products tested in clinical trials sustain no damage to tooth enamel.

Tooth whitening is an art requiring prior assessment of tooth colour/shade. Patients with very dark stains on their teeth may not be suitable candidates for whitening procedure as it would take quite a long period of time and the banding-striations will remain. Also not Ideal for tooth bleaching are teeth with severe tetracycline discolouration and enamel hypoplasia (surface malformations). Bleaching alone will not fix the problem. The surface colour contrast in the bands will remain. Ultrathin minimal intervention porcelain veneers developed by Dr Nalbandian and his laboratory (dental Xpressions) are the answer.

Ideal Clinical Situation

The presence of even discolouration on surface with no bands or pits fissures or grooves. Yellow teeth, with light discolouration restricted to enamel as opposed to dentine, and plenty of enamel.

light yellow tetracycline staining

brown fluorosis stains: the white spot lesions become less apparent as the surrounding brown/tooth lightens up

bleaching single or few discoloured teeth as per patient preference

extended bleaching of calcified pulpal-yellow golden tooth with history of trauma

all surface stains: coffee, tea, tobacco, chromogenic bacteria

Staining due to Chlorhexidine (CHXO)

Possible reduction in root caries-anticariogenic properties of carbamide peroxide

Patient with an ideal clinical situation before and after tooth whitening However the most important factor in a successful treatment is: realistic patient expectations.

What are the two kinds of stains that develop?

Extrinsic—Stain, which is deposited on the outside surface. Whiteners will lighten calculus and the subsurface structure. Intrinsic—Stain, which is incorporated into the tooth structure before or after eruption. Yellow brown-amelogenesis imperfecta, hypoplastic form which is usually transmitted as autosomal dominant trait White -Fluorosis (se enamel microabrasion)


Grey Brown-necrotic pulp

Red brown-Congenital porphyria

Blue brown- dentinogenesis imperfecta

What agent or agents lighten teeth?

Peroxide is an active agent. Found in Carbamide Peroxide (CP). Breakdown: 10% CP=3% HP+7% Urea; (HP = Oxygen + Water; Urea = Ammonia + Carbon Dioxide)

How does it work?

Carbamide peroxide breaks down into hydrogen peroxide and urea, materials commonly found and readily disposed of in the body.

Hydrogen peroxide breaks down into water and an oxygen free radical

The 10% Carbamide Peroxide is the safest and tested and is regarded the standard of care in Evidenced Based Dentistry. We, in dentistry are now trained in biochemical concepts of tooth whitening.

The tooth whitening procedure at Designer Smiles is very simple. We have the experience and expertise in advising you on tooth whitening. Dr Sarkis Nalbandian tested the first revolutionary tooth whitening system in 2001 and he is recognised and approached by media for assessment of current whitening systems. He appeared on Channel Nine’s A Current Affair, and evaluated and tested a range of tooth whitening systems: both in-house and over the counter products.

The truth

Very few therapies work for everyone.

Advantages of bleaching alone

Chief advantage is minimal invasiveness requiring no alteration of tooth structure and loss of enamel. Presence of even discolouration on surface including no bands or pits fissures or grooves. Yellow teeth, with light discolouration restricted to enamel as opposed to dentine.

Serve as an adjunct to cosmetic procedures by enhancing general colour-combined Tx Over the years, teeth can become discoloured for a number of reasons. Smoking, certain foods, aging, medication and poor oral hygiene can all contribute to the problem where the change can be so gradual, you never notice. With the new techniques in bleaching, you’ll be surprised at the difference in your smile.
Over the years, teeth can become discoloured for a number of reasons. Smoking, certain foods, aging, medication and poor oral hygiene can all contribute to the problem where the change can be so gradual, you never notice. With the new techniques in bleaching, you’ll be surprised at the difference in your smile.

dr-sarkis-nalbandian-discussing-patient-requirements Instant Power tooth whitening special formulation by Designer Smiles® is the most effective whitening procedure in modern dentistry today. We provide this service in One Visit with in-house whitening lasers and can improve the shade of your teeth by at least 2-3 shades. If you have golden-brown discolouration teeth can improve 7-12 shades lighter. Tooth whitening is offered to all our patients and, as we are the only surgery in Australia with two fully equipped rooms for this procedure, appointments can be arranged for you as soon as possible.

Alternatively, we also offer home whitening systems. With our home bleaching program, using a custom-fitted lightweight mouthguard and special gel, results can be seen after only a few days of treatment.

Contraindications for tooth whitening

Patients with resin allergies or peroxide allergies

Pregnant or lactating patients

How old should patients be before bleaching?

Should not lighten teeth while patient is in mixed dentition

Tooth whitening for individual teeth has a different policy (Ped Dent 30(7 Sup):61-63;2008)

Disadvantages of bleaching alone

Tooth whitening is eventually reversible

Patient must stop smoking, and drinking red wine

Number of sessions required

Not effective for all forms of discolouration: tetracycline banding will lighten up but remain distinct entities: depending on the lip line, the tips tend to get quite white

Bleaching cannot alter shape or position of the tooth

Bleaching can be unpredictable. Cannot change colour of existing restorations

How long does bleaching last?

It depends on the person!

Special consideration for bleaching patients

Teeth which have yellowed due to age produce the most dramatic results

Adequate enamel thickness helps

Shrinkage of pulp helps, reduced regenerative capacity of pulp needed to make an informed decision

Presence of wear and tear, old amalgams and enamel discolouration

Enamel thinning, flat surface, optical reflective effect of enamel is lost

Minimal invasive laminates are better in these cases

Dentofacial aesthetic rejuvenation

It is not just about the teeth, it is all about the face! Determining the patient’s specific concern(s) is of major clinical importance. Many tooth surface loss patients (TSL and heavily restored teeth) will be primarily concerned about the longevity of their dentition, but aesthetics is also likely to be of concern. It is easy to presume that this results from the shortened appearance of the teeth. However, the patient may just dislike the yellow/brown appearance of exposed dentine surfaces. Bleaching here also will not work and restorative coverage is required. Porcelain veneers & crowns are placed on lower 10 teeth.

I want white white teeth!

There are few patients for whom white teeth really suits them and make them very happy. If you are one of those patients than please have a look. 10 ultra-white porcelain veneers placed on upper arch for this lovely patient who is a professional presenter. This special request made by the patient, was completed after considerable assessment, diagnosis and planning. You have different aesthetic criteria. It is our duty to listen to you, because realistic expectations are always met with satisfying results. Our patient’s wishes are respected and you can see it complements this patient’s lovely dentofacial aesthetics.

Ultra-white porcelain veneers

Make an Appointment Today!

Designer Smiles Dental Centre provides the
highest standards of dental health, function
and aesthetics to help you retain and get maximum
benefits from your teeth throughout your life.

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