Top ten tips on teeth whitening

1st Mar 2025

Doctor A shares expert insights on mastering tooth whitening with confidence, achieving predictable results, managing sensitivity and exceeding patient expectations.

Teeth whitening is one of the most straightforward and accessible forms of cosmetic dentistry. However, it must be understood that many of us need more formal training. But what if we could make the process predictable and consistently deliver the exact results our patients desire while prioritising their comfort? Achieving that would undoubtedly establish you as a skilled cosmetic dentist with an excellent reputation. 

1. Patient expectations 

Discuss early on what the patient is looking for in a result. Use shade tabs and show them on their teeth with mirrors and photos. Can you realistically achieve what they’re looking for? This must be discussed before you start to avoid a disappointed patient later. 

2. Diagnosis 

Why are they seeking whitening treatment? Are there any teeth that won’t be whitened or change colour as well as the others? If there are going to be any issues or changes to your normal whitening protocol needed, then change your tactic. Use less sensitive gels. Consider whitening or internal bleaching, too, if you have a specifically darker non-vital tooth as part of the treatment. 

3. Limits of system 

Every system will have limitations. Understand your system’s level of sensitivity after trying it on yourself, staff and patients, and incorporate that into your discussion at the start with each patient. Get a whitening history from your patients to be aware of what their experience has been like before if they have whitened previously. Ask about cold sensitivity, what type of toothpaste they use, and why. It’s all part of the detective work needed. 

4. Options 

Depending on what will suit your patients best, you may need more than one whitening system. Price isn’t the only factor when choosing a whitening product; results and comfort matter just as much. 

5. Sensitivity 

If patients already use sensitivity toothpaste, do you need to trial a night-time gel first, or will they need a daytime whitening system instead? Trial phases for a few days beforehand on low concentrations give you and your patients great peace of mind and build their confidence in you. 

6. Tray design 

Two different tray systems exist: vacuum-formed and pressed trays. Both have their uses. Pressed trays have a tighter seal and let in less saliva to mix with the gels and dilute them, but they are more expensive to produce. 

7. Time scales 

Ignore the traditional time scales and do your own. In the US, typical whitening lengths can take 6-8 weeks to achieve the whiter finishes. The days of two-week whitening are disappearing, and patients are looking for whiter and brighter results, but that needs time. Tailor your results accordingly. 

8. Future top-ups 

No whitening treatment is complete without recommendations for maintaining the results and post-op instructions that are tailored to each case. If patients are happy with the results, they will keep coming back to you for life. 

9. Understand damage 

We are using peroxides, so understand that the damage is very limited, but it still exists. With the legal concentrations we use in the UK, we can control this superbly, but higher concentrations can cause more permanent damage, so be aware of non-official UK products. 

10. Grinding 

This will have a detrimental effect on your night-time whitening treatments, as the patients won’t be able to keep their trays in, and the gels will definitely become diluted. Consider a daytime whitening system, and expect sensitivity, too.