Vital and Nonvital Teeth Whitening

The difference between vital and nonvital teeth whitening is whether the tooth has had a root canal. If a patient has had a root canal, and wants to bleach or whiten the discolored tooth, that is nonvital bleaching. Vital bleaching is for normal and healthy teeth which are bleached a couple of shades whiter. In other words, nonvital is with root canal and vital is non-root canal. There are a variety of whitening systems. The basic principle behind all of them is that there is some form of peroxide, such as hydrogen peroxide or carbamide peroxide, for vital bleaching. Nonvital bleaching is mainly a perborate mixed with 30% hydrogen peroxide into a paste. Even light-based whitening treatments are peroxide-based. The light activates and speeds up the process like a little catalyst to turbo charge the bleaching process. The result is teeth that are lighter and healthier looking than before the treatment.

Am I a Good Candidate for Vital and Nonvital Teeth Whitening?

Patients who are GOOD CANDIDATES for vital and nonvital teeth whitening include:

• Tea and coffee drinkers, and tobacco users, looking to get rid of stains and discoloration on the teeth
• People with stains that can easily be seen on the front of the teeth
• Patients with grayish intrinsic stains located below the surface of the teeth

A person that is generally NOT A GOOD CANDIDATE includes:

• People with chronic tooth sensitivity
• Patients with worn or damaged enamel
• Those with cavities that need to be treated

How is Vital and Nonvital Teeth Whitening Performed?

Teeth whitening can be performed in the office of a dentist or at home.

In-office teeth whitening can take anywhere from 60 to 90 minutes to complete. There are steps the dentist follows when performing in-office whitening:

• The dentist makes a record of the current shade of the teeth.
• The teeth are then polished with pumice which is a grainy material that removes any plaque on the surface,
• The mouth is filled with gauze to keep the teeth dry. Retractors might be necessary to keep the lips and tongue away from the whitening solution. The gum line is also covered to protect it from exposure to the whitening solution.
• The front side of the teeth is covered with a whitening solution that acts as a bleaching agent.
• A curing light or laser is used to activate the peroxide in the whitening solution. The solution is left on the teeth for 60 to 90 minutes.
• Once the optimum shade is reached, the solution is rinsed off the teeth.

At-home whitening kits can be obtained from a dentist and require a dental impression in order to create a mouth guard that fits the patient's teeth. The mouth guard allows optimal contact between the gel and the teeth while minimizing any contact the gel has with the gums. The whitening gel is applied to the mouthpiece and is then inserted into the patient's mouth. Patients will continue the treatments at home, on a daily basis, over the next 2-4 weeks. Each whitening session takes approximately 30 minutes. The dentist will check the tray fitting and monitor the whitening process during follow-up exams.

Is Vital or Nonvital Teeth Whitening More Difficult?

In general, nonvital tooth whitening is more difficult because the tooth has already had a root canal. The doctor has to be careful to seal the tooth in a certain area. Sealing the tooth keeps the bleach from reaching the root of the tooth and leaking. Nonvital is technique sensitive, and more challenging, but it can offer great results for a tooth that has had a root canal.

What is the Cost of Teeth Whitening?

The cost of teeth whiting varies according to the type of treatment performed on the patient. At-home treatments supervised by the dentist cost from $200 to $400. On the other hand, in-office teeth whitening treatments cost in the range of $500-$700.    

Recovery and Downtime

Whether a patient visits a doctor for vital or nonvital teeth whitening, they can be in and out in 60-90 minutes and back to work instantly. There is virtually no RECOVERY or DOWNTIME necessary since it is not an invasive surgery.

Some patients may experience a bit of sensitivity the day after the treatment. However, Tylenol can be used to provide relief. Patients are advised to refrain from food and beverages that are extremely hot or cold for about 48 hours after the treatment. 

Results

The amount of shades lighter a patient achieves from vital and nonvital teeth whitening depends on each person. Some people get six to eight shades lighter while others only get two to four shades lighter. It depends on whether or not the person has been smoking or drinking coffee for years. Sometimes it takes multiple treatments to get the patient where they want to be. Overall, there is a wide range of shades that patients can achieve with teeth whitening.

The results usually last for 4-6 months before they begin to fade. The results can last longer if the patient avoids food and beverages which stain the teeth.

Limitations of Vital and Nonvital Teeth Whitening

Some of the limitations of vital and nonvital teeth whitening include:

• The main limitation of nonvital teeth whitening is related to trauma. If the tooth was fractured, or had some kind of sports trauma, the bleach getting into one of those microfractures can cause resorption (the bleach seeping into the root of the tooth).
• The main limitation of vital teeth whitening is found in intrinsic stains like tetracycline antibiotic stains people get when they are young. These stains are very difficult to bleach. There can be minor changes but it is difficult to get dramatic improvements with intrinsic stains.
• Tooth whitening only lightens the natural color of the existing shade.
• Patients with receding gums, tooth sensitivity, cavities or exposed roots are restricted from having the procedure until the condition is addressed.

Risks of Vital and Nonvital Teeth Whitening

Some of the common risks of vital and nonvital teeth whitening are:

• For nonvital teeth whitening, the main risk is resorption. With resorption, the bleach seeps into the roots. The cells that are in the roots react to the bleach like it is an invader and start attacking it. It is much like an immune system attacking a virus and bacteria. During that response, the root gets eaten away and the tooth becomes brittle. If it is caught early enough, resorption can be treated with medicine that removes the bleach from the body.
• For vital teeth whitening, there is sometimes postoperative sensitivity but systems are getting better in preventing that sensitivity. If a patient does have some sensitivity, it can be fixed by the use of a special paste to help soothe the teeth.
• Tooth and gum sensitivity after the treatment.
• Allergic reaction to the solution.
• White patches on the gum line.
• A burning sensation if the bleaching solution comes in contact with the gums or the root of a tooth.

 The Whitening Effect Depends on the Diet

In order to maintain the results of vital or nonvital teeth whitening, patients need to follow a good diet to keep their teeth healthy. They need to stay away from dark food items that stain the teeth. If somebody is drinking coffee and smoking a pack of cigarettes on a daily basis, the results are not going to last. However, a non-smoker that takes care of their teeth can see results that last for years. Vital and nonvital teeth whitening procedures are simple and quick treatments with immediate, dramatic cosmetic results.

Written by Cosmetic Town Editorial Team - MA

Based on an exclusive interview with Yahya Mansour, DDS in Fort Worth, TX