A hygiene visit alone
If the staining is on the surface — and with Scottsdale water it very often is — scaling and polishing does more than any gel. We will suggest that first if that is what your photographs show.
Treatment 04
Whitening
Supervised peroxide whitening, in-office or in custom trays at home, with sensitivity managed rather than ignored.
2–3 weeks at home, or a single 90-minute visitHome whitening with custom trays: $420
What it actually is
Whitening works by diffusing peroxide through enamel into dentine, where it breaks down the pigmented molecules that have accumulated there. It changes natural tooth structure only. Fillings, crowns, veneers and bonding do not lighten, which is why shade decisions have to come before restorative work, not after. In Arizona the usual culprits are coffee, red wine, sun-aged enamel and the mineral load in hard water, which leaves a surface film that a hygiene visit removes far more effectively than any gel.
The sequence
5 stages, in this order, for this reason.
- 01
Check and clean
Whitening an untreated cavity is painful and pointless. We examine, take a shade record with photographs, and clean first — a hygiene visit alone lifts most surface staining from hard water and coffee.
Visit one · 45 minutes - 02
Custom trays
Scanned and made to fit the gum margin precisely, so gel sits on the tooth and not on the gum. Ill-fitting stock trays are the main cause of chemical burns to the gum.
Made in 3–5 days - 03
Wear schedule
Carbamide peroxide overnight for ten to fourteen nights, or hydrogen peroxide for 30–60 minutes daily. We start at the lower concentration and step up only if you are comfortable.
2–3 weeks at home - 04
In-office session, optional
A single 90-minute appointment with gum isolation and a higher-concentration gel, for people who want a head start before an event. Usually combined with home trays, because in-office alone rebounds.
90 minutes - 05
Review and top-ups
Shade re-recorded against the original photograph. Most people top up for two or three nights once or twice a year.
2 weeks after finishing
Who it suits
- Generalised yellowing from age, coffee, tea, red wine or tobacco
- Surface staining from hard water, which often needs cleaning more than whitening
- Before veneers or bonding, so the restorations can be matched to the final shade
- People with healthy gums and no untreated decay
When we would say no
- Untreated decay, leaking fillings or exposed root surfaces — treat those first
- Single dark teeth after root canal treatment, which need internal whitening instead
- Front teeth already restored with crowns or veneers, which will not change
- Pregnancy or breastfeeding, where we defer as a precaution
Instead of this
The alternatives, including the cheaper ones.
A cosmetic practice that never names the less profitable option is not giving you a choice.
Internal whitening
For a single dark root-treated tooth, whitening gel is sealed inside the tooth for several days. Far more effective on that one tooth than any external product.
Composite or ceramic
Where the discolouration is intrinsic — tetracycline banding, severe fluorosis — whitening will only partly help, and a bonded restoration is the honest route.
Before you agree
What can go wrong, and what we cannot promise.
This is the part most sites leave out. It is also the part that a consent discussion is legally and ethically built on.
- Sensitivity to cold during whitening is common. It is dose-related and it resolves. Dropping to alternate nights, using a potassium nitrate gel, or lowering the concentration all help.
- Gum irritation usually means the tray does not fit or too much gel was loaded.
- Results are not permanent. Colour rebounds gradually, faster for coffee and red wine drinkers.
- Existing restorations will not change shade, and may become more noticeable afterwards.
- We do not promise a specific number of shades. We record the start shade photographically and show you the comparison.
Fee
$420
Home whitening with custom trays. In-office session $650. Combined $850. Top-up gel $35 per syringe. Members receive one top-up syringe a year at no cost.
Indicative. Your written plan is itemised and is produced only after an examination. Members take 15% off restorative fees. We are out of network; you receive a coded receipt for out-of-network reimbursement.
A word on language. You will not read the word “painless” on this site, and you will not read that any restoration is permanent. Local anaesthetic makes most treatment comfortable at the time; some procedures are sore afterwards and we will tell you which and for how long. Restorations are maintainable, not eternal. Anyone promising otherwise is selling rather than consenting.
Questions
About whitening
Supervised peroxide whitening at clinical concentrations has been studied extensively and is not shown to soften enamel in a clinically meaningful way. What does cause damage is uncontrolled acidic products, abrasive charcoal pastes, and gels applied over untreated decay.
Starting shade, dentine thickness and the type of pigment all differ. Grey-toned discolouration responds less well than yellow-toned. We show you your own before-and-after photographs against a shade tab rather than compare you to anyone else.
Typically one to three years before most people want a top-up, and less if you drink a lot of coffee or red wine. Keeping your trays means a top-up costs the price of a syringe of gel.
No. Ceramic and composite do not change colour. If a front crown is already a good match, whitening the teeth around it will leave it looking dark, and it may need replacing — we will flag that before you start.
Related
Often discussed alongside this
Ninety minutes, and you leave with a written plan.
$190, credited against treatment. Scottsdale, Arizona.