Teeth Whitening and Setting Realistic Expectations: Communication Tips and Analogies That Make Sense

Image Courtesy of Jonathan Borba

Whether you’re browsing the oral care aisle or scrolling through Gwyneth Paltrow’s top picks for at-home whitening treatments on Goop, or considering professional whitening treatments with your dentist, choosing a teeth whitening option can be more complex than we’d like. There's cost, and time it takes to see results, but ultimately, many of us just want to know two things: How white will my teeth get and how long will it last?

When hosting routine hygiene appointments, the whitening-curious patients typically ask these questions frequently, so it’s important to set realistic expectations. In the dental office, we sometimes use shade guides. Think of a Pantone swatch of whites and beiges or a color swatch guide you'd see at the nail salon. We’ve been accustomed by brands to market whitening systems to both patients and consumers alike, “they will get your teeth up to 10 shades whiter.” However, after conducting hundreds of in-office professional whitening treatments, these guides and marketing taglines can be somewhat misleading.

We can't compare apples to oranges here, since not all teeth start off looking the same. Factors like oral hygiene, natural tooth shade, fillings, and porcelain crowns play a role. It’s crucial for patients to understand this first, to avoid disappointment.

So what happens when someone asks: "How white will my teeth get?" Here’s how I like to explain it:

Analogy #1

When you go on vacation and layout in the sun, some people tan very easily, some don’t tan at all, and some burn. This depends on someone’s unique skin type. If three people with different complexions were to all lay out in the sun for the same time under the same UV index, their tan lines would likely look somewhat different. Similarly, we don’t all start off with the same shade of enamel. Those with naturally ‘yellow’ undertones to our teeth tend to get ‘whiter’ after whitening treatment, while those with a naturally ‘grey’ undertone tend to get ‘brighter’. Some see a drastic change, some minor. This skin/tanning analogy typically resonates with everyone and shifts a patient’s mindset.

Next up, when the patients ask “How long will it last?” The answer depends on lifestyle and diet. Exposure to stain-inducing food and beverages, smoking, copious plaque build-up (which is a magnet for stain), enamel erosion from acid, and enamel dehydration after whitening, are crucial factors to discuss.

This brings me to the Analogy

#2 which piggybacks off of Analogy #1.

“When people go on vacation, lay out in the sun, and come home with a tan, some people hold on to their golden glow for days, weeks, maybe longer. (I envy them). Some people naturally fade quickly. Some people lock in their tan with a great skincare routine. Some people exfoliate often and it sloughs their tan right off. If you’re like me, you just don’t change color at all.”

The same goes for our teeth. Teeth shifting back to its natural shade can be from diet, lifestyle habits, and oral hygiene routines.

Opting for an at-home system or an in-office treatment depends on time and preference. I trust commercial whitening strips by Crest. I’ll tell friends and patients to only whiten one arch at a time, so they can have a track record of the before and after by comparing top teeth to bottom teeth. But when time is finite, a one-and-done in-office professional treatment is definitely the way to go.

From my experience, no matter the system, your unique enamel shade will only ever get so white to your body’s own personal threshold. Using a before picture as a benchmark is a great way to celebrate the final results. Even tiny wins and mild changes in brightness can be a huge confidence booster!