It's always most prudent that you have your dentist perform a dental examination before you start your teeth whitening treatments. This is true whether you are using a dentist dispensed or over-the-counter whitening product. While the process of the examination doesn't necessarily need to be substantially different than that examination your dentist performs at the time of your regular dental check ups, there are factors and issues that need to be specifically addressed and documented.
As with any dental examination your dentist will want to evaluate your oral health and make sure you are in good shape. A large portion of this evaluation will involve visual inspection. Your dentist may also feel that radiographs (x-rays) need to be taken, especially in those cases where they have not been taken in a while or else the status of individual teeth is a concern. If your dentist has the capability to do so, they may also take photographs of your teeth.
If any dental problems are found your dentist will make a determination as to when they should be treated. Some dental problems will need attention before teeth whitening treatments are begun, others should possibly be repaired afterwards (after your new tooth color has been achieved).
Your dentist will have what is termed a "shade guide". This is simply an assortment of small pieces of porcelain whose colors, collectively, encompass that range of shades of white that are typically considered to be normal for human teeth. Your dentist will hold the shade guide up next to your teeth, make a determination as to which shade of porcelain seems to match closest with the color of your teeth, and record their findings.
The purpose of this determination can be twofold. Some people will be surprised to find that the coloration of their teeth is already quite light. This reinforcement may help them to decide that using a teeth whitening product is not needed. In the case where a decision is made to proceed with the whitening process, documenting the pre-treatment shade provides a "baseline" point of reference.
Understanding the underlying cause of the tooth discoloration that exists is an important factor in determining the prognosis for the effectiveness of the teeth whitening process. In the case where teeth whitening treatment alone does seem a proper solution understanding the likely cause of the staining can help in determining the manner in which the bleaching process should be performed. Not all types of tooth discoloration can be remedied by peroxide-based teeth whiteners however and a pre-treatment dental examination can help to determine this also.
Information in your medical history can play a role in determining the cause of your tooth staining. Medications you are currently taking or else those you have taken in the past may be related to tooth discoloration. Information about chromogenic habits you have such as smoking or a diet rich in the consumption of stain producing foods and beverages is important to know about when trying to determine the ease with which tooth staining might be improved upon.
Especially in the case of individually stained teeth, the discoloration that is noticed might be related to a defective filling, the presence of decay, or a necrotic tooth. Each of these apparent cosmetic dilemmas in reality is based in dental pathology. They require dental treatment as part of their solution. Not only will teeth whitening not be a solution for these types of conditions but these situations will progress and worsen unless they are resolved by dental treatment in an appropriate time frame.
Peroxide-based teeth whitening will not change the color of existing dental restorations (with the possible exception of this being dental veneers). A person needs to be specifically conscious of the location of fillings, crowns, and any other dental work, realizing that the tooth structure and teeth surrounding these items will be affected by the whitening process but they will not.
It is very common place that after the teeth whitening process has been completed old dental restorations are replaced with new ones so to match the new coloration of the person's teeth. This type of treatment must be anticipated and planned for. It may involve considerable expense.
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