Are you interested in a brighter smile? You aren't alone! Many people are and that is why there is a huge market for teeth whitening products. Deciding what to use can be overwhelming, so let’s explore some of the options out there.
First, it’s important to note why teeth become discolored. Extrinsic staining is caused by environmental factors such as what you are consuming. Dark foods and beverages like coffee, tea, red wine, dark fruits, etc. can create a buildup of stain on your teeth. Another big stain producer is smoking and tobacco products. These outside sources can cause discoloration of your teeth and as it accumulates over time they will appear darker. Cleaning habits are also important to consider. A collection of plaque or calculus can cause teeth to appear dark or yellow in color.
Managing these extrinsic factors is the first step to achieving a brighter smile. Rinsing your mouth out with water after consuming a darkening food or drink can help remove the film before it adheres to your teeth. Keeping up with your oral hygiene at home is also important- brushing twice a day for two minutes at a time and flossing daily will help prevent buildup. Also cutting back on, or removing all together, the food, drinks, or habits that cause stain will be a tremendous help.
Intrinsic staining is discoloration that is within the tooth itself. Sometimes this is due to genetics. During the developmental stages, if layers of the tooth do not form properly it can cause a different appearance than the normal white color of teeth. History of use of a tetracycline antibiotic, dark colored fillings, cavities, or a necrotic tooth can cause a darkening appearance. Aging can also have an effect on tooth color. As you age the outer layer of enamel can become thinner and when this happens it is easier to see the underlying dentin of the tooth, which is darker in color. Some of these reasons for intrinsic staining can be easier to correct than others. This is why prior to whitening it is important to have a dental exam so that the reason for discoloration can be identified and treated appropriately. It is also important to note that fillings, crowns, and other restorative work that your teeth may already have will not whiten with teeth bleach.
Over-the-counter products:
In stores and online you can find whitening toothpastes, whitening strips, whitening pens, and more that all promote a brighter smile. When looking for a whitening agent it is recommended to look for something with the American Dental Association (ADA) Seal of Approval which approves products for safety and effectiveness.
Products that will change the true shade of the tooth contain carbamide peroxide or hydrogen peroxide. Chemically, the reactive oxygen models from the peroxide will interact with organic colored compounds within the teeth and through an oxidation process the teeth whiten. Many over-the-counter products contain a peroxide, but this is often of a lesser strength than what would be given to you in professional whitening with your dentist. Whitening products that contain a peroxide will whiten your teeth over time, but since it is a lesser strength sometimes results take longer or are less noticeable than professional whitening.
Some whitening toothpastes may contain a small percentage of a peroxide, but overall they mostly rely on abrasiveness to give a “whitening” effect. Since these whitening toothpastes are more abrasive they work by removing extrinsic surface stains, but may have little effect on changing the actual shade of the tooth. A significant downfall of the whitening toothpastes is that this repeated use of a more abrasive paste can be harmful to the tooth structure and surrounding gingival tissue. Instead, I always recommend a sensitive formula toothpaste since it is less abrasive on the teeth and gums. It also helps to protect against sensitivity that can come with using other whitening products that will have a better chance of changing the actual shade of the teeth such as whitening strips or gels.
If you would like to try something over the counter before professional whitening then my recommendation is to try using whitening strips. Crest White Strips often work well for people, especially if you are just starting out with whitening. You can always try this first to see if you are happy with your results. After trying the over the counter whitening strips, if you are still unhappy with the shade of your teeth then you can always consider professional whitening with your dentist.
Crest White Strips
The benefit of over the counter products is that they are easily accessible and often less expensive than professional whitening. However, I urge you to use caution before jumping into the latest whitening trend you see on the internet. Use of charcoal, acidic fruits, vinegar, or “oil pulling” are just some of the many crazes that have been advertised recently, but there is not enough research to support its efficacy or safety. A lot of these trendy products out there may cause damage to your oral health by being too abrasive or erosive on your teeth and gums. Also many simply just do not work effectively.
Professional Whitening:
Professional whitening with your dentist will similarly involve applications of carbamide or hydrogen peroxide. This is done by making trays and providing syringes of whitening gel to administer at home. Professional whitening contains a higher concentration of peroxide, which will often yield quicker and more pronounced results. Some dental offices use a professional light system with an application of the whitening gel in the office; however, at-home professional whitening can often get you the same result with less tooth sensitivity and cost.
Whitening tray and gel
If you wish to pursue professional whitening, first your dental team will make sure are up to date with a dental exam. This way any reasoning for discoloration can be identified and treatment planned appropriately. Extrinsic staining may need to be removed in the dental office prior to whitening. Also, it’s important to discuss the expectations for whitening results. As mentioned earlier, crowns and fillings will not brighten with teeth whitening, so those teeth may need to be treated with new restorations if you are looking to change their shades. Teeth that are darkened after root canal treatment sometimes will need a more extensive treatment called “internal bleaching” where the tooth is treated from inside.
After a treatment plan is discussed your dental team will take a scan or impression of your teeth to make trays. Once the trays are made they will have you back for an appointment to confirm the appropriate fit and deliver your whitening materials and instructions. The wear time of your whitening trays will depend on which whitening product your dentist uses. Similar to over the counter whitening, sensitive toothpaste use is always recommended and will help combat sensitivity that frequently comes with tooth whitening. If you are not using a sensitive formula already, you should begin to prior to starting your whitening treatments. If you are finding significant sensitivity throughout treatment then consider spacing out applications to give your teeth a break. It’s important to remember that everyone’s experience is different from tolerance of the whitening material to overall results. If you have any questions or concerns throughout the process be sure to contact your dental team so they can help.
Reference: ADA's article on dental whitening