White teeth are traditionally seen as a sign of good health and youth. When your smile is bright and white you feel more confident and smile more often. Teeth that are yellowed or discolored may make you feel self-conscious and others may perceive you as older than you actually are.
Fortunately there are a number of products and procedures to give you a beautiful bright smile, no matter your budget.
What causes tooth stains?
Just about anything can stain your teeth. The most common sources of stains are:
- Tobacco – smoking and smokeless tobacco, e-cigarettes and marijuana all contain ingredients that can stain teeth.
- Foods – wine, coffee and tea, greens and soda, are the most common staining foods that people consume. However, anything that can stain your shirt can contribute to staining your teeth. Any food and drink with color, if consumed in excess, can contribute to stains.
- Age – Teeth may yellow or darken as we age. This may come from the buildup of food and drink over time, wearing of the teeth and thinning of the enamel.
- Trauma – Teeth that have been subjected to trauma from sports, an accident, cracking or clenching, etc., may change color. These "dead teeth" can darken quickly or it may take several years to notice a difference.
- Medications – liquid iron supplements and B-vitamins, as well as other over-the-counter supplements, may lead to staining of the teeth. Certain antibiotics (especially tetracycline) given at a young age or even to a pregnant or nursing mother may lead to stained teeth.
- Enamel Defects – areas where the enamel has been damaged from lack of calcium or an extreme excess of fluoride supplements can appear as white or brown stains.
- Plaque – bacterial by-products found within plaque and tartar can stain teeth. If plaque or tartar is left on the teeth for longer periods of time, it can create "decalcifications" that show up as white spots. Plaque can also absorb stains from food and drink or tobacco.
Types of tooth stains
There are two types of staining that occurs in teeth: intrinsic or extrinsic. Some sources of stains can be either intrinsic or extrinsic:
- intrinsic – the stain comes from within the tooth. These usually do not respond to traditional whiteners applied to the teeth.
- extrinsic – the stain comes from something outside the tooth. They are the most easily removed stains:
How to whiten your teeth
Depending on your type of staining, the severity of the stain and your budget, there is a whitening product or procedure that is right for you:
- Products – there are many, many mouthwashes, toothbrushes and toothpastes marketed to whiten your teeth. While promising to deliver dramatic results, many fall short of expectations. They are fairly inexpensive however and can prevent stains from building up too quickly. Because of this, they may have a place in your whitening routine. A word of caution: the whitening action comes from "polishing" agents that can be abrasive. If your teeth or gums become sensitive, you should discontinue your use of the product(s).
- Over-the-counter whitening – strips, lights, trays and pens are just a few ways whitening agents can be used at home. These products usually contain a weaker version of professional strength whitener, as there is a limit to what strength can be sold by a non-dentist. Many people find they get satisfactory results with these products. If used incorrectly, however, they may lead to tooth sensitivity or damage of teeth and gums. It is important to follow the directions exactly as they are written.
- Professional whitening – Whitening gel can be used at its highest concentration when delivered by a trained professional such as a dental hygienist or a dentist. Professional whitening may come in the form of customized take-home trays to be used with a strong gel. The trays may be worn daily for a prescribed period of time to gradually whiten the teeth. In-office whitening saves time for those looking for a quicker result than with the take-home trays. The strongest whitening gel is applied directly to the teeth, taking care to protect sensitive tissues such as lips and gums. Results can usually be seen after just one session. The gel can be activated through a light or chemically mixed and activated before being applied to the teeth. The advantage of professional whitening is that we can customize and tailor a regiment that works for your individual needs and expectations.
- Internal Bleaching – darkened teeth that have intrinsic staining and have received a root canal may be whitened from the inside. The gel is placed inside the tooth and the color is checked every day to every few days until it is the desired color. Internal bleaching may not be done on "live" teeth that have not had root canals.
Ingredients of teeth whitening products
Most over-the-counter or professional whitening gels use one of two common well-studied ingredients. Both can deliver great results depending on their strength and are generally recommended as safe and well-tolerated.
Hydrogen peroxide and carbamide peroxide are both used in dental whitening products.
Carbamide perioxide is a larger, weaker molecule compared with hydrogen peroxide. Because of this, it takes a higher concentration of carbamide peroxide to deliver the same whitening results. Because the carbamide peroxide breaks down into hydrogen peroxide, it has to sit on the teeth longer.
The benefit to using carbamide peroxide over hydrogen peroxide is that it can be less irritating to the tissues and is more stable. The straight hydrogen peroxide delivers a more rapid result but may not last as long.
Can I whiten my teeth?
Most people who are in good dental health are candidates to whiten their teeth. There are times where whitening should be avoided:
- cavities – if you have cavities that need to be filled, whitening your teeth may lead to pain or sensitivity. Also, when the cavities are removed, the teeth may change color.
- recession – areas where gums are receded appear darker and can be more heavily stained. These areas are much more sensitive and should not be bleached, as they will not change color and will be extremely sensitive
- gum disease – if you have active gum disease that has not been treated, whitening may not work for you. It may lead to an increase in sensitivity or pain. Whitening products cannot penetrate through plaque or tartar to right after a cleaning is the best time to whiten your teeth!
- restorations – dental caps, veneers or fillings – Any restoration in your mouth will not change color with whitening products. If you whiten your teeth, you may find that restorations may need to be replaced to create a more uniform smile.
- sensitivity – generally, if you have very sensitive teeth, you may not want to whiten your teeth. Whitening products can increase sensitivity and you may find that your inability to tolerate hot or cold foods has worsened.
What can I expect when I whiten my teeth?
The most common side-effect that is reported with whitening products is sensitivity. After a round of whitening your teeth you may find extremely hot or cold foods trigger "zings" in your teeth. These "zings" may also be felt during the whitening procedure itself. The good news is that this sensitivity is usually fleeting. Sensitivity should return to normal within a few days of ending your treatment.
Some whitening products, if used incorrectly, can lead to an irritation of your tissue. Your gums, lips, cheeks or tongue may be irritated or "burned" if they come into contact with the bleach. This is especially true with very high concentrations of hydrogen peroxide.
If you use an at-home product, be sure to follow directions exactly as they are written so as to minimize the chance of sensitivity or irritation. We always recommend customized professionally made trays be used at-home to ensure the whitening product only comes into contact with the teeth.
Our individuality makes us unique! Eye color, skin color and hair color are just a few traits that come in all shades and colors. Tooth color is no exception. It also varies from person to person.
Teeth have "undertones" similar to the familiar "warm and cool undertones" we see in skin:
- A undertones – red-brown
- B undertones – yellow
- C undertones – gray
- D undertones – red-gray
These letters also have a number assigned to them to communicate how "light" or "dark" the tooth is. For example: A1 is lighter than A4. A tooth that is a very dark C4 will show more dramatic results changing to an A1 compared with someone who changes from A2 to A1.
There is no single way to determine exactly what shade your smile will end up at the end of treatment. Just as some individuals can spend a day at the beach with a very dark tan while others only tan a little bit, whitening can have the same variance!
How can I maintain my new white smile?
If your teeth have been whitened through an in-office procedure, we recommend abstaining from any colored food, drink or product for 24 hours. Following a strong whitening agent being applied to the teeth, the teeth are dehydrated. As they rehydrate, they may re-absorb stains. Things such as coffee, spaghetti sauce or even mouthwash should be avoided or 24 hours to ensure your teeth stay white!
In general, staining foods and drinks should be consumed in moderation. Tobacco and marijuana use should be stopped not just for keeping your teeth white but for obvious health reasons. Depending on your habits, you may find you need to touch up your smile after 6 months or over a year. Using whitening toothpastes or mouthwashes may help keep your teeth bright in between sessions. As always, maintaining great oral hygiene at home and visiting our office for regular checkups and cleanings will ensure your smile remains picture perfect!
More information about teeth whitening?
If you are considering teeth whitening or have any questions or worries, please feel free to contact us for an appointment. You can call us at: +1 203-377-9300