Teeth Whitening

Brushing and flossing are everyday ways to keep your teeth bright, white and healthy. Still, if you might feel like your smile is lacking some sparkle you’re not alone. When the American Academy of Cosmetic Dentistry asked people what they’d most like to improve about their smile, the most common response was whiter teeth. The American Association of Orthodontists also found that nearly 90% of patients wanted whiter teeth.

Thinking about teeth whitening? Get the facts first. Here are five of the most commonly asked questions about the process.

1. Why Did My Teeth Change Color?

Over time, your teeth can go from white to not-so-bright for a number of reasons:

Food and Drink – Coffee, tea and red wine are some major staining culprits. What do they have in common? Intense color pigments called chromogens that attach to the white, outer part of your tooth (enamel).

Tobacco Use – Two chemicals found in tobacco create stubborn stains: Tar and nicotine. Tar is naturally dark. Nicotine is colorless until it’s mixed with oxygen. Then, it turns into a yellowish, surface-staining substance.

Age – Below the hard, white outer shell of your teeth (enamel) is a softer area called dentin. Over time, the outer enamel layer gets thinner with brushing and more of the yellowish dentin shows through.

Medications – Tooth darkening can be a side effect of certain medications such as antihistamines, antipsychotics and high blood pressure medications.

Young children who are exposed to antibiotics like tetracycline and doxycycline when their teeth are forming (either in the womb or as a baby) may have discoloration of their adult teeth later in life. Chemotherapy and head and neck radiation can also darken teeth.

2. How Does Teeth Whitening Work?

Whitening is actually a pretty simple process. Whitening products contain one of two tooth bleaches (hydrogen peroxide or carbamide peroxide). These bleaches break stains into smaller pieces, which make the color less concentrated and your teeth brighter.

3. Does Whitening Work on All Teeth?

No, this is why it’s important to talk to your dentist before deciding to whiten your teeth, as whitening may not correct all types of stain. For example, yellow teeth will probably bleach well, brown teeth may not respond as well and teeth with gray tones may not bleach at all. Whitening will only work on natural enamel and will not have any bleaching effect on caps(crowns), veneers, or fillings. It also won’t be effective if your tooth discoloration is internal, this is the result of the staining associated with medications or trauma.

4. What Are My Whitening Options?

Talk to your dentist before starting. If you are a candidate, there are three ways to put the shine back in your smile:

  • Whitening Toothpastes – All toothpastes help remove surface stain through the action of mild abrasives that scrub the teeth.  Look for the ADA Seal for safe whitening toothpastes that have special chemical or polishing agents to provide additional stain removal effectiveness. Unlike bleaches, these types of ADA Accepted products do not change the color of teeth because they can only remove stains on the surface.
  • In-Office Bleaching – This procedure usually requires only one office visit. The dentist will apply either a protective gel to your gums or a rubber shield to protect your gums. Bleach is then applied to the teeth. A special light or laser might be used to enhance the action of the whitening agent. Not all offices offer this type of system so speak with your dentist and see if this is an option.
  • At-Home Bleaching – Peroxide-containing whiteners actually bleach the tooth enamel. They typically come in a gel and are placed in a tray that fits on your teeth. You may also use a whitening strip that sticks to your teeth. The concentration of the bleaching agent is lower than what your dentist would use in the office. The white strips are usually the first recommendation that I make to people that have never used whitening products before as it is a good “first step” to test whether whitening will be effective on an individual’s teeth or if they will be sensitive to the whitening chemicals at all.

5. Are There Any Side Effects from Teeth Whitening?

Some people who use teeth whiteners may experience tooth sensitivity. That happens when the peroxide in the whitener gets through the enamel to the soft layer of dentin and irritates the nerve of your tooth. In most cases the sensitivity is temporary. If you experience sensitivity, delay treatment and try to use products high in fluoride to help strengthen your enamel and thus, make it less prone to dentinal hypersensitivity.

Overuse of whiteners can also damage the tooth enamel or gums, so be sure to follow directions and talk to your dentist.

Chelsea Brooks is a dental hygienist at the University of Vermont Medical Center Dental and Oral Health practice.

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