How To Get - And Keep - A Pearly White Smile

By: Dr. Preet Clair

The holidays are upon us, and what better way to look great in holiday pictures than brightening your smile! There are many tooth whitening procedures that are available, but The American Dental Association recommends that you first be evaluated by your oral health care professional to determine
which treatment option best fits you.

Before whitening, first think about what caused your smile to be not-so-bright in the first place. Tooth staining can be caused by a variety of factors. As we get older, teeth darken due to general wear and tear, and age tends to affect translucency or thinness of teeth as well. It’s easier to bleach thicker, opaque teeth than it is to whiten thin, brittle teeth, which is why a teenager may see a greater lightening effect than an older individual who’s experienced a lifetime of stain.

Extrinsic staining due to coffee, soda, tea and red wine is quite responsive to most whitening methods, and yellow/brown stains are easier to whiten that grey tones. No matter what your whitening issue, up to 95% of patients will see a brightening effect upon bleaching, although there are some stains that are tough to remove. Smoking and tobacco stain is less susceptible to whitening since these stains penetrate deep into secondary tooth layers, making bleaching more difficult. Trauma to the teeth, childhood fevers and tetracycline exposure can lead to brown bands on teeth that can be impervious to whiteners. Excessive fluoride ingestion or use also can lead to brown spots (called mottling) that can’t be bleached. Usually these patients need to bleach for a longer period of time (months or years), and not all methods may work. Grinding or clenching (called “bruxism” by us dentists) is usually caused by stress and may cause teeth to darken. Cracks are created, and this leads to stain. This stain is usually susceptible to bleaching but not always.

The best method to keep teeth white is to take care of them the natural way. Limit your consumption of tooth staining beverages. Stop smoking! Your pearly whites will thank you as will the rest of your vital organs. Peroxide rinses (mild ones) will aid in whitening due to a bubbling effect that leaves the best method to keep teeth white is to take care of them the natural way.

teeth surfaces smooth and less susceptible to plaque accumulation. Whitening toothpastes or pastes containing baking soda can minimize further yellowing as well. If you are a gum chewer, try a whitening gum or a product containing xylitol. Used in Sweden for years, xylitol whitens by stimulating salivary production. A professional cleaning every 6 months by your dental hygienist will keep surface stains at a minimum. Modern dental technology has special pastes and tools, such as ultrasonic scalers, that will leave tooth surfaces extra smooth and plaque-free. If these methods aren’t yielding results then professional whitening can be an option.

The bleaching method involves an oxidizing agent called carbamide peroxide which penetrates deep into the tooth layer, leading to whitening of the enamel. There are two main methods of bleaching-take-home whitening or laser whitening, which is performed in the dental office. Take-home bleaching involves the fabrication of custom-fit trays and applying bleach for one to two hours every day for two weeks. Some trays can be worn overnight depending on the concentration of bleach. Every couple of months a touch-up might be needed, depending on dietary habits. Laser or in-office whitening involves applying a high concentration of carbamide peroxide to the tooth surface, changing the chemical composition of the enamel. The effect is short-lived and ultimately trays must be fabricated to maintain the desired shade.

Side effects of bleaching include chemical burn (if too much of the bleaching agent is used), sensitivity to hot and cold, gum irritation, sore throat (due to swallowing bleach) and overbleaching (teeth start to have a blue hue). Not everyone can bleach and not every mouth will see noticeable change. Children under 14 should not bleach, because the pulp chamber is enlarged and still forming, and is susceptible to sensitivity. Pregnant women or women who are breastfeeding should not bleach their teeth. A mouth with multiple crowns or restorations should not bleach. These restorations will not change color.
Ask your dentist what option is best for you, and make sure you’re focusing on the health of your teeth as much as you are on the color. Now get ready for your close-up!

Dr. Preet Clair has been practicing dentistry in Colorado for the past eight years. Please contact her at Quebec Square Family Dentistry, 303.322.2081.