Teeth may appear dark, discolored for a variety of reasons, but whitening procedures can effectively restore some of these smiles and enhance others that may not be that bad but you just want it better.
First, let’s talk about some of the reasons teeth may appear dark. Some are intrinsic, that is the discoloration is inside of the tooth. This can include traumatic injuries, medications (tetracycline is a major one) and fluorosis (actually too much naturally occurring fluoride). No matter how much you floss and brush, these discolored teeth are not going to get whiter. Some are extrinsic stains, occurring on the surface of the enamel. Foods such as coffee, tea, berries, soy sauce, and red wine are some of the biggest offenders. Smoking and chewing tobacco will also stain teeth. Flossing and brushing can help control this type of stain.
What we think of as the white part of the tooth is the enamel. It covers the rest of the hard part of the tooth, the dentin. Dentin is naturally darker than enamel and as we age our enamel gets worn and thinner, allowing the darker dentin to show more. As a result, older people naturally have darker appearing teeth than they did when they were young.
More and more people today are choosing one or more tooth-whitening procedures to reverse these effects. These procedures range from whitening toothpastes, to over the counter whitening strips, to custom bleaching trays for home use to in office bleaching.
Some commercially available toothpastes can be somewhat effective at removing surface stains and making teeth a few shades brighter. However, many of these products have abrasive substances that can actually wear away your tooth’s enamel.
Whitening agents actually change the color of your teeth, but only are effective on certain types of stains. For example, bleaching agents have a difficult time removing brownish or grayish stains. These products also are not as effective on pitted or badly discolored teeth, and don’t work on restorations such as crowns, bridges, bonding and tooth-colored fillings. Porcelain veneers may be more appropriate in this case.
Whether you use an over the counter bleaching agent or one obtained or done in our office, it will be some type of peroxide as the active agent. OTC materials are generally a weaker concentration and the strips don’t follow the contours of your teeth. If you cover all parts of your teeth with the strip, you will also be placing it on your gums. If you avoid your gums you will miss the top, curved portion of your tooth and may create a two-toned tooth. Our whitest results have been obtained by patients bleaching at home using custom trays fabricated in the office. These custom trays follow the exact contours of your teeth and no one else’s. You are basically in control of how much lighter you go, but keep in mind you can go overboard in our opinion. When bleaching at home you may not notice just how much lighter they look because the change has been in small increments over weeks. In office whitening is more expensive due to the chairtime involved, but does tend to make more of an “instant” change.
Anyone considering bleaching should keep a couple of things to keep in mind with any of the bleaching options. Tooth sensitivity may be increased, especially if you have exposed roots which are often sensitive anyway. This can be treated most of the time. Maintenance bleaching needs to be done periodically to maintain the shade, even when choosing in office bleaching, you will have a custom tray to use at home. Failure to do so will result in the teeth becoming darker again over time. Partaking of things that are known to stain your teeth is counter-productive.
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