How can I get my teeth whiter?
One of the most frequent questions we get asked at Hagan Dentistry is “How can I get my teeth whiter”? If this is a question you’ve also had, it may be helpful to know a little more about what causes teeth to darken in the first place.
First, it is important to know that teeth naturally come in many different colors or variations of white/ off-white. Some teeth naturally have more grayish tones. Others are more yellowish or brownish. Patients are always amazed when we pull out our shade guide to choose a color for a filling or crown that matches the patient’s other teeth. Some of our shade guides have around 30 different colors to choose from. (And sometimes we still have to improvise).
But if you feel that your teeth are darker than they used to be, you are probably right. Teeth are slightly porous and can pick up stains from foods and drinks. Frequent coffee, tea, soda ,or red wine drinkers will often find that their teeth darken quicker than other people. Smokers are also prone to having their teeth turn a more brownish or yellowish color.
In addition, as we all get older, the composition of our teeth changes slightly. The white part of the tooth is called enamel and it is the outer shell of the tooth. As we age, the enamel layer gets thinner due to natural wear, intense brushing, and/or chemical breakdown by the foods and drinks we consume. The thinner enamel layer allows the inner layer of the tooth called dentin to show through. The dentin layer tends to be yellow or yellowish brownish. This show through makes the whole tooth appear darker.
Certain medications can also have an effect on the color of your teeth. Antibiotics in the tetracycline family are well known to discolor teeth when taken in childhood while teeth are developing. However, some medications can also affect teeth color even when taken as an adult. These include some chemotherapy medications, some blood pressure medications, and some allergy medications.
So, if you are unhappy with the color of your teeth, what can you do about it? Luckily we have some great options to help brighten your smile.
Almost all whitening products use either hydrogen peroxide or carbamide peroxide in a gel form. Without getting into too much of the chemistry process, the peroxide molecules can enter the pores of the tooth to help break down stains and discolorations. This, in turn, makes your teeth appear brighter.
The two options that we recommend most frequently to our patients are in-office whitening and take-home whitening trays. In-office whitening is a great option for patients that are looking for the quickest results. We use a very concentrated peroxide gel that gets impressive and quick results. Because of the concentration of the peroxide, we take special care to place a protective barrier over the patient’s gum tissue.
Patients often see an immediate improvement of several shades after we are finished, and the teeth may continue to whiten over the next few hours even after they leave our office. We do not use a special light during the in-office whitening procedure. Scientific studies have shown that using the light does not achieve any better results than not using it. Furthermore, using an intense light during whitening can also cause an increase in sensitivity after the procedure due to the heat generated by the light.
The second option we recommend is take-home whitening trays. We make molds of the patient’s teeth and custom-make very comfortable, but tight fitting trays that hold peroxide gel against the patient’s teeth. Custom whitening trays work better than over the counter whitening trays because they have a higher concentration of peroxide. Furthermore, because they are custom-made for each patient, the patient is assured that all teeth and all parts of each tooth are in contact with the whitening gel. This is especially important for patients with wide smiles or for patients that have some overlap in their teeth.
Custom take-home trays do, of course, take longer to get results than the in-office whitening. However, the patient has more control over what shade they want their teeth to be. Patients can stop whitening at any point if they feel their teeth are getting too white. However, patients can usually achieve the same results as the in-office whitening if they continue using it over a long enough period of time. The take-home trays are less expensive than the in-office whitening.
Whitening procedures are very effective and very safe. Some people do experience tooth sensitivity during or shortly after using whitening gels. However, this is always a temporary type of sensitivity, and will go back to normal within a few days of discontinuing use of whitening gel. Some people also experience temporary mild to moderate gum discomfort. Our office will give you several suggestions and techniques you can use to help minimize sensitivity in your teeth or gums.
There may also be a health benefit to whitening your teeth. More research is needed, but some studies have shown that using a whitening gel in a custom tray once every two weeks may help prevent tooth decay. The thought is that the peroxide may kill the bacteria that cause cavities. This is an exciting possibility to help prevent cavities, but we do recommend that our patients treat any open or active cavities before initiating whitening treatment. Otherwise, they are likely to experience more extreme sensitivity than normal.
It is also important to note that whitening gels will not work on teeth that have porcelain crowns or veneers or on fillings. Furthermore, teeth that have been discolored due to medication use are typically less responsive to whitening procedures than other teeth.
Teeth whitening is not a permanent fix. Teeth will gradually darken again over time, especially for smokers or people who heavily consume coffee, tea, and red wine. Luckily, you can keep your custom whitening trays and use them in the future to touch up your teeth when you feel they are darkening. The cost to buy refills of the whitening gel to place in the trays is significantly lower than the original cost of buying the trays themselves. We also provide custom trays for free to patients who choose the in-office whitening so that they can touch up as well.
Whitening toothpastes can also be used as an adjunct to help teeth get whiter or maintain their color. However, these toothpastes only work on superficial stains and will not significantly change the color of the teeth. I don’t recommend their use long term, as they use abrasive particles to remove the stain. This can cause premature wear of teeth, especially in aggressive brushers.