Treating Tooth Stains
Know what to expect from tooth whitening
Some teeth whiten better than others.
Yellow teeth whiten best. Gray teeth and deeply darkened teeth will not whiten and you will not be satisfied with the results. No matter the type of whitening product you choose, the final result will depend on the starting color of your teeth.
Do whitening products make fillings whiter? The short answer is, no. They don't change color at all! This means that after the whitening of the other teeth are completed, it will be necessary to change the white fillings in the front teeth so they match the new whiter colors of the teeth around them.
Natural teeth will never turn pure white
There is no such thing as pure white teeth. It is important to recognize that no matter the original color of the teeth, the final result will never be bright white. When my patients would ask me to make their teeth ‘bright-white’ or ‘pure white’, I would grab hold of a piece of photocopy paper, hold it up, and tell the patient - ‘it is not possible to make your teeth this white’. Sometimes my patients would then ask ‘but what about movie stars?’ The answer is, ‘movie stars do not whiten their teeth. Their teeth look white because they place porcelain on their teeth and, unfortunately, the final result is often not very natural looking.
The goal is to have a brighter smile, not a pure white smile
Take my advice, a pure white smile is very rare and only one in a thousand individuals actually have teeth that are naturally bright white. To brighten your teeth, try first to use a bleaching product at home or try the bleaching products in your dentist’s office. If you are still dissatisfied and decide instead to place porcelain crowns or laminates, try not to get carried away by choosing the brightest, whitest porcelain colors. Remember, a natural smile is a lovely smile.
Be realistic. Pearly white teeth do
not look natural. When bleaching, do
not seek snow-white teeth and do
not place crowns or laminates that are
bright white. In Hollywood, bright-
white may be ok, but in the real
world bright-white looks fake.
Bleaching trays are made by your dentist on models of your teeth. Home bleaching with trays allows you to control potential discomfort. Office bleaching, using powerful bleaching lights, comes with a greater risk of discomfort.
When placing bleaching gel in a tray, place a thin line of gel in the tray bottom. If any gel spreads out over the gums, wipe it away gently with a wet cloth to prevent gum irritation.
Whitening Products
Whitening toothpastes
Whitening toothpastes contain high levels of abrasives (like sand-paper) and detergents as well as low levels of hydrogen peroxide. The abrasives and detergents remove the surface stains and the hydrogen peroxides brighten the stains that are deep in the teeth.
Choose the whitening toothpastes carefully
Here are some of the lesser abrasive toothpastes: Biotine, Sensodyne, Aquafresh Sensitive and Rembrandt Plus. Some of the very abrasive pastes include: Crest Sensitive Whitening, Crest Pro Health, Crest Tarter Control, Colgate 2 in 1 Tarter Control Whitening, Arm and Hammer Dental Care PM Fresh Mint. Care must be taken with highly abrasive toothpastes since they can cause tooth and gum damage when overused. I suggest that you alternate weeks between using whitening toothpastes and your regular toothpaste. Studies also find that whitening toothpastes containing over 1.5% hydrogen peroxide are not recommended due to a chance of mouth irritation.
Whitening toothpastes rarely satisfy
Don’t have high expectations from whitening toothpastes. Studies find no significant difference between regular fluoride toothpastes and whitening toothpastes.
Whitening strips
When applied diligently and properly, whitening strips (available in the pharmacy) will produce noticeable results.
For many of the products, simply brush your teeth and then wear the strips for about an hour nightly before bed time. If tooth sensitivity develops, take a break. Stop using the whitening strips for three or four weeks until the sensitivity decreases and then begin again. Cut down on the amount of time that the strips are worn nightly. Instaead of an hour, for instance, try wearing the strips for say 40 minutes. When choosing a whitening strip brand try not to purchase products with higher than ten percent hydrogen peroxide. A ten percent or lower the chance of sensitivity decreases. (As example: Crest white strip professional is at 6.5% hydrogen peroxide)
Whitening rinses
Rinses are slow acting and not effective. If you want to give it a try then recommended products include: Crest Whitening Mouthwash and Colgate Optic Whitening Mouthwash. Most rinses contain only 2% hydrogen peroxide, which is not a significant level for whitening.
Tray based whitening products
These products are used nightly for 5-30 minutes depending on the product. Some may foam up and others don’t (not much difference here). Some of the products: 'GlossRay'. Very popular with a powerful light, tested gentle, ADA approved. Another popular brand 'HiSmile' contains anti-inflammatory and anti-bacterial properties. Studies have shown this brand to be comfortable and needs only a 10 minute treatment.
Heat lamps, blue lights and UV lights
Some home bleaching kits advertise deep stain removal with a heat lamp, UV lamp, or blue light. It remains unknown, however, if these lamps provide any true benefit. With or without a light, all home kits take two to four weeks to show improvement. Note that home kits range from 3 to 20 percent hydrogen peroxide (at the dentist you will get up to 40 percent). The higher the concentration the greater the potential for teeth and gum irritation. Use according to the instructions on the kit and the instructions from your dentist.
