Pearly whites. When we think of a beautiful smile, we envision a nice set of straight, glistening, white teeth. Many many factors can affect the color of our teeth, and it is important to diagnose the root cause to whiten effectively.
Common causes of tooth discoloration
When there is an issue, it is important to find out what caused it and solve accordingly. Any good dentist will ask a series of questions to figure out where the tooth discoloration came from. If the root cause is not addressed, we cannot achieve the most effective and long lasting results. Everyone will have different reasons for discoloration. Work with your dentist to find the root cause to whiten teeth most effectively.
Extrinsic Discoloration (color changes on the on the surface of the teeth)
- Smoking: cigarettes, cigars, chewing tobacco, marijuana
- Staining food and beverages: coffee, tea, red wine, curry, turmeric
- Poor oral hygiene
- Old, failing restorations (composite fillings & crowns)
Intrinsic discoloration (color changes from the inside of the teeth)
- Genetic conditions (e.g. amelogenesis imperfecta)
- Systemic conditions (e.g. jaundice, porphyria)
- Medications during tooth development (e.g. tetracycline, fluoride)
- Pulp changes; teeth that no longer have nerves will change color
Extrinsic and intrinsic discoloration (color changes from the inside of the teeth)
- Fluorosis: excessive use of fluoride from an early age
Available teeth whitening agents and whitening treatments
With so many teeth whitening products on the market, patients struggle to know which is the best one. However, the active ingredients of teeth whitening agents are the same. Products differ in marketing, concentration of the key ingredients, and whether they are professional use only or over-the-counter.
The key teeth whitening agents are hydrogen peroxide or carbamide peroxide. In an oxidation-reduction reaction, these ingredients break down to release radicals that oxidize and remove the staining in the inter-prismatic space of the tooth’s most outer enamel layer.
- Hydrogen Peroxide breaks down faster than carbamide peroxide, which means that most of its effects happen in the first 30 minutes - 60 minutes. Because Hydrogen Peroxide works fast in a short amount of time, it can cause more sensitivity which is the most common side effect of the whitening treatment. Therefore, it is recommended to be used in a controlled environment under supervision of a dental professional.
- Carbamide Peroxide works more slowly and can remain active for up to 6 hours.
Truth to be told, there is no one best way to whiten your teeth. And there’s no one best product to whiten your teeth. All of these options below work well with proper assessment.
- Over-the-Counter: Whitening strips or serum + LED accelerating Mouthpiece whitening system
- At Home Bleaching Trays: Customized bleaching whitening trays made by dentist + whitening gel; 10-14 days at home
- In-Office Bleaching: Usually 1-hour sessions with or without LED light.
* Note that using an LED light does not mean it is a better product, it simply means that the ingredient they use is activated by an LED light.
An in-office bleaching session may give you better results as a professional is there to make sure every little space of the tooth is being bleached, as opposed to a bleaching strip or tray that spreads through your teeth in general. Whichever product you choose to use, the most important thing to do is read the instructions carefully and follow them.
Teeth whitening recommendations
- Understand the root cause of tooth discoloration and whether your teeth can handle the potentially harsh bleaching process with dental professionals. DIY teeth whitening can do more harm than good when misused.
- Get your oral health examined by your dentist prior to whitening your teeth. Check for cavities, receding gums or any other gum disease, as the peroxide can be harmful and aggravate pain in your teeth.
- Get teeth professionally cleaned and complete any other dental procedures prior to starting the bleaching process for the best results. Existing extrinsic stains (coffee, tea, wine) need to be removed first for the bleaching process to bring out the best results.
- Use nano-hydroxyapatite toothpaste (nHA) after whitening procedures (at home or in office bleaching). Its enamel restoration property can significantly decrease teeth sensitivity before and after the whitening procedures.
- nHA can lengthen the whitening effect from the procedure. It not only protects against sensitive teeth and cavities but also restores translucency and gloss. By restoring mineral density to both surface and subsurface enamel contributing to brighter and whiter teeth, it has more benefits than off the shelf hydrogen peroxide based whitening toothpastes.