Problem: I would so love to have a perfect white smile. I hate the color of my teeth. I want them to look like the way models’ and celebrities’ teeth look. What should I do?
Solution: There are many reasons why someone may have yellow or stained teeth. Mostly it’s genetic: Some people just have teeth with a yellowish or off-white appearance. But if silver fillings have grayed the surrounding tooth enamel, changing those for the new, tooth-colored material dentists are using can make a world of difference. Foods like coffee, tea, red wine, and berries can also cause stains. You can cut back on the foods causing the problem, but who wants to give up their coffee in the morning, much less fresh berries and red wine (like a beautiful pinot noir or cabernet sauvignon at the end of the day)! Smoking is perhaps the worst offender because not only does it discolor the teeth, it also kills healthy gum tissue, causing serious health risks for your mouth. Serious staining and discoloration, natural or otherwise, cannot be corrected with toothpaste no matter what the claim on the label says. But the teeth whitening, lightening, and bleaching products, from your dentist or at the drugstore, in the form of strips, liquids, or gels can work miracles.
The whole subject of improving the color of your teeth gets complicated because the terminology has been regulated, but the regulation is too confusing to be of help to consumers.
According to the FDA, the term “bleaching” is permitted for use on products that can “whiten” or “lighten” teeth over and above their natural color. Plus bleaching products must contain “bleach” (not the kind for your laundry), but the kind that “bleaches” teeth, making the color lighter, with the typical ingredients being hydrogen peroxide or carbamide peroxide.
Now here is where it gets really confusing, because the term “whitening,” can only be used on products that clean teeth, meaning toothpaste. So any product that cleans the surface of a tooth can be labeled a whitener. However, because the term whitener sounds so much better than bleaching (which we think of in terms of Clorox and the washing machine, not our teeth), “bleaching” products call themselves whiteners or whitening to sound more appealing to the consumer. Yet the term whitening is only about cleaning your teeth, not changing the color.
One more bit of confusion to clear up. As mentioned, the two ingredients used in bleaching products are almost always either carbamide peroxide or hydrogen peroxide. Hydrogen peroxide is the stronger of the two. In order for carbamide peroxide to be effective it has to break down into hydrogen peroxide. That means a 10% solution of carbamide peroxide (CP) is about one-third the strength of the same percentage of hydrogen peroxide (HP). As a general rule, keep these numbers in mind: 3% HP equals 10% CP; 6% HP equals 20% CP; and 9% HP equals 30% CP.
Before you jump in to make any choice for teeth whitening, be aware there is a risk of mild to painful gum sensitivity. Mild to moderate isn’t bad, but when it’s painful, believe me, it isn’t pleasant. However, one way to resolve that problem is to brush your teeth with a toothpaste containing potassium nitrate. Research shows that this desensitizing, teeth – friendly ingredient can make a huge difference in reducing some of the side effects.
Dentists would like you to believe that they are the only solution for teeth whitening but that isn’t the case. Most teeth whiteners (“bleaches”) work incredibly well, so you can either choose by cost or just start with whatever is most readily available, which would be at the drugstore. All teeth whiteners use the same type of ingredients, either carbamide peroxide or hydrogen peroxide, but with different strengths to lighten teeth. The higher the percentage of the active ingredient, and the type of ingredient, determines how fast you see improvement, which is usually within 1 to 14 days depending on the product you buy and how diligently you follow the application instructions.
If you choose the in-office dentist procedure it would cost on average about $500 per visit. Dentists can also give you take-home kits that you can only buy from them (though there are Web sites that sell the exact same product to consumers as well, such as www. aplussmile. com). The cost for the dentist-sold kits ranges from $100 to $300 (expect to pay about half that from most Web sites selling the same products). At the drugstore the “bleaching” kits cost between $20 and $100, and they often go on sale.
Teeth-whitening kits at the drugstore or from various Web sites come in many different forms, from strips, to paint-on types, to gels that are used with a mouth guard. Choosing which one is all about your own personal preference because they all pretty much work as claimed when they contain the same active ingredients; just follow the ratio of effectiveness I explained above.
No matter what the claim on the label may say, there are pros and cons to each type of application. Strips can slip off the teeth, creating uneven results. Some people don’t like dental trays. Paint-on products require more time to evenly cover each tooth surface. Strips are also limited because they can only cover the front teeth, which means only those teeth will be affected, leaving the others as they were.
Another problem is that bleaching kits of any kind cannot change the color of dental crowns, bonding material, porcelain veneers, fillings, or any other material in your mouth other than your teeth. You can imagine how strange an appearance you can end up with if each of your teeth were a significantly different color from the other. None of these treatments is very effective if your teeth are grayed rather than yellowed, or if they are completely yellowed. Teeth-bleaching systems work best for partially yellow or food-stained teeth.
Keep in mind that bleaching products have a short shelf-life. This is because the active ingredient is a form of peroxide and it is an exceptionally unstable ingredient. It can happen that by the time you find, buy, and start using your whitening strips the peroxide may have become inactive.
Other than bleaching, if the yellow or dull color of your teeth is from tartar buildup, get your teeth cleaned, and have them cleaned regularly. If you can, avoid foods that can grab onto teeth and make them look darker, such as chocolate, dark-colored berries, red wine, and coffee. Milk can also bond onto front teeth and cause a yellow tartar buildup. Clearly, it would be best to brush immediately after eating these foods, but if that isn’t possible, rinse your mouth well with water and then chew sugarless gum. Many dentists recommend using the Sonicare automatic toothbrush to prevent tartar or plaque buildup. You definitely cannot manually brush your teeth as well as the Sonicare can, so it is a worthwhile option to check out.
Word of warning: There is no FDA approved laser for use in teeth whitening. There are studies that have looked into using lasers or other light sources to activate the hydrogen peroxide or carbamide peroxide, but results so far show they have caused problems as well as successes.
(Sources: Operative Dentistry, July-August 2008, pages 379-385; Journal of Dentistry, February 2008, pages 117-124; Dental Materials, May 2007, pages 586-596; Cochrane Database Systematic Reviews, October 18, 2006, CD006202; Journal of Contemporary Dental Practices, February 2004; pages 1-17; Compendium of Continuing Education in Dentistry, June 2003, pages 461-464; Journal of Clinical Dentistry, 2002, volume 13, pages 91-94; and Journal of Esthetic and Restorative Dentistry, 2001, volume 13, number 6, pages 357-369.)