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What should I use to whiten my teeth?

Updated: Mar 18

Almost everyone feels that their teeth are not as white as they should be. With the toilet-bowl-white standards brought about by "Hollywood smiles," people are becoming increasingly interested in tooth whitening. Whitening your teeth is one of the fastest and easiest ways to improve your smile, but what option is best for you? The best way to decide what treatment to move forward with is to have a discussion with your dentist. Every mouth, just like every body, is different and what worked best for your friend or neighbor may not work best for you. Your dentist can assess the cause of your discoloration, what restorations you currently have in your mouth that will be affected by treatment, and what other factors in your mouth need consideration. For example, if you have a thinner biotype or receded gums, the chemicals in certain bleaching agents may irritate your gums and cause further recession. Your exposed roots may also experience more severe sensitivity since the nerve endings are exposed unlike they are in your enamel.

What Causes Tooth Discoloration? Many things including age, but to put it simply:

  • Extrinsic causes include things that stain your enamel: smoking, coffee, wine, dark pops, dark teas, and other foods or drinks.

  • Intrinsic causes include things that discolor your dentin: excessive fluoride exposure as a child, tetracycline use by a pregnant mother or young child, trauma as a child, trauma in a permanent tooth, or a developmental issue. What is important to figure out before deciding which whitening method is right for you is the cause of your discoloration. Some discolorations are better treated with dental work or intrinsic bleaching, for example.

What Are My Options?

Professional In-Office Whitening: This is the quickest, and most expensive, treatment option. But, time is money. If you are looking to achieve dramatic results in one session, then this will allow you to do just that. This method uses the highest concentration of hydrogen peroxide or carbamide peroxide to whiten and precautions are taken to protect your gums and nerves.

Professional Take-Home Trays:

This includes custom trays that are made for you in your dental office that allow you to whiten during the day or overnight. This option also allows you to touch up your tooth color later if they begin to discolor again. This option has a healthy balance of cost and efficacy. It uses a lower level of hydrogen peroxide than in-office whitening, so it takes a little longer, but it is effective, safe, and less expensive. Drugstore Options:

  1. Whitening Strips: this treatment takes longer than professional treatments, but will whiten with time. If not applied correctly, gum irritation and sensitivity can occur.

  2. Whitening Toothpaste or Gel: this treatment takes longer than professional treatments, and is not as quick as whitening strips. Gels also tend to work better than toothpastes and are not as abrasive. If not used correctly, you can damage your enamel or cause your existing dental work to lose its shine.

  3. Whitening Pen: this treatment is portable and can work well for refreshing the effects of a different whitening method. The serum in these pens does tend to dissolve with time, so you may need to continually purchase new pens to notice any visible changes.

  4. Whitening Mouthwash: this treatment has the lowest concentration of whitening agents and can take several months before any kind of changes are noticed. This may work best for maintaining a whiter smile. Off-The-Beaten-Path Options: This includes "DIY" treatments such as using baking soda, hydrogen peroxide on a brush, activated charcoal, lemon rinds, oil-pulling, etc. While some of these treatments cause no harm and little change, others can actually be harmful for you. Baking soda can be too abrasive and remove enamel, hydrogen peroxide can dull the shine of your enamel or restorations, activated charcoal and lemon acids can lead to enamel erosion, and oil-pulling takes time with limited actual results.

Which Option Is Right For Me?

All of the different options will likely work to whiten your teeth. The question is how much time and money are you willing to invest? Like anything in life, time is money. If you are looking to whiten your smile for this weekend's events, then the drugstore options simply won't work quickly enough. If you are looking for the most economical choice, then a drugstore treatment may be best for you. Read the "Food for Thought" section below before settling on an option.

Is it Safe?

If you are following the instructions given to you by your dental office or as listed on the product you have chosen to use, then whitening is safe. However, if you overuse whitening products, or use alternative treatments you can cause damage to your teeth. Using treatments more aggressively than recommended may cause your enamel to demineralize which can actually weaken your enamel.

What About Sensitivity?

The sensitivity cause by whitening agents is typically temporary and decreases with time. The best treatment for sensitive teeth while whitening is to decrease the frequency of which you are using these agents and to incorporate a sensitivity toothpaste into your routine. This toothpastes contain ingredients such as potassium nitrate or strontium chloride, which block the tunnels to your nerve thereby decreasing the tooth's sensitivity. Also important to keep in mind: if you have existing fillings - especially ones on your front teeth - whitening may cause even more sensitivity.

Is Whitening Safe For Kids?

Generally, it is best not to start any whitening regimen until age 16 or older. The younger you are, the larger the nerves are in your teeth. This means that your teeth are more likely to become sensitive and there is a chance that you could cause damage to your nerves.

What Else Can I Do To Keep My Teeth White?

Maintaining excellent oral hygiene will help to maintain a bright smile. Brush at least twice daily - preferably after meals or staining drinks - and floss at least once daily. Schedule regular appointments with your dentist to ensure healthy teeth and gums and to remove surface stains and yellow tartar that cannot be removed with your toothbrush or floss. If you have drinks or foods that stain your teeth and can't get to a toothbrush, follow up with a glass of water and try to limit discoloration-causing foods and drinks. Final Food for Thought:

If you have any existing dental work in your front teeth, whether it be fillings, veneers, or crowns, it's important to have your dentist take a look before beginning any whitening treatment. The color of your teeth will be affected by the whitening product, but dental materials will not change color - they may, however, lose their surface luster. So if there are fillings that currently blend in with your teeth, when your teeth are whiter these fillings will need replacement with a new color. Also, if you are planning on having dental work done on your front teeth, you will want to consider if you are happy with your existing color before having treatment completed. If you are not happy with the color of your teeth, figure out which whitening method you are going to use, follow the instructions, and then give your teeth a break from the whitening for two weeks to allow the color to bounce back slightly. Once the color has settled, and if you are happy with it, then your dentist can pick the shade of your restorations to match the shade of your teeth that you are now happy with. If you have any concerns about existing work on your front teeth, ask your dentist if this is something that you should be concerned about. Keep smiling bright!

Dr. Stephanie Stephan DDS, Dentist in Auburn Hills and Rochester Hills, Michigan 1590 Baldwin Avenue, Auburn Hills, Michigan 48340

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