Tooth whitening, often called bleaching, is one of the more discussed subjects in the modern dental office. Teeth whitening has become a very popular trend and most patients would like their teeth lightened, or “brought up a shade or two.” Since the patents have expired on the primary chemical used to whiten teeth, the cost has declined significantly over the past several years. The fact that it is easy to do, can be rather quickly done, and with a significantly reduced cost, makes this procedure one of the more highly sought-after dental treatments. But is teeth whitening really necessary?
The Natural Color of Teeth
The general color of teeth is primarily yellow, but there are also teeth which are blue, pink, brown and gray. A few folks are born with beautiful and naturally white teeth. You also need to know that permanent teeth are darker in shade than deciduous (baby) teeth and there is always some concern about this during the mixed dentition stage since the baby teeth are often very white.
The gray shade is the most difficult to whiten or bleach. It can be done but usually takes a bit longer. In addition, some teeth may have dental fluorosis, caused by too much fluoride in the water, usually from well water. This results in a blotchy brown stained tooth.
Causes of Dark Teeth
One of the causes of darker teeth is grayness caused by the use of the antibiotic tetracycline as a child when the permanent teeth are still developing. Others are too much fluoride in well water, smoking, drinking coffee, iron in medication or the water supply, cracks in your teeth which hold stains, red wine, blueberries, beets, tea, or your teeth may just be naturally “off-color.”
Excessive brushing can thin the enamel over the years, allowing the darker dentinal layer to show through the enamel thereby making the tooth darker in color the harder one brushes. It also pushes the gums up or down the tooth exposing the roots of the teeth which are darker in color. Heavy brushing or toothbrush abrasion is never good.
Energy drinks, lemons, limes, grapefruits, and oranges contain citric acid which erodes the enamel making it thinner and allows the darker-colored dentin to shine through. As the enamel becomes thinner, the shade becomes darker.
Other than tetracycline, these are superficial stains and may be polished away.
Things to Keep in Mind Before Whitening Your Teeth
There are many basic shades of teeth: white, grey, brown, pink, yellow and blue. If whitening is desired, the goal is to lighten the shade and bring it into the white range. Teeth cannot be whitened more than is genetically possible.
I would be remiss if I did not mention that some patients go overboard and desire a shade that is abnormally too white and certainly not naturally appearing. Whitening your teeth too often makes your teeth translucent and slightly bluish in tint.
It must also be remembered that many stains are superficial and that simply removing the stain does not change the shade. Also, porcelain crowns and fillings cannot have their shade changed, but superficial stains can be bleached.
There is a variety of methods utilized for teeth whitening, some of which are more effective and quicker than others. You can apply several of them by yourself while some need the expertise of your dentist.
What You Need to Know About Bleaching Teeth
The chemical used to bleach teeth is carbamide peroxide in solutions of approximately 11% up to about 40%. The stronger the solution the quicker the whitening. But there is one caveat. The stronger the solution the more sensitivity affects the teeth and gums. When this chemical mixes with saliva, it changes to hydrogen peroxide and is diluted. A younger person, 16 years old and below, has greater sensitivity, so they are usually encouraged to wait until older or to proceed very, very slowly. The chemical may be applied in three primary ways. Clear strips, custom-made trays, and zoom whitening.
It must be remembered, and this should be pointed out to you by your dentist, that this bleaching/whitening technique will not change the shade or color of your existing porcelain fillings, porcelain crowns, laminates, porcelain fillings, or bonding.
Most dentists will have before-and-after photos of this procedure with their actual patients and will be most helpful in giving you advice. Also, it is advisable to do the maxillary (upper) arch first so that you can easily see the difference the whitening has made. Should you do both arches at the same time, the change will be less apparent to you.
The methods of tooth whitening and their pros and cons are briefly discussed below.
Ways to Whiten Teeth
Home Teeth Whitening DIY
1. Home Remedies
- Baking soda and hydrogen peroxide mixed with your favorite toothpaste
- Swabbing your teeth with hydrogen peroxide
- Swabbing your teeth with olive oil prior to normal brushing
- Rubbing orange peels on your teeth
- Brushing with lemon juice and salt
- Brushing with mashed strawberries
- Adding approximately 2 tablespoons of hydrogen peroxide to your mouthwash and gargle
Cons–Takes long time, thins the enamel, not completely satisfactory results
With 2 tablespoons of 3% hydrogen peroxide swish around in your mouth for a minute or so. It is somewhat debatable as to whether this process is safe, and at the very best, the whitening is a lengthy process time-wise
Some of the commercial mouthwashes such as Listerine, Crest White, Colgate Optic White, and others do have some merit.
Cons–Very slow in changing shades, 3% hydrogen peroxide may not be safe
3. Teeth Whitening Toothpaste
Toothpastes with whitening additives, clean and whiten teeth by brushing away the superficial stains. The whitening additive helps to some degree by adding a surface chemical to the enamel. This creates an optical illusion which makes them look whiter.
Pros–Inexpensive, promotes good oral hygiene
Cons–Patient may seek an additional method, slow acting
4. Whitening Strips
Whitening strips are plastic with a coating of hydrogen peroxide and carbamic peroxide which will whiten teeth as well as bleach surface stains. Gray and brown shaded teeth are the most difficult while yellow is the easiest. Often, the patient begins to like the results and continue using them to an extreme. This can actually damage the enamel by making them too translucent.
Clear strips often take much longer as the solution is much, much weaker.
Another plus to this method is that you can keep the “mold” and use the same tray two to three years later for touch-up whitening.
Pros–Inexpensive, unless used too much
Cons–Slow to work, requires several treatments
Teeth Whitening Done by Your Dentist
5. Gel Trays
You can actually do this teeth whitening procedure at home using over-the-counter trays. However, these OTC gel trays are far more likely to not fit properly than the ones made by the dentist which fit perfectly. They may cause irritation to the gums and waste a significant amount of the whitening gel.
Custom made trays are the take-home, wear-while-you-sleep treatment, and are quite effective. These trays provided by your dentist fit properly can be used again after many years, and do not waste the gel. They are very effective and reliable. One can easily go two nights, skip a night, and then go two more. This creates very minimal sensitivity.
Remember that the dentist can legally utilize much stronger and more quickly effective chemicals than the patient can buy over-the-counter. This yields faster and more reliable results.
Pros–Reliable, effective, can be utilized years later for touch-up, reasonable cost
Cons–Cost of $200 to $300 may seem unreasonable to some
6. Laser Light
Dental professionals use the laser light to activate the oxygenation process of the gel applied to your teeth. It adds a slight amount of heat (103 degrees) and causes penetration of the whitening gel. It takes two visits of approximately 15-20 minutes each. Many laser lights are not true lasers but only a mild heat source.
Pros–Fairly quick, effective
Cons–Takes more than one visit, cost, sensitivity
7. Zoom Whitening
The Zoom! Whitening System is copyrighted and is only at the dental office. The procedure is quick and effective. After applying a protective barrier for the lips and gums, the dentist applies the Zoom gel to all the teeth on the arch. The Zoom light activates the gel and increases its penetration into the enamel. This leads to quicker teeth whitening. The dental practitioner then applies fluoride to lessen any sensitivity.
Pros–Quick and effective
Cons–Expensive, slight sensitivity, sometimes takes more than one visit
American Dental Association-Life Member, Fellow of Academy of General Dentistry, American Academy of Implant Dentistry