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Whiter Teeth

By Paula Begoun

Problem: I would so love to have a perfect white smile. I hate my yellowing, stained teeth. What should I do?

Solution: There are many reasons why someone may have yellow or stained teeth. Silver fillings might have grayed the surrounding tooth enamel, so changing those for the new tooth-colored material dentists use can make a world of difference. Foods like coffee, tea, and berries can 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, unfortunately, some people just have natural yellow-colored teeth. Serious staining and discoloration (natural or otherwise) cannot be corrected with toothpaste, but products like Colgate Total Plus Whitening Toothpaste are as good a place to start as any. (Source: Journal of Clinical Dentistry, 2002, volume 13, number, pages 91–94).

Abrasive toothpaste can also be a problem because over time the abrasives help erode the surface of the tooth, and that can further the yellowing. The external part of the tooth is white, but underneath the white enamel is a yellow dentin core. The white part erodes, in part because of age, and the erosion is just sped up by hard toothbrushes or abrasive toothpaste.

For startling results that can make teeth whiter than you ever thought possible, one solution is to ask your dentist to bleach your teeth. Teeth-bleaching treatments used by dentists come in two forms, one you use at home and the other that is done at the dentist's office. The process done at the office can take several weeks, at about a half-hour per visit, for a cost of $300 to $800. The kit you buy from a dentist and take home uses a similar carbamide peroxide–based bleaching gel. Your dentist will fit a mouth guard to your mouth, and it must be left on for several hours over several nights. These at-home kits can cost between $100 and $200. The whitening effect can last up to 47 months in 82% of the patients who use it with no adverse side effects (Source: Journal of Esthetic and Restorative Dentistry, 2001, volume 13, number 6, pages 357–369). One major drawback of this process is increasing and even painful gum sensitivity.

The teeth-whitening kits you buy at the drugstore ($15 to $25) use a much weaker peroxide-based bleach and the mouth guard is not specially fitted to your mouth. If your teeth are even that is fine, but if they aren't the mouth guard will not fit evenly and you can get uneven results. The mouth guard the dentist has made for your mouth has individual spaces for each tooth. If the teeth do not lighten evenly you can do extra treatments for the teeth that didn't become light enough.

Bleaching or whitening strips were created to eliminate the problems associated with having to use mouth guards and a bleaching solution (not everyone is comfortable wearing a mouth guard). Whitening strips are available either over-the-counter or from your dentist. Both types of whitening strips use hydrogen peroxide to whiten teeth. The strips that are available from your dentist use a stronger concentration of hydrogen peroxide than those available at the drugstore. Both types of whitening strips can be very effective when applied twice daily for 14 days, yielding a highly significant improvement in tooth color versus baseline (Source: Compendium of Continuing Education in Dentistry, June 2000, Supplement, pages S22–S28). Drugstore versions will require more applications to net the same results as those from the dentist. Regardless of your choice there are definite drawbacks to these strips. They can leave a yellow area on the teeth near the gumline. Whitening strips also are limited because they can only cover the front teeth, which means only those will be lightened, leaving all the other teeth unaffected. Perhaps most discouraging is that whitening strips have a short shelf-life. This is because whitening strips use hydrogen peroxide as the active agent, and it is an exceptionally unstable ingredient. It can happen that by the time you find, buy, and start using your whitening strips the hydrogen peroxide may have become inactive. The teeth-whitening kits available through dentists have mouth guards that use carbamide peroxide, which is far more stable than hydrogen peroxide and has a very long shelf life.

It is important to keep in mind that 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.

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, and it is a worthwhile option to check out.



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