Many of my patients ask me about whitening their teeth: it might be when we first meet at their exam, or it might be during a hygiene check, or a cleaning appointment. Most patients I see have staining on the outside of their teeth, called extrinsic staining, which can be caused by food and beverages, hygiene problems and especially tobacco products. A lot of patients ask, “How do my teeth get stained?” Our teeth have very, very small imperfections like pits, scratches and grooves, that make the surface rough and can collect colored molecules from foods, drinks and habits. As the molecules collect more and more in those imperfections they start to show dark stains. Extrinsic staining can often be removed with the use of a whitening tooth paste, modifying any behavior that has a high risk of causing staining, or a professional prophylaxis (or “cleaning”). Whitening tooth paste has pumice, an abrasive ingredient, that helps get rid of stain by polishing away the rough imperfections on them. The staining goes away because the imperfections have been smoothed out, so they cannot collect stain. This is just like when you get a cleaning at the Dentist. The Hygienist uses a polishing paste, that removes even more stain and surface imperfections than whitening tooth paste, which is why your teeth feel so smooth afterwards.
Many patients who use whitening tooth paste and have regular hygiene visits are still not happy with how white their teeth are. This is usually due to intrinsic staining, which is when the tooth is discolored internally. Intrinsic staining cannot be removed by polishing away surface stain… it must be chemically whitened. Our teeth have a few layers: the outside is enamel, it is very hard and usually has a clear, milky, or white color. Dentin is the second layer, it makes up most of the tooth, and can have many different colors, anywhere from whitish-yellow to brownish-black. The tooth color that we see is determined by how dark the dentin is and how much light bounces off of it. There are several ways to whiten our teeth including over-the-counter whitening products, professional whitening products and even restorations like composite or porcelain.
In the next few weeks, I’ll go into greater detail about ways to get your smile to its whitest and brightest. Maybe you have tried whitening before and it did not work for you? The good news is that there are other options that may help! For some people, whitening alone is not an option due to older fillings or crowns… so you may need some additional treatment to make your smile as white as you want it. I’ll go over these situations as well. I will be careful to discuss some of the pros and cons of each treatment; so that if you are interested in whitening and brightening your smile, you can have a better understanding of what is best for you.
If you have questions about whitening, please feel free to leave a comment below, and I’ll do my best to answer them here!
Dr. Ben Tubo