1. What makes our teeth get discolored?

Many things contribute to this, age being the most common. Caffeinated beverages (tea, colas, coffee), smoking and red wine are common culprits. Our genetic predisposition plays a part. Also, some medications, e.g. tetracycline, which will stain teeth for life if given to young children or pregnant women. Even fluoride, if ingested in excess, will cause patches of a whiter shade, or brownish areas. Sometimes an individual tooth becomes darker in color if it’s been traumatized somehow, such as in an accident, or if it’s had root canal treatment.

2. How does tooth whitening work?

There are two ways it can work: by abrasion or by bleaching. Abrasion is used by all toothpastes, but the whitening toothpastes contain extra polishing agents which will work for those whose teeth have superficial staining.

Bleaching gives a more noticeable result, sometimes quite dramatic. Bleaching gels contain hydrogen peroxide or carbamide peroxide, and the tooth whitening depends on two factors: the strength of the peroxide in the gel and the amount of time it’s in contact with the teeth.

The tooth whitening gel can be applied to your teeth at the dentist’s, or at home. The dentist will make a tray that fits precisely over your teeth. At home, you can put gel in the tray and wear it either for several hours during the day or overnight. Results can sometimes be seen after a few days, but more often after a couple of weeks, and the change is gradual enough that others probably won’t notice that you’re doing the treatment.

When done in the dentist’s office, the results are fast because an activator is used to speed up the breakdown of the peroxides in the gel. After just one visit, your teeth will be dramatically whiter. This method is more expensive however.

Individual outcomes vary depending on your particular dental conditions, the cause(s) of the discoloration of your teeth, your age, and how well you care for our teeth. Consulting a dentist is the first step, even if you plan to do the tooth whitening at home.

3. Is there an ideal shade of white I should shoot for?

No. Everybody’s teeth have their own shade of maximum whiteness.

4. Do tooth whitening treatments make your teeth hurt?

This is an individual matter. Some people say their teeth are more sensitive afterwards but it’s usually just for a day or so. Fluoride can be used both before and after the treatment, which will re-mineralize the teeth, strengthening the enamel and reducing sensitivity. If a tray treatment is done, the tray can be worn just a couple of hours a day instead of overnight and this reduces sensitivity, although it lengthens the treatment time too.

5. How do I know whether tooth whitening treatments will work on my teeth?

You can’t know that without consulting a dentist. He can examine your teeth to determine the causes of discoloration. Not everybody is a good candidate for tooth whitening treatments.

6. How can I tell which over-the-counter tooth whitening treatment is best?

The first thing to do is look for the ADA seal of approval (American Dental Association). Whitening gels contain peroxides, usually carbamide peroxide, which bleach the teeth and are at different strengths in different products (10%, 16% or 22%). Only those which are given to you by your dentist, and which contain 10% have the ADA seal.

You may save some money by opting for a take-home system, but you’ll lose something too. Results will be better if you have the tooth whitening done professionally; there’ll be a fluoride treatment before and after which will strengthen the tooth enamel; and results will be faster, accomplished perhaps in just one visit.

Whitening toothpastes contain extra polishing agents and work by mild abrasion, not by bleaching. So they don’t affect the basic color of you teeth, just remove surface stains perhaps a little more effectively than regular toothpaste. Again, look for the ADA seal. And keep in mind that such toothpastes can be too abrasive for your particular teeth, and destructive to the enamel. Professional tooth whitening would avoid this potential danger.

7. Why do some tooth whitening treatments use a light and others don’t?

There’s a discussion in the dental community as to whether such lights are necessary. Tooth whitening gels contain peroxides and when purchased by the dentist, are packaged in two separate components. One is the chemical activator of the other and the dentist mixes them at the time of use. The activator speeds up the breakdown of the peroxide into its reactive components (oxygen free radicals) which shortens the tooth whitening treatment time and increases its effectiveness.

Another way to speed that breakdown of the peroxide is use of a light, which provides heat that speeds the process. Many of the better-known brands of tooth whitening systems such as Zoom! require this light. When such lights were first used they generated more heat, which in turn sometimes led to tissue damage, pain, or increased sensitivity after the treatment was finished. More recently, the lights used have a filter which blocks the infrared part of the light and this has reduced such after effects.

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