“How can I have whiter teeth?” is one of the commonest questions I am asked when people find out I am a dentist.
There are a wide range of interventions available. Indeed, a quick search on google should bring up an amazing range of suggestions of procedures to whiten your teeth at home, along with pictures and attestations but insufficient clinical evidence. It is best to visit your dentist for optimum results. Here’s why…
- Your teeth may be whole and sound with just stains around them(extrinsic stains)
Extrinsic stains may result from: frequent intake of coffee and tea, smoking(nicotine stains), chewing cola nut and even plaque and calculus. Less commonly, newly teeth may erupt with an overlying membrane known as the Naysmyth’s membrane which may also present as a discolouration of the teeth. These can be corrected by a clinical procedure known as “scaling and polishing”. An adjunct of the procedure include stain removal using the chairside sand blasting method. - What may resemble a stain may actually be a defect of the tooth substance itself. An example is tetracycline stains which develops on a child’s teeth from intake of tetracycline antibiotics during tooth development right from the mother’s period of pregnancy. Defective enamel development such as enamel hypoplasia and amelogenesis imperfecta may resemble stains on the teeth, manifesting as white spots, pits, grooves etc. These can be identified by your dentist and treated as found appropriate. Dental caries may also cause discolouration of the tooth from its initial lesion (whitish) right down to its arrested form (brown/black). Other conditions such as Fluorosis and pulpal necrosis may also result in tooth discolouration. All these will be properly treated by your dentist using composite, veneers, crowns, root canal treatment etc as required.
Now what next?
In the absence of all these pathologies though, it is important to note that we have different shades (colours) of teeth as individuals. Indeed, the tooth colour even in the same person at different times of their lives differ significantly. Milk teeth in a toddler is generally whiter than permanent teeth in the same person as an adult. It is even expected that the colour may even grow darker with aging because of wear of the enamel with concurrent increasing deposition of dentine on the inner parts of the tooth. This is absolutely normal.
People who may still prefer a whiter shade of teeth should best visit their dentists. Your dentist may take you through whitening using carbamide or hydrogen peroxide. The down side of this treatment is that it may result in sensitivity or ulceration of the gums. Over the counter variants of these whitening kits also exist. Over enthusiastic patients may apply the chemical for longer periods than is required, resulting in ‘blanching’ ie a chalky white smile which is far from the aesthetic goal desired. Certain types of tooth bleaching also results in the uniform wear of the enamel, exposing the inner dentine more, resulting in a generally more yellow shade of teeth.
In recent times, there have been the introduction of ultraviolet and argon laser whitening. There is also a proliferation of “tooth whitening” toothpastes which mainly remove extrinsic stains on the surface of the tooth by their content abrasives. As a matter of fact, the interventions are quite varied. Some may also be temporary, requiring a repeat of procedure from time to time. Hey! The choice is yours. It’s definitely best to seek a professional consult first and then take it up from there.