I Want White Teeth

Most everyone I know wants whiter teeth.  People have been searching for whiter teeth since Roman times. The ancient Gauls used urine as a mouth wash.  Urine contains urea, which whitens teeth.  Luckily for us, modern dentistry has definitely improved on the delivery system to get a brighter, whiter smile.   Information on whitening is the most common inquiry I get from my patients at Great Smile Dental.   Let's explore the topic of whitening.  (After all the dark and gloomy posts on gum disease, tooth decay, heart attacks and sleep apnea, it was time for something fun-- or at least what I call fun!)  The great thing for me in doing this blog is I get to read a lot, and learn about new science and products.  Which is exactly what happened in doing the research for this post.  I thought I knew "all" about whitening and bleaching, but found out I did not.  There's more than I had expected. So much for whipping off this blog and going back to gardening. *sigh*  Until I have more concrete information on new professional whitening, (which, incidentally, is very exciting) today's post will discuss over-the-counter whitening toothpastes and  mouthwashes, and stain.  Stay tuned for part II on bleaching.
Today's post will be in a Q & A format.  If you still have an unanswered question, Facebook message me at Barbara Tritz RDH, or leave a comment here!

1. Why do people want to whiten their teeth?
       For a better looking smile! Whitening is an affordable way to enhance self esteem,  improve confidence, and significantly improve appearance.  It truly makes you look younger.

2. What's the difference between whitening teeth and bleaching teeth?
      Bleaching refers to products that can take your teeth beyond their natural color.  Whitening products remove stains and debris.

Teeth shade guide
found here

3.  Do whitening tooth pastes and mouthwashes "whiten" your teeth?
      Any toothpaste that removes surface stain, dirt and debris is technically a "whitener"--  it's semantics, and a pretty dirty play on words.  People purchase these toothpastes and rinses to get whiter teeth, with the idea (or hope) their teeth will lighten up a shade or two.  I called Crest, Listerine and Colgate to ask what in their mouth rinses will "whiten".  Colgate's phone service was so poor their machine hung up on me,  Listerine's professional could not answer my question and is having another Listerine professional call me back (still waiting on that ;] ) and Ashley from Crest says the ingredient in Crest 3D Whitening mouth rinse that keeps stain from adhering to teeth is sodium hexametaphosphate. It places a barrier on the tooth surface to prevent future staining.  Both the Crest and Listerine people say there is hydrogen peroxide in their rinses as well.  In professional "take home trays" from your dentist, you place carbamide peroxide gel in your trays and wear them for six to eight hours, so I asked both ladies how they could claim their mouth rinse, used for one minute daily could cause  any tooth color change to possibly take place. Silence... No answer from either of them.

4.How does toothpaste remove surface stains?
      Toothpastes have many ingredients in them designed to remove stain and debris.  In years past charcoal, sand and salt were used.  Hydrated silica, which is a derivative of sand, and calcium carbonate, a refined chalk, are still used in toothpastes of today. The industry has relied on abrasives to remove the surface crud.  New technology in toothpastes have changed how they work.  Instead of being similar to soap, toothpaste is now similar to laundry detergent in it's actions.  This will damage tooth structure much less, be more efficient and work more quickly.  Solvents now go into teeth, and break the stain molecular bonds and lift the stains off. This technology is improving the quality of tooth paste and will reduce toothbrush abrasion in the future.

5. What's the difference between the surface stains and the stain within the tooth?
 Extrinsic stains are on the surface of your teeth. These can be polished or removed by your favorite dental hygienist.  Extrinsic stains can become intrinsic stains.   Intrinsic stains are those that absorb into the tooth and change the color of the tooth.  Bleaching with peroxide or carbamide peroxide will lighten these teeth. More on bleaching in another post so stay tuned for that one!  Note the little experiment I did with three virgin teeth below.  These three molars were kindly donated by a patient after he had his wisdom teeth removed by an oral surgeon.

Left to right: one tooth soaked in lemon juice for 24 hours,  one untouched, and one soaked in Coke Zero for 24 hrs each.

Notice the frosty color of the tooth on the left-  that's eroded enamel from the acidity of the lemon juice, and note also the brown, intrinsic stain of the rightmost tooth from the cola. **

**Side note:  Remember Kissability (Not really a Homemade DIY Fix)?  This is why you shouldn't use lemon juice in those recipes. All the light/bright colored spots on that tooth on the left are spots with no enamel left. Without enamel your teeth are sensitive-- the Sensodyne commercials are correct. There's nothing protecting your teeth at that point, so you would need crowns or other serious restorative action to make your mouth comfortable again.

6. Why do teeth get darker or yellower?
      Whatever stains your carpet will also stain your teeth.  Tea, coffee, cola (see above), wine, mouthwash (yep!), chocolate, licorice, tobacco, and aging are all modern day culprits.  Medications such as tetracycline (an antibiotic), minocycline (another antibiotic), childhood diseases, infections, or trauma to baby teeth can all affect the color and development of permanent teeth.

7.  How do you prevent staining?
      Good oral hygiene on a daily basis. Get all the plaque off!  My secret is dry brushing.  No toothpaste, no water.  Brush until your teeth feel and taste clean and smooth- not fuzzy, or like you have little sweaters on your teeth.  Then use toothpaste for that minty fresh breath feeling.  Toothpaste makes your tongue slightly numb so you really can't tell if your teeth are clean when you're done brushing.  Wet baking soda is also an excellent stain remover.   Clean teeth won't stain. Use a straw if possible when drinking tea, sodas or juices.

After I do a little more research we'll explore bleaching.  Go enjoy the last rays of summer sunshine!

Keep smiling,
Barbara