Tooth Whitening - It takes all types

Charcoal, anyone?
(photo: Y. Mikalopas)

Often a bright white smile can be obtained simply by brushing and flossing regularly, but even people with good hygiene habits can still be unhappy with the color of their teeth. Factors such as age, heredity, medications, coffee, tea or wine drinking, and habits like smoking can cause teeth to be dull or yellow looking. External stains can usually be removed during regular dental cleanings while internal stains cannot. It is important to look at the reasons why the teeth are stained or discolored, any dental conditions that may be present, cost factors, and the level of whiteness one wants to achieve. There are also several “natural” or “home” remedies that range from the practical, to the strange, to the doubtful. At the end of this post I discuss one I recently tried for myself.

Professional whitening in the dental office is perhaps the best way to get that bright “Hollywood” smile. But there are several things to consider. Staining caused by inherited conditions or some medications, will not respond even to professional treatment. In that case bonding or veneers may be needed to whiten the teeth. Existing bonding and caps or crowns will also not usually respond to whitening treatment. People with recessed gums or sensitivity may have increased tooth sensitivity after whitening treatment. 
Treatments may also take repeated visits and can be expensive.

If time and money is an issue (when isn’t it?) your dentist may suggest whitening trays. These trays, along with professional grade whitening gels can be used at home as needed and instructed. Often these products will come with a desensitizing gel to be used along with the whitening agent to decrease or eliminate sensitivity. 

Professional grade whitening strips can also be ordered through most dental offices. These strips contain a higher amount of the whitening agent than usually found in over the counter products.

For patients who are already sensitive due to gum recession or other reasons, whitening may not be appropriate at all. Let’s face it – it is better to have teeth that are not sparkling white than teeth that hurt. For others, a good place to start is with the over the counter strips while using a desensitizing toothpaste (like Sensodyne.) Strips are available that can be worn from 10 to 30 minutes for a period of days, usually about two weeks.

Another way to brighten the smile is with the use of everyday products you may already have around the house. Swishing a couple of times a week with diluted hydrogen peroxide (half water, half hydrogen peroxide) can help whiten the smile. The active ingredient in whitening agents is a form of hydrogen peroxide and at about $1.00 a bottle, this is a very cheap alternative. (The whitening effect was first noticed in patients with periodontal conditions who were asked to rinse with hydrogen peroxide as part of their therapy.) Always check with your dentist or dental hygienist first, however, to review any dental or medical conditions you may have.

Baking soda (sodium bicarbonate) is a mild abrasive which may help to remove external surface stains and can also be used a couple of times a week. Just dip your toothbrush in a little of the powder, with or without toothpaste, and gently brush the teeth. This is not recommended for people with medical conditions like high blood pressure as baking soda contains sodium.

There are a host of other whitening remedies I have read about and been asked about. Some are harmless – like applying a thin layer of Vaseline on the teeth to make them look shiny (an old technique from the modeling world.) Others are more questionable, like pastes made with fruits such as strawberries or lemons. Because fruits also contain sugar, it is not recommended that they be applied to the teeth for whitening, especially if there are any other existing dental conditions like recessed gums, bridgework, or active cavities. Sugar causes the germs that live in the mouth to grow and make acid on the teeth, which can cause cavities.

Oil pulling with coconut or other oils has also been touted as a whitening remedy and while not necessarily harmful, has its downsides. “Proper” oil pulling needs to be done for a minimum of five minutes at a time and claims that it is a substitute for brushing or flossing have not been supported by hard research. (See my post on oil pulling here: http://mydentalhygienist.blogspot.com/2014/08/oil-pulling-fab-or-fad.html )

Charcoal tablets, anyone? 

(photo: Y. Mikalopas)

Charcoal tablets which are sold in stores as an antacid are also rumored to be useful in reducing stains on teeth. I  purchased a box  for about $4 and after reading up on a couple of different methods, I opened several tablets and, using a toothbrush, applied it to my teeth. A "volunteer" I enlisted used another method and simply chewed on the tablets. While using charcoal is not harmful, it was a complete mess. The charcoal, once on the teeth, was difficult to get off the teeth as well as the gums. The stain removal benefits may be in the amount of brushing it takes to remove it!

Do you have questions about whitening techniques? What techniques have you used or heard about? I welcome your comments and questions.

Please see your medical or dental professional regarding any conditions you may have. This blog is not intended to treat or diagnose any condition.