TOOTH WHITENING – THE INS AND OUTS

There are three basic types of teeth staining:
1. Extrinsic staining is the most common type and is a result of the outer layer (enamel) of tooth becoming discolored due to darker pigments found in food and/or beverages, and it can also be caused by smoking or chewing tobacco. Brushing at least twice per day with sodium fluoride toothpaste, decreasing the intake of these pigments, and seeing your dentist at least every six months will help reduce the amount of extrinsic staining that may occur.
2. Intrinsic staining occurs when the inner layer (dentin) of a tooth becomes discolored, which can be caused by several factors:

  • The use of tetracycline antibiotics at eight years or younger
  • Mother used tetracycline during pregnancy
  • Overuse of fluoride in children younger than six years
  • Trauma of a primary (baby) tooth resulting in damage to the underlying permanent tooth
  • Trauma to the permanent tooth, leading to internal bleeding and bruising
  • Rare genetic disorder

3. Age-related staining is the natural yellowing of teeth as the enamel becomes thinner.


Professional tooth whitening treatment has become very effective, predictable, and affordable. Over-the-counter whitening systems are available at your local grocery store or pharmacy, but the efficacy is much less and shorter-lasting than the treatment provided by your dentist. There are basically two forms of tooth-whitening treatment: take-home or in-office. The key differences between these treatments are the concentration of the bleaching material, the time needed for treatment, and the total cost of the treatment. Both methods use the same material, either hydrogen peroxide or carbamide peroxide, with concentrations ranging from 10 to 45%. The take-home system is applied in trays that are worn for 30 to 60 minutes and for a duration of 5 to 10 days. The in-office system uses a high concentration of peroxide (45% or higher), but usually only takes about an hour of chair time. The in-office treatment is generally 3 to 5 times the cost of the take-home system.
Sometimes, especially with intrinsic staining, teeth whitening bleaching systems are not effective and require internal bleaching of the tooth (drilling into the tooth and doing a root canal), replacing stained tooth structure with bonded composite, or covering the entire tooth with a porcelain veneer.
No matter what the case, minor or major, whitening the teeth makes a big difference in the appearance of one’s smile, which in turn leads to increased self-confidence, more smiling disposition, and overall improved quality of life.