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Teeth staining and whitening 101

Updated: Nov 5, 2023




Everybody deserves a bright and healthy smile. Unfortunately in world of coffee, wine and tobacco, your teeth will eventually stain. Some products may lead to a cycle of sanding down teeth enamel and making them stain more easily. If you want to learn more, read below and then consult with your Dentist.


Costs of Whitening?


For those who want to jump ahead, here's what you need to know.


  • Professional Whitening is considered the the most effective and safest. Costs range from $300-$1000. While Insurance companies may pay between $400-$800. Our costs are on the lower end.

  • Prescribed from a Dentist - Take home prescriptions are a less expensive option, $300-$500, they will be less effective then the in-office whitening, may be more damaging to your teeth because you will not have a professional advising you

  • Over The Counter options will be much cheaper. You will get what you pay for. They will be less effective, require more treatment, may be more damaging to your teeth and you will not have a professional advising you on harm.


Why do teeth become stained?


1. Extrinsic Stains: "Outside"


These are stains on the surface of the tooth.

  • Foods and Drinks: Coffee, tea, red wine, colas, and certain fruits like blueberries can stain teeth.

    • Citation: Joiner A. (2006). The bleaching of teeth: a review of the literature. Journal of Dentistry, 34(7), 412-419.

  • Tobacco Use: Both chewing and smoking tobacco can cause extrinsic stains.

    • Citation: Reibel, J. (2003). Tobacco and oral diseases. Update on the evidence, with recommendations. Medical Principles and Practice, 12(suppl. 1), 22-32.

  • Poor Dental Hygiene: Not brushing, flossing, or rinsing properly can cause staining. Accumulated dental plaque and tartar can also lead to discoloration.

    • Citation: Löe, H. (2000). Oral hygiene in the prevention of caries and periodontal disease. International Dental Journal, 50(3), 129-139.

2. Intrinsic Stains: "Inside"


These are stains that occur inside the tooth.

  • Certain Medications: Tetracycline antibiotics can cause staining in children’s teeth if taken by mothers during the second half of pregnancy or by children under the age of 8.

    • Citation: Dean JA, Avery DR, McDonald RE. Dentistry for the child and adolescent. 9th ed. Maryland Heights, MO: Mosby Elsevier; 2011.

  • Trauma: Trauma or injuries can cause the discoloration of a tooth, especially in children where a traumatized tooth may react to an injury by laying down more dentin, which is a darker layer under the enamel.

    • Citation: Andreasen, J. O., Sundström, B., & Ravn, J. J. (1971). The effect of traumatic injuries to primary teeth on their permanent successors: I. A clinical and histologic study of 117 injured permanent teeth. Scandinavian Journal of Dental Research, 79(4), 219-283.

  • Fluorosis: Excessive fluoride intake during early childhood can lead to fluorosis, which can discolor the teeth.

    • Citation: Fejerskov, O., Manji, F., & Baelum, V. (1990). The nature and mechanisms of dental fluorosis in man. Journal of Dental Research, 69(Suppl 2), 692-700.

  • Age-Related Stains: As people age, the enamel gets thinner, and the dentin beneath becomes darker, leading to a general discoloration.

    • Citation: Hattab, F. N., Qudeimat, M. A., & al-Rimawi, H. S. (1999). Dental discoloration: an overview. Journal of Esthetic and Restorative Dentistry, 11(6), 291-310.


It's important to note that while some of these factors are controllable (like tobacco use and dental hygiene), others are not (like the effects of certain medications or traumas)


My teeth are white, how do I avoid them staining?

  • Regular Oral Hygiene: Brushing and flossing daily help remove food and plaque that can lead to staining.

    • Citation: Löe, H. (2000). Oral hygiene in the prevention of caries and periodontal disease. International Dental Journal, 50(3), 129-139.

  • Regular Dental Check-ups and Cleanings: Professional cleanings at the dentist's office can remove accumulated tartar and surface stains.

    • Citation: Yaacob, M., Worthington, H. V., Deacon, S. A., Deery, C., Walmsley, A. D., Robinson, P. G., & Glenny, A. M. (2014). Powered versus manual toothbrushing for oral health. Cochrane Database of Systematic Reviews, (6).

  • Limiting Consumption of Staining Foods and Drinks: Beverages like coffee, tea, red wine, and cola, as well as foods like beets and blueberries, can cause extrinsic stains.

    • Citation: Attin, T., & Schmidlin, P. R. (2009). Color changes of stained tooth enamel during tooth bleaching. Schweiz Monatsschr Zahnmed, 119(10), 974-9.

  • Using a Straw: For drinks that stain, using a straw can help by allowing the liquid to bypass the front teeth.

    • Citation: Joiner, A., & Hopkinson, I. (2008). A review of tooth discoloration—Part 2, external discoloration. Dental Update, 35(9), 556-564.

  • Drink Water Alongside: When consuming acidic or staining drinks, drinking water alongside can help in washing away the residues that can stain teeth.

    • Citation: Lussi, A., & Carvalho, T. S. (2015). Erosive tooth wear: a multifactorial condition of growing concern and increasing knowledge. Monographs in Oral Science, 25, 1-15.

  • Rinse with Water After Consuming Staining Substances: After drinking coffee, tea, or wine, or after eating a staining food, rinsing the mouth with water can help reduce the potential for staining.

    • Citation: Joiner, A., & Hopkinson, I. (2008). A review of tooth discoloration—Part 1: extrinsic staining. Dental Update, 35(8), 509-515.

  • Avoid Tobacco Products: Both smoking and chewing tobacco can lead to significant extrinsic staining.

    • Citation: Reibel, J. (2003). Tobacco and oral diseases. Update on the evidence, with recommendations. Medical Principles and Practice, 12(suppl. 1), 22-32.


How can I remove existing stains?


When it comes to teeth whitening, there are both professional treatments and at-home remedies that people use. Some of these methods are unsafe and may brighten your smile temporarily but result in worse staining later as you drink coffee and wine leading to a cycle of more treatment and worse staining.


Professional Whitening Methods:


Generally speaking, consulting with your Dentist is best thing to do. We love teeth and spend our entire lives studying and caring for them.

  1. In-Office Bleaching: A dentist applies a concentrated hydrogen peroxide gel to the teeth, which can be activated using a special light or laser. A dentist also helps protect your gums from being burned or damaged from the treatment. This is the fastest method and generally considered the safest.

  2. Professional Take-Home Kits: These are provided by dentists and usually consist of a custom-made tray and a less concentrated gel of hydrogen or carbamide peroxide than the in-office treatment. The tray is usually worn for a short time each day.

Over-the-Counter Whitening Products:


Although these can be safe in moderation, they can also have side effects.

  1. Avoid: Whitening Toothpastes: They have abrasives and polishing agents that remove surface stains but do not change the intrinsic color of the teeth. These toothpastes may "sand down" your enamel making it porous so they stain more easily.

  2. Whitening Strips and Gels: Applied directly to the teeth, these peroxide-based gels or strips are worn for a few minutes but do not change the intrinsic color of the teeth.

  3. Whitening Rinses: These are like mouthwashes that bleach the teeth. They contain hydrogen peroxide and need to be swished around in the mouth for for short time a few times day but do not change the intrinsic color of the teeth.

The following Natural or Home Remedies:


You should generally avoid these remedies unless consulting with a professional Dentist first. Your dentist may have safer tooth pastes and enamel protection on hand in their office they provide you with.

  1. Always Avoid: Baking Soda and Hydrogen Peroxide: This method acts like sandpaper grinding down excessive amounts of enamel. Much like sanding and staining wood, your teeth may more easily stain.

  2. Always Avoid: Activated Charcoal: This method acts like sandpaper grinding down excessive amounts of enamel. Much like sanding and staining wood, your teeth may more easily stain.

  3. Always Avoid: Apple Cider Vinegar: Apple Cider is highly acidic and can erode tooth enamel. Much like sand paper, the tooth can become porous and stain more easily.

  4. Oil Pulling: Swishing coconut or sesame oil in the mouth for 15-20 minutes is believed to pull out toxins and lighten teeth. It's a traditional Indian remedy, and while generally safe, there's limited scientific evidence supporting its efficacy for whitening.

Precautions:

  1. Sensitivity: Both professional and at-home whitening treatments can lead to increased tooth sensitivity or worse staining over time. If you experience significant sensitivity, it's advisable to consult your dentist.

  2. Gum Irritation: The bleaching agents can irritate the gums. This is usually temporary, but it's crucial to be careful and avoid excess contact with gums.

  3. Not for Everyone: Teeth whitening might not be effective for everyone, especially if you have fillings, crowns, or very dark stains. It's essential to consult with a dentist before undergoing any whitening treatment.

  4. Limit Frequency: Over-whitening can lead to significant tooth enamel erosion and increased sensitivity. Always follow the product recommendations or dentist's advice.

Lastly, one of the best ways to maintain a bright smile is through regular dental check-ups, brushing, flossing, and avoiding excessive consumption of staining agents like coffee, tea, red wine, and tobacco. If you're considering any teeth whitening method, it's always a good idea to discuss it with your dentist first.

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