Do your teeth stain easily? Are you worried that your new white fillings won't remain white for very long? Staining generally falls into one of two categories — extrinsic (external) staining, which affects the outside of the teeth, and intrinsic (internal) staining, which is discoloration of the tooth structure itself. The good news is that both can be treated and, once we determine the exact cause, there are a number of options to remedy it. You can have whiter teeth in almost no time!

External staining is generally caused by beverages or foods like red wine, tea, coffee and some spices, or even substances like tobacco. Stain that is brown, black or gray can become even worse in the presence of dental bacterial plaque and when the mouth is dry. On the other hand, internal tooth staining can make the teeth appear more yellow as a natural result of aging, or after root canal treatment when tooth structure can become more brittle and dry.

Treatment for external (extrinsic) staining includes:

• Lifestyle modification: You can help put a stop to your staining problem by reducing or eliminating the habits that cause it, such as smoking and drinking red wine.
• Practicing efficient oral hygiene: Preventing extrinsic staining can be as simple as brushing twice a day with toothpaste that contains tooth-whitening agents or other solutions to reduce the appearance of stains. Don't be embarrassed to ask our office about brushing and flossing because most people do it wrong until they're properly instructed.
• Professional Cleaning: We can remove some extrinsic staining with ultrasonic cleaning followed by polishing with an abrasive prophylactic paste.

Other treatment options to reverse either intrinsic or extrinsic staining include:

• Whitening by bleaching: Bleaching for extrinsic stains can be performed either in our office or at your home using a whitening kit. Bleaching for internal (intrinsic) stains can only be conducted in our dental office because it typically involves bleaching the tooth or teeth from the inside.
• Fillings and restorations: For teeth that have been stained due to decay, or for fillings that are old and discolored we can remove the decay and restore the teeth, which will restore them to their natural brighter color.

If you are ready to say goodbye to your stained teeth, call our office today to make an appointment. For more information about treating stained teeth, read the Dear Doctor magazine article “Tooth Staining: Getting To The Cause Of Tooth Discoloration Is The First Step Toward Successful Treatment.”

Some of the most popular smile enhancers on the market today are both over-the-counter (OTC) and professional teeth whitening products. And while studies indicate that bleaching can successfully achieve noticeable increases in whitening of stained teeth, there are some facts you need to know about these products and the results that they can deliver.

• Nearly all bleaching products contain the same basic ingredient, carbamide peroxide or its breakdown product, hydrogen peroxide. However, the products our office uses to professionally whiten your teeth are much stronger without compromising the health and safety of your teeth, gums, and mouth.
• OTC bleaches typically contain no more that 10% carbamide peroxide while professional bleaches can contain between 15% and 35%. And to make professional bleaching even more effective, we may use them in combination with specialized lights or lasers.
• Bleaching is NOT a permanent solution and thus results will diminish over time. The “fade rate” begins to occur 6 to 12 months after treatment.
• While you can't avoid the fading process, you can extend your bleaching results by avoiding foods and drinks that stain your teeth, such as red wine, red (tomato-based) sauces, coffee, tea, sodas/colas, and blueberries to name a few.
• Another method for extending your results is to use a straw when drinking beverages that can stain your teeth so that the liquid does not come in contact with your teeth.
• If you have visible crowns and/or veneers mixed with your natural front teeth, it may be quite difficult for you to bleach your natural teeth so that they perfectly match your veneers or crowns. Remember, tooth whitening is not effective on crowns, veneers, bridgework, or any type of artificial tooth.
• One of the most common side effects of whitening teeth is tooth sensitivity and irritation of the gum tissues. They both are usually temporary and often occur when you start bleaching; however, they generally subside after a few days.

Overall, bleaching your teeth is an effective way to brighten your smile with minimal side effects. If it is something you are interested in pursuing, talk it over with us first — even if you plan to use OTC products — so that you have a clear understanding about your specific options and projected outcomes. Or, learn more by reading the Dear Doctor article, “Teeth Whitening: Brighter, Lighter, Whiter....”

If you are pleased with your smile except for that one front tooth that appears darker, then we have good news for you. Often a tooth appears darker as a result of trauma that may have occurred years ago. Your tooth may need root canal treatment or may have already had root canal treatment in the past. Regardless, you can whiten this tooth via a process called internal bleaching. And as the name suggests, the tooth can be bleached from the inside out. Here's a brief summary of how this entire process works:

1. Performing an x-ray exam: The first step is to take a radiograph (x-ray) to make sure that your root canal filling is intact adequately sealing the root canal and the surrounding bone is healthy.
2. Making an access hole: To apply the bleaching agent, a small hole will need to be made in the back of your tooth to apply the bleach. However, before doing that, the area must be thoroughly cleaned and irrigated.
3. Sealing above the root canal filling: This step is critical to prevent the bleach from leaking into the root canal space.
4. Applying the bleach: To obtain the whitening needed, it typically requires between one and four office visits for additional bleaching.
5. Applying a permanent restoration: Once your tooth has lightened to the desired color, a permanent filling will be placed over the small hole to seal your tooth's dentin. This is then covered with tooth-colored composite resin (filling material) so that the access hole is undetectable to the naked eye.

To learn more about this procedure and see amazing before and after images, continue reading the Dear Doctor article, “Whitening Traumatized Teeth.” Or, you can contact us to discuss your questions or to schedule an appointment.

If you don't like your smile when you look in the mirror, or feel self-conscious because your teeth are discolored, there are a variety of whitening procedures that can help you obtain the smile of your dreams.

Choosing the Right White: With strips, trays and toothpastes all claiming to be the best tooth whitening systems, it can be hard to choose how to whiten your teeth. Our office can help you decide the best approach based on your individual needs, time constraints and budget. Whiteners may not correct all types of discolorations.

Whitening in Our Office: This procedure is called chair-side or professional bleaching and may require more than one office visit. Each visit may take from 30 minutes to one hour. We use an in-office whitening gel that is professionally applied to your teeth and activated by a light source, giving you significantly whiter teeth in less than an hour. Typically, teeth with a yellowish hue respond best to whitening.

Whitening Your Teeth at Home: If you are an adult who practices good oral hygiene and doesn't suffer from periodontal disease, our office can help you decide whether an at-home whitening system, or having your teeth whitened in our office best meets your needs. If you decide to go with an at-home system, you will wear a custom-made whitening tray that looks like a thin, transparent night guard. You fill the tray with a mild whitening gel and need to wear the gel filled tray for a specified period of time each day (per our office's instructions). This procedure must be continued over a period of time that generally extends from 2-4 weeks.

Whitening Products Found in Stores: If you are considering over-the-counter whitening products we can also recommend products that will offer you the best results. Whitening toothpastes that have the American Dental Association (ADA) Seal of Acceptance contain special chemical or polishing agents that generally provide some stain removal effect.

Contact us today to schedule an appointment or to discuss any questions that you may have regarding teeth whitening. Read more about this topic in the Dear Doctor magazine article “Teeth Whitening.”