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First, it is helpful to understand the different kinds of teeth stains and how they occur. Different types of teeth discolorations require different treatments.
There are essentially three classifications of discolored teeth:
Extrinsic stains are stains on the surface of the teeth. These stains occur from microscopic scratches and pores on the surface of the enamel, bonding, or porcelain restoration, collecting dark colored materials from food, drink, and bacteria.
Red wine stains, coffee stains, tea stains, nicotine stains from smoking, and even stains from certain foods, such as berries, beets, soy sauce, and tomato sauce, accumulate on the rough surface or teeth and can darken the teeth over time. Not brushing and flossing regularly and eating acidic foods can increase the chances of extrinsic staining. This kind of staining is probably the easiest to treat.
Intrinsic staining occurs when discolorations are below the surface of the tooth. This internal discoloration may be from medications you took as a child, from trauma resulting in nerve damage to the tooth, or simply how the tooth enamel formed in the first place.
This staining is often more gray in color and is more difficult to get rid of. Calcium deficiencies or excess intake of fluoride (at much higher levels than found in city water supplies) can result in white spots within the tooth enamel.
As you get older, most people notice their teeth getting darker. This is due to a combination of extrinsic and intrinsic staining and thinning enamel. As you age, the enamel of your teeth slowly erodes away. Under all that beautiful white tooth enamel is a layer of yellow material called dentin. As the enamel thins, more of the dentin shows through, making the teeth appear more yellow.
Add in the wear-and-tear of years of eating and all the cracks, chips, and staining that accumulate over time and you end up with darkened, yellowed teeth. Dentin also covers the root surfaces of teeth and will show as gums recede.
Similar wear can occur in much younger people if they have a tendency to clench or grind their teeth. Eating and drinking lots of acidic foods or using stiff bristled toothbrushes or heavily abrasive materials to clean your teeth can also erode the enamel over time.
Additionally, tooth-colored dental restorations, such as fillings or bonding, tend to yellow over time due to both staining and natural chemical break down of the materials used.
Now that we understand the different types of dental stains and how they occur, we can address how to treat each type of tooth discoloration. There are several commonly used methods to whiten teeth. Some methods work well for one type of stain but are not effective for another.
One of the most commonly available, inexpensive, and easy to use treatments for stained teeth is the use of whitening toothpastes. These are a little misleading in their name, however, because they have no bleaching ability and don’t actually change the color of the tooth enamel.
They simply are abrasive pastes that are good at removing extrinsic stains. These types of pastes usually contain abrasives such as silica, calcium carbonate, or aluminum oxides in higher concentrations than found in normal toothpastes.
Activated charcoal based toothpastes are becoming more common as well. If your staining is solely from coffee, wine, or smoking, whitening toothpastes do a fair job of scrubbing away the dark residue and allowing the natural tooth color to show through.
Overuse of such abrasive pastes can have negative effects, however. Using such pastes too frequently or brushing too aggressively with a hard-bristled brush can attribute to wearing away enamel, leading to thin enamel where the yellow colored dentin underneath can show through.
They can also scratch the polished surfaces of crowns and fillings, leading to even more staining on these restorations.
Additionally, these abrasive pastes can cut into soft, exposed dentin on the roots of teeth, leading to tooth sensitivity. If you choose to use whitening toothpastes, it’s best to use them no more than a few times a week and use regular fluoride pastes the majority of the time.
For more information on keeping your teeth looking their best, check out these great oral hygiene tips.
The next level of treatment for tooth staining is an at-home bleaching kit. This is a significant step up in effectiveness from simple abrasive toothpastes because they can actually whiten tooth enamel and don’t just scratch off the extrinsic stain.
Most professional grade at-home bleaching kits use a gel containing hydrogen peroxide or carbamide peroxide as the active ingredient.
Both of these compounds are great oxidizing agents, effectively breaking down into water and reactive oxygen molecules.These oxygen molecules attack stains, breaking them apart and making them colorless. Hydrogen peroxide can also be found as the active ingredient in some types of whitening mouthrinse.
The conversion of peroxide into reactive oxygen can be enhanced with the use of light activation. Very few at-home kits provide such a light, with a notable exception being the AuraGlow Deluxe Home Teeth Whitening Kit. Our system uses not one, but five separate LED lights, all housed in a comfortable delivery tray for maximum effectiveness in at-home whitening.
Dental offices usually offer either take-home whitening kits, similar to those discussed above, or in-office whitening. In-office whitening uses the exact same hydrogen peroxide or carbamide peroxide gels but with a higher concentration of active ingredients.
This allows for much shorter treatment times to achieve the same result as lower concentration gels. Professional in-office treatment will also normally involve multiple applications in a single session and the use of light activation.
While using such high concentrations of gel can speed the process of tooth whitening, it can also have unintended consequences. In order to safely apply such powerful bleaching agents, the gum tissue must be covered with a “block out” material, which keeps the gel on the teeth and off the gums.
If the bleach gets on the gum tissue, either by direct placement or a leaking block out, the gum tissue can burn and turn white. While only a temporary situation, it can be disconcerting for the patient. In-office teeth whitening can be costly, often running around $1500, and has a much higher chance of tooth sensitivity after treatment.
As you can see, there are several ways to treat stained teeth, all with different levels of effectiveness and costs. If your stain is simply surface stain due to food, drink, or smoking, you may do well with whitening toothpastes, as long as you don’t over use them.
Actually whitening your tooth enamel requires a bleaching agent like the carbamide teeth whitening gel available from Auraglow. In-office professional whitening methods are the fastest way to get results but do have some drawbacks.
Whatever way you choose to whiten your teeth, you are sure to love having a bright, beautiful smile!