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Whitening Your Not-So-Pearly Whites

Whitening Your Not-So-Pearly Whites
By Carol Sorgen
WebMD Feature
Reviewed by Cynthia Dennison Haines, MD

Your pearly whites not so pearly anymore? That can happen to any of us, for any number of reasons. The good news is that you don't have to live with a smile you're less than happy with. Tooth whitening can restore your teeth to their earlier brightness. But given the number of options and the cost and time involved with each one, how do you know which one is right for you?

As we age, the outer layer of enamel on our teeth is worn away, eventually revealing the darker tissue underneath, at the center of the tooth around the nerves and blood vessels. Our teeth may also become discolored from smoking, from drinking coffee, tea, and wine, and even from taking certain medications as a child such as tetracycline.

What Your Dental Health Says About You

teeth
It's easy to ignore the effects of poor oral hygiene because they're hidden in your mouth. But gum disease may point to problems with diabetes and heart disease and loose teeth could be a sign of osteoporosis. Could it be that a healthy mouth means more than just a sparkling smile? And what could your dentist learn about you the next time you open wide?

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"It's like wearing a great outfit or wonderful accessory," says Wynn Okuda, DMD, national president of the American Academy of Cosmetic Dentistry (AACD). "Having your teeth whitened makes you feel good."

Almost everyone wants whiter teeth these days, adds Melissa Ing, DMD, associate professor of prosthodontics at the University of Connecticut Health Center. "It's the number one aesthetic concern of my patients," she says.

Ing is not alone in noticing the upsurge in requests for a brighter smile.

That may be because it's fairly easy to accommodate those requests, says Ing. "Tooth whitening or bleaching works for most people and my patients who have done it are happy with the results."

Two Ways to Tooth Whitening

Tooth whitening can be achieved in two ways. A product can bleach the tooth. That means it actually changes the natural tooth color, usually anywhere from five to seven -- but even up to twelve -- shades brighter, which is how dentists assess tooth color. Bleaching products contain peroxides that help remove both deep and surface stains. The second whitening process uses non-bleaching products that work by physical or chemical action to help remove surface stains only.

A newcomer to the world of tooth whitening is known as chairside bleaching. This may require more than one visit, with each visit lasting 30 to 60 minutes. During chairside bleaching, your dentist applies either a protective gel to your gums or a rubber shield to protect the soft tissues in the mouth. A bleaching agent is then applied to the teeth, and a special light may be used to enhance the action of the agent.

The cost of professional whitening varies -- depending on where you live, what product the dentist uses, and what other services may be offered), but usually starts about $500 per session, says Okuda. If your teeth aren't very dark or very stained, you may need only one session.

Your dentist can also provide you with a tooth-whitening system that you can use at home. At-home products typically come in a gel form that contains carbamide peroxide; the gel is placed in a custom-fitted mouthguard, created from a mold of your teeth. Depending on the product you and your dentist choose, the guard is worn either twice a day for 30 minutes or overnight -- usually for a couple of weeks. The length of time can range from one week to one month depending on how much whitening you need. This procedure usually costs around $400 and whitens the teeth four to seven shades.

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