Those Pearly Whites

Turn up the wattage on your sparkling smile

If a whiter smile is one of your New Year’s resolutions, you’re in the right place. Depending on your budget and your teeth, you have a variety of options.

Whitening Toothpaste
The least expensive option is whitening toothpaste, says Dr. Cappy Sinclair of Coastal Cosmetic Dentistry in Virginia Beach. According to the American Dental Association, these toothpastes remove surface stains without bleaching.

Crest Pro-Health Whitening Toothpaste does a pretty good job of lightening teeth one to two shades over three to four months, Sinclair says. Crest Pro Health Whitening Toothpaste also has earned the American Dental Association’s Seal of Acceptance. Other whitening toothpastes include Colgate Total Advanced Whitening Toothpaste and Tom’s of Maine Simply White Clean Mint Toothpaste.

“Most of the whitening toothpastes get their whitening effects from abrasive paste within the toothpaste,” Sinclair explains.

Whitening Strips
The next step is over-the-counter whitening strips. “Crest Whitestrips obviously have the biggest name associated with them,” Sinclair says. (The ADA currently has not awarded its Seal of Acceptance to any over-the-counter whitening strips.)

Whitening strips give fairly fast results—two to three shades lighter in about three weeks. The best candidates are people in their 20s and 30s who have light stains on their teeth from drinking tea or coffee and who haven’t had any dental work done, Sinclair says. If you have fillings on the front or sides of a tooth, the strips won’t whiten those areas, he notes.

He says the results are similar to what you’d see after a standard six-month cleaning and polishing at your dentist’s office.

Although you don’t have to see a dentist to use OTC whitening strips, doing so is a good idea, according to the ADA. This is especially important for patients with many fillings, crowns and extremely dark stains. A thorough oral examination, performed by a licensed dentist, is essential to determine if bleaching is an appropriate course of treatment. Some tooth discolorations may be the result of a disease or condition that requires dental treatment, and whitening your teeth without seeing a dentist first could mask the problem and delay diagnosis, the ADA says.

Your dentist is also able to educate you about how bleaching will work with existing restorations you have and to make sure you have realistic expectations. For example, bleaching won’t work on existing crowns, so you’d have to factor in the expense of replacing the crown. But if you’re getting your first crown, that might be the time to consider bleaching.

Custom Bleaching at Your Dentist’s Office
Custom bleaching trays made in the dentist’s office are the next step and are a good option for patients in their 40s and 50s who have a lot of internal staining from longtime use of tea, coffee and red wine, Sinclair says.

The dentist will first clean your teeth, fill any cavities and address other problems.

Then the dentist takes impressions of your teeth and creates a special mold for the bleaching agent, Sinclair says. The bleaching agent (10 to 25 percent of hydrogen peroxide or carbamide peroxide) works by dehydrating the teeth and then pulling out internal stains. Users may sleep wearing the trays or wear them an hour or more during the day, he notes.

Users should avoid coffee, tea, red wine or smoking for 15 minutes after use because the newly dehydrated teeth would be especially susceptible to new stains, he says.

For in-office bleaching, the ADA recommends that dentists consider prescribing non-steroid anti-inflammatory medications (such as Advil) because patients’ teeth may be sensitive afterward.

In-Office Laser Bleaching
In a rush? Your best option may be in-office laser bleaching, Sinclair says. “This is if you want your teeth as white as you can get…tomorrow. A great example is someone who is getting married or has another event on Saturday and comes in on Thursday and wants her teeth whitened immediately.”

The dentist will isolate and protect your gums and lips, apply light-activated gel and then activate the gel with a special laser, Sinclair says. You will also take home a set of custom trays for maintenance and touchups.

Crowns and Veneers
For some stains, the best options are veneers and crowns. People in their 50s and 60s whose teeth were stained by antibiotics such as tetracycline or by chemicals in water systems probably won’t see results from bleaching, Sinclair says. The main options for these patients are veneers, which are on the outside front of the tooth, or crowns that encapsulate the entire tooth. Veneers preserve more natural tooth structure than crowns, Sinclair says. Crowns may be called for if the patient has previous fillings or tooth decay.

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