At Hollywood award shows, the stars' smiles reveal teeth so bright they could blind the audience. And thanks to today's better and less expensive tooth whitening techniques, you too can have a dazzling set of pearly whites.
An array of products and choices are available to a smile-conscious consumer — from toothpastes and whitening strips to professional whitening procedures done by your dentist. So how can you figure out which method will make your grin glow?
Why Your Teeth Aren't Pearly White
The first item of business for you and your dentist is to uncover why your teeth are discolored, because not everyone is a candidate for tooth whitening techniques.
"Before beginning the process of tooth whitening, it's important for people to talk to their dentist to make sure their teeth are in a healthy situation," says Dr. Matthew Messina, a consumer advisor for the American Dental Association (ADA) and a practicing dentist in Cleveland, Ohio.
Whitening is not a good option for people with untreated tooth decay or gum disease. Not only are whitening agents ineffective for people with certain dental diseases, but they can also cause hypersensitivity in teeth. So a dentist will need to work on improving the health of the teeth and gums before addressing any purely cosmetic matters.
Others who might need an alternative solution are those with stains from taking certain antibiotics, like tetracycline, as a child; those who experienced some kind of trauma to their mouth or people who have had bonding or tooth-colored fillings in their front teeth. While whitening might make these teeth a little lighter, it might not provide even results. Experts generally recommend using porcelain veneers that completely cover the affected teeth.
For most people, however, tooth discoloration can be chalked up to the passage of time and a habit of eating dark or brightly colored foods, like blueberries or cherries, and drinking certain liquids, like red wine, coffee or tea. Another culprit is cigarettes. White-teeth seekers in this group are considered good candidates for whitening techniques. People with yellowish teeth are thought to be the best bleaching candidates, followed by those with brownish-colored teeth and then those with grayish teeth.
According to the ADA, people should not experience tooth enamel damage or side effects beyond temporary tooth sensitivity and gum irritation. Some researchers have raised concerns about the peroxide in the bleaching solution being linked to oral cancer, but no clear connection has been established.
"In patients who have been in controlled, clinical trials for up to 10 to 12 years post-treatment with [dentist-prescribed night-guard bleaching], we didn't see any differences in the gums beyond what we would see in a normal situation," says Dr. Ralph Leonard, a clinical associate professor at the University of North Carolina at Chapel Hill School of Dentistry. "Nor have we seen any increase in fractures, tooth decay or in root canals. We think it is as safe as anything we do in dentistry."
What Are Your Options?
When choosing the best whitening option, you'll need to consider your goals, the expense and your level of commitment.
"Tooth whitening products run on a continuum from the simple to the involved," Messina says. At the low end are whitening toothpastes, which contain mild abrasive agents that help remove surface stains. However, according to Messina, toothpastes are better at maintaining brightness after a whitening procedure than actually lightening teeth in the first place.
The next step up is whitening strips, which contain hydrogen peroxide. To use the strips, you apply the gel-coated side of the strip to the surface of your teeth and leave it on for about a half-hour. According to Crest Whitestrips manufacturer Procter & Gamble, after using their strips for two weeks, you'll have whiter teeth for a year. The premium version of the strips is supposed to provide results in three days.
If you want to see a greater difference between your "before" and "after" smiles and you're willing to invest more time, money and effort, you might consider a home bleaching system. These systems can be purchased over-the-counter or through your dentist.
If you take the professional route, your dentist will take a mold of your teeth to create customized trays that you wear. While systems vary, you generally place a bleaching gel into the trays, which resemble a mouth guard, and wear them for an hour or two a night for about two weeks. Over-the-counter systems will provide bleach and trays, but the trays may cause irritation since they are not specifically tailored to your teeth. The customized bleaching systems a dentist provides usually cost between $200 and $400, while the over-the-counter systems can range from $15 to $85.
For the most dramatic result, you might want to consider an in-office bleaching procedure, which can make your teeth about nine times whiter in about an hour. Dentists use a protective gel that coats your gum tissue, and then apply a solution that contains between 15 percent and 35 percent hydrogen peroxide. A light is directed at your teeth to activate the gel. After the session, you're asked to avoid colored foods and beverages for about 48 hours. These procedures range in cost from $500 to $1,000. Some dentists also offer a combination of in-office and at-home methods.
No matter what whitening method you use, your teeth will gradually assume their old shade over time, regressing, Messina estimates, by about half a shade every six months. Someone who has had an in-office procedure might opt to use a home whitening kit or whitening strips to prevent future staining. If you are doing follow-up maintenance, however, you should check in with your dentist regularly — which you should be doing anyway, for that routine cleaning every six months.
"One of the nice side effects is that if you're proud of your smile, if you're investing in the care of your smile, then you're more likely to brush and floss and see the dentist regularly," Messina says.
"Tooth whitening is a fairly simple procedure that can produce a lot of beneficial effects," he continues. "If we improve someone's self-confidence, then they look better because they hold their head up high and smile."