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Teeth Bleaching

Does At-Home Teeth Whitening Really Whiten Your Teeth?

Teeth Whitening

Jul 18, 2011

At Home Teeth Whitening — ©Igor Gratzer/Shutterstock.com

A few months ago, one of my patients asked me if the whitening products that you can buy from the store actually whiten your teeth. She wasn’t too excited about the expensive price that our dental school charges for a custom bleaching tray and professional-strength bleach.

She was looking for a cheaper alternative. There’s nothing wrong with trying to save money (as long as you don’t get caught up in an online teeth whitening scam), but the question remained: Do at-home teeth whitening products really work?

At the time, I told her that they do work, but they’re not as effective as getting it done at the dental office because we can use a higher-strength gel than the whitening products that are available over the counter. I hate answering patients questions when I’m not entirely sure what the answer is, so I decided it would be a good idea to research this question.

Does At-Home Teeth Whitening Really Work?

I was able to find a systematic review, which is an academic paper that reviews lots of studies, eliminating the poorly designed studies, and tries to state the best-available evidence on a given topic.

The systematic review that I found from the Cochrane Collaboration states that at home teeth whitening products do whiten your teeth. However, the effectiveness of the whitening varies based on the strength of the peroxide used in the product. Here’s their explanation using their academically-appropriate big words:

There is evidence that whitening products work when compared with placebo/no treatment. There are differences in efficacy between the products, mainly due to the levels of active ingredients, hydrogen peroxide and carbamide peroxide. All trials were however short term and the majority of the studies were judged to be at high risk of bias and were either sponsored or conducted by the manufacturers. There is a need for pragmatic long-term and independent clinical studies that include participants representing diverse populations. There is also a need to evaluate long-term harms.

So, the verdict is in! At home teeth whitening products do actually work to get your teeth whiter.

Before you whiten your teeth it is a good idea to visit your dentist (here’s six reasons why) and to be familiar with the two main side effects of teeth whitening.

Do At-Home Teeth Whitening Products Work For You?

I’ve only used over the counter teeth whitening products a handful of times. The paint-on gel worked the best for me, while I never got very good results with teeth whitening strips.

How about you? Have you ever tried whitening your teeth? Did you notice a difference? I’d love to hear what you have to say in the comments section below. Thanks for reading!

Discolored Teeth: 4 Ways Root Canals Can Stain Your Tooth

Root Canal Treatment

Mar 14, 2011

Root Canals Stain Teeth — ©Warren Goldswain/Shutterstock.com

Last week, Pam left a comment asking whether or not root canal treatment can darken a tooth. I gave her a short answer, telling her that sometimes root canals can discolor teeth.

If you want to know about the four different ways that a root canal can darken your tooth, this article is for you.

4 Ways Getting a Root Canal Can Discolor or Stain Your Tooth

1 – The tooth can get discolored if any pulp tissue is left inside the tooth. If you’ve read this post about the anatomy of a tooth, then you know that the pulp is the center layer of the tooth.

It can be easy for a dentist to accidentally leave some pulp tissue inside of the tooth because sometimes the pulp isn’t all together in the middle of the tooth. Sometimes there are little offshoots of pulp tissue in little tunnels that branch away from the main pulp chamber known as pulp horns.

The book Esthetic Dentistry by Aschheim states, “Elusive pulp horns and lateral extensions of the pulp chamber often remain untouched during routine endodontic access preparation…Careful removal of tissue and debris from these areas may help prevent subsequent tooth discoloration.”

If any pulp tissue is left inside of the tooth after the root canal is completed, it can decompose and eventually discolor the tooth.

How to fix discoloration caused by pulp tissue: Usually internal bleaching can remove any discoloration that was caused by pulp remnants left inside of the tooth.

2 – A tooth with a root canal get get discolored if root canal filling materials are left in the crown portion of the tooth. When dentists do root canals, they remove the pulp tissue from the tooth (hopefully enough so that it doesn’t discolor the tooth – see above) and replace it with a liquid sealer and a solid rubber filling material called gutta percha.

This study showed that all root canal sealers can cause tooth discoloration when remnants of the sealer are left in the crown portion of the tooth. Certain sealers may stain the tooth more than others. Gutta percha is also believed to be able to discolor teeth.

Prevention is the best approach for this type of root canal discoloration. The dentist can prevent this by removing any root canal filling materials that are in the crown portion of the tooth and keeping them isolated to the root portion of the tooth.

How to fix discoloration caused by root canal filling materials: Internal bleaching is the best method to remove this type of root canal discoloration. However, if the staining was caused by a sealer with a high metal content, bleaching may not be extremely successful and if it is, the tooth may discolor again in the future.

3 – Medications that are put into the root canal can discolor a tooth with a root canal. Sometimes dentists add certain medications when they do root canals to help increase the chances that the root canal will be successful.

The book Endodontics: Principles and Practice by Torabinejad says, “Several medicaments have the potential to cause internal discoloration of the dentin. Phenolic or iodoform-based…medications, sealed in the root canal space, are in direct contact with dentin, sometimes for long periods, allowing for their penetration and oxidization. These compounds have a tendency to discolor the dentin gradually.”

How to fix discoloration caused by root canal medications: A majority of root canal discoloration caused by medications can be reversed by simply bleaching the tooth.

4 – A tooth with a root canal can get discolored depending the material that is put inside of the crown. If an amalgam (silver metal) filling is used to build the crown of the tooth back up after completion of the root canal, the amalgam filling can stain the tooth a dark gray color.

You can prevent this staining by asking your dentist to not use amalgam to fill any of your front teeth so that your smile remains aesthetically pleasing.

How to fix a discoloration in a tooth with a root canal caused by an amalgam filling: Metallic discoloration caused by an amalgam filling is hard to remove, but some experts say that internal bleaching may work depending on how discolored the tooth is. Sometimes, replacing the metal filling with a white composite filling can help gradually reduce the staining caused by the amalgam filling.

Conclusion

As you can see, there are a variety of ways that root canals can discolor your teeth, but they are usually reversible.

This doesn’t mean that root canals will always discolor your teeth. I had a root canal on a tooth four years ago. I had it filled with a white composite filling and it hasn’t discolored.

In fact, many times a root canal can turn a discolored tooth white again!

Do you have any comments or questions about tooth discoloration due to root canal treatment? I’d love to hear what you have to say in the comments section below. Thanks for reading!

Teeth Whitening and Teeth Bleaching: The Difference

Teeth Whitening

Feb 16, 2011

Teeth Whitening and Teeth Bleaching — ©Lenetstan/Shutterstock.com

When our permanent teeth first come into our mouths, they are nice and white. Not quite as white as our baby teeth were, but they are still a respectable shade of white.

Over time, as we eat different foods our teeth begin to lose their bright white luster. Eventually our teeth’s enamel, the outermost layer of our teeth, develops little tiny cracks in it. These cracks make the tooth more susceptible to becoming a more yellow-brown dark shade.

Darker teeth are generally viewed as less attractive than white teeth. This simple fact often leads many people to try to make their teeth whiter.

The Difference Between Teeth Whitening & Teeth Bleaching

Although the two terms are often used interchangeably, and I confess that I use them interchangeably when explaining the concept of teeth whitening to patients, there is a subtle difference in the way that the FDA defines them that can help you choose the best product for your needs.

Teeth whiteningrefers to whitening teeth back to their natural, white color. Toothpastes are advertised as teeth whitening because they contain abrasives that remove stain from teeth, but most teeth whitening toothpastes do not contain any chemicals that bleach the teeth.

Teeth bleaching refers to whitening teeth beyond their natural white color so that they appear whiter than normal. This is usually accomplished through gels or strips that are applied to the teeth at home or in the dental office.

If you were wondering, the young woman pictured above has undergone teeth bleaching, as her teeth are much whiter than natural and in my opinion they are too white!

Conclusion

If a product claims to whiten your teeth, it may only be able to restore your teeth to their original shade of white. However, if a product claims to bleach your teeth, then it is capable of making your teeth whiter than they originally were when they first came into your mouth.

A product that bleaches the teeth is allowed to use the phrase whitening, but a product that only removes stain from your teeth is notallowed to use the phrase bleaching when referring to their product.

Do you have any questions or comments about teeth whitening or teeth bleaching? I’d love to read them in the comments section below! Thanks for reading!