Tags Posts tagged with "Teeth Whitening"

Teeth Whitening

3
Is Teeth Whitening Not Making Your Teeth Whiter?
©Antonio Guillem/Shutterstock.com

Commercial teeth whitening products have grown exponentially over the last 20 years.  The market has grown so much that even toothpastes want a piece of the action.

If you’d walked down the toothpaste aisle at Wal-Mart 20 years ago, you’d have noticed that “Tartar Control” were the two big buzzwords.

Nowadays, “Whitening” seems to be the best word to put on a toothpaste tube to make it sell.

Learn why your whitening toothpaste isn’t making your teeth any whiter.

The problem with most teeth whitening systems is that it’s often difficult to tell if your teeth are getting whiter since the change can be very gradual.

An Easy Way to Tell If Your Teeth Are Getting Whiter

Tooth Shade GuideOne of the easiest ways to tell if your teeth whitening system is actually working is to simply ask your dental hygienist to grab a tooth shade guide at your next dental visit.  Your hygienist can let you know what shade your teeth are.

Then you can try an over-the-counter teeth whitening system or get a professional-strength whitening gel from your dentist.

At your next visit, have your dental hygienist check your tooth shade again to see if the method you’ve used to whiten your teeth has actually made your teeth any whiter.

What If My Whitening Gel Came With a Shade Guide?

Some teeth whitening systems do come with a shade guide, but these are usually printed on paper.  The shade guide that your dentist uses actually contains tooth-shaped pieces of plastic that allow light to pass through them, similar to your natural teeth.

This shade guide will generally be able to give you a better idea of what shade your teeth are before you start whitening your teeth.

Do you have any questions or personal experiences about teeth whitening that you’d like to share?  Leave them below in the comments section.  Thanks for reading!

4
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 Home Teeth Whitening: Does It 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?

Crest WhiteStips Advanced Seal Professional EffectsI 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!

4
Teeth Whitening Side Effects
©Lucky Business/Shutterstock.com

Did you know that more than half of all people who bleach their teeth end up with sensitive teeth as a result?  It seems like people are willing to go through a lot just to get whiter teeth.  In this article, I’m going to talk about the two main side effects of whitening your teeth: tooth sensitivity and sore gums.

Sensitive Teeth

Teeth Whitening Side EffectsTooth sensitivity is the most common side effect of teeth whitening.  It can range from very mild tooth sensitivity to a sharp, shooting type of pain.  Almost always, the sensitivity goes away within a few weeks and no permanent harm is done to the teeth.  But, in rare cases, irreversible tooth damage can occur according to this page on the American Dental Association’s website.

When I whitened my teeth last year, I ended up with really sensitive teeth and had to stop after a few nights to keep my teeth from driving me crazy!

This study from the American Dental Association found out the following during a study about tooth sensitivity after teeth whitening:

“Fifty-four percent of subjects in both test and controlgroups reported mild sensitivity; 10 percent of test subjectsand 2 percent of control subjects reported moderate sensitivity;4 percent of test subjects and no control subjects reportedsevere sensitivity. Sensitivity decreased with time; by thesecond week, no severe sensitivity was reported, and by thefourth week, no moderate sensitivity was reported.”

How to Stop Sensitive Teeth Caused by Teeth Whitening

There are desensitizing gels available that can be applied to your teeth either before or after whitening your teeth.  These gels contain similar ingredients to those found in toothpastes for those with sensitive teeth.

This study found that using a desensitizing gel before getting your teeth whitened at the dental office actually reduced the amount of tooth sensitivity that a patient experiences.  In the words of the researchers, “The use of a desensitizing gel (5 percent nitratepotassium/2 percent sodium fluoride) before in-office bleachingdid not affect the bleaching efficacy but did reduce tooth sensitivity.”

Your dentist can also give you desensitizing gel if your tooth sensitivity does not seem to be decreasing within a reasonable time after the procedure..

Sore Gums

The second main side effect of teeth whitening is sore gums.  There are a couple of theories as to why you get sore gums with teeth whitening.

Hydrogen peroxide is able to cause chemical burns (much like aspirin) on the inside of your mouth.  One theory suggests that since hydrogen peroxide is present when you whiten your teeth, it can irritate your gums.

Most teeth whitening gels contain carbamide peroxide which ends up breaking down into hydrogen peroxide to whiten the teeth.

Another theory as to why you get sore gums when you whiten your teeth doesn’t have to do with the whitening gel – it is caused by the tray that holds the whitening gel up against your teeth.  The ADA says that “Tissue irritation, in most cases, results from an ill-fitting tray rather than the tooth-bleaching agents.”

How to Stop Sore Gums Caused by Teeth Whitening

If you often have sore gums after you whiten your teeth, you can often solve the problem by getting a tray that fits better.  Dentists can make teeth whitening trays that are custom made to fit your teeth and that hold the gel on your teeth rather than on your gums.  If that doesn’t work, it may be best to take a break from whitening your teeth to keep your gums from hurting.

What to Do If You Develop These Teeth Whitening Side Effects

The dental textbook Sturdevant’s Art and Science of Operative Dentistry states “If either of the two primary side effects occurs (i.e., sensitive teeth or irritated gingiva), the patient should reduce or discontinue treatment immediately and contact the dentist so that the cause of the problem can be determined and the treatment approach modified.  The dentist may prescribe desensitizing agents to help alleviate sensitivity associated with bleaching.”

Conclusion

Although these are the two main side effects, there are other side effects that have been suggested such as:

  • Nausea
  • Sore Throat
  • TMJ disorder due to tray usage
  • Alteration of the normal bacteria leading to taste-bud enlargement
  • Oral infection

If you experience any of these side effects associated with teeth whitening, get in touch with your dentist to get more information on your individual situation.  Sometimes having pearly whites is not worth the discomfort and possible damage to your teeth!

Have you ever had any of these teeth whitening side effects?  What happened?  I’d love to hear your stories, comments, and questions in the comments section below.  Thanks for reading!

84
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

Pink Rubber Dental Dam1 – 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!

2
Products with American Dental Association Seal
©Natalia Gaak NWH/Shutterstock.com

Not many people are aware that the American Dental Association keeps an updated list on their website of all of the dental products that have received the ADA Seal of Acceptance.

You can view and print the entire list of ADA Accepted dental products here in PDF format.

When people think of the ADA Seal, the first product category to come to mind is usually toothpastes.  However, the toothpaste category came in second place.  There are more than twice as many mouth rinses than toothpastes that carry the ADA Seal.

Below you can find a list of all the categories and how many products in each category have received the ADA Seal of Acceptance.

The 15  Categories of Dental Products that carry the ADA Seal

ADA Seal of Acceptance1 – Mouth Rinses.  143 different brands of mouthwash qualified for the ADA Seal.

2 – Toothpastes.  65 toothpastes currently carry the ADA Seal.

3 – Fluoride Mouth Rinses.  44 brands of fluoride mouthwashes qualified for the ADA Seal.

4 – Toothbrushes.  34 different toothbrushes received the ADA Seal.

5 – Floss.  30 different brands of floss qualified for the ADA Seal.

Even if you’re using ADA approved floss, you can still make these 10 mistakes when you floss.

6 – Chewing Gum.  5 different brands of chewing gums qualified for the ADA Seal.

7 – Fluoride Gels.  4 brands of fluoride gel qualified for the ADA Seal.

8 – Denture Adhesives.  3 denture adhesives qualified for the ADA Seal.

9 – Water Filters.  2 water filters carry the ADA Seal of Acceptance.  I wondered why a water filter would get the ADA Seal.  It turns out that the PUR water filters reduce levels of contaminants in water while not reducing the level of tooth-protecting fluoride.

10 – Canker Sore Pain Relief Ointments.  2 canker sore pain relief ointments qualified for the ADA Seal.

11 – Plaque Disclosing Mouth Rinses.  Only 1 plaque disclosing mouth rinse, Listerine Agent Cool Blue Tinting Rinse, qualified for the ADA Seal.  Unfortunately, I don’t think it was deserved as Listerine Agent Cool Blue does not disclose plaque; it simply tints all of the teeth blue.

To see what my teeth looked like after rinsing with Listerine Agent Cool Blue, read the article Listerine Agent Cool Blue Doesn’t Disclose Plaque.  If you want to find plaque disclosing solutions that actually show you where the plaque is on your teeth, read the article How Plaque Disclosing Tablets Can Help You Brush Better.

12 – Denture Pain Relief Ointment.  Only 1 denture pain relief ointment, Benzodent Analgesic Denture Ointment, qualified for the ADA Seal.

13 – Emergency Tooth Preservation Products.  Only one product got the ADA Seal in this category, Save-A-Tooth.

To learn more about how to use the Save-A-Tooth System, read the article What to Do When Your Permanent Tooth Gets Knocked Out.

14 – Interdental Cleaners.  Only one brand of interdental cleaners, Stim-U-Dent Plaque Removers, qualified for the ADA Seal.

15 – Dentist-Dispensed Teeth Whitening Gels.  Only 1 brand of teeth whitening gel, Opalescence Whitening Gel 10%, qualified for the ADA Seal of Acceptance.

Does the ADA Seal Mean Everything?

As I stated above, there are many great plaque disclosing tablets/solutions that don’t have the ADA Seal while the one that does only tints your teeth without showing you where the plaque is!

Usually the ADA Seal indicates that a product actually does what it is supposed to do (is effective) and is safe.  You can read more about the ADA Seal in this previous article: The ADA Seal of Acceptance: Everything You Need to Know.

Do you have any questions, comments, or concerns about the ADA Seal or products that have received it?  I’d love to hear what you think in the comments section below.  Thanks for reading!

Why Your Child Has a Dark Tooth
©Tatyana Vyc/Shutterstock.com

If you have kids, you know that they can get themselves into a lot of interesting accidents.  Many times when kids get a head injury they knock out a tooth.  Other times, they simply hit the tooth really hard and injure it.

It has been estimated that 8-30% of kids under 7 suffer an accident that injures one of their baby front teeth.

Dark Tooth - Tooth DiscolorationAny time a tooth suffers an injury, there is a possibility that it may turn a different color.  If you’re wondering what it means if your child’s tooth has turned pink, red, gray, black, brown, or yellow, then you’re the reason I wrote this article!

Tip – I will use words like pulp, dentin, and enamel in this article. If you don’t know what those mean, you might want to brush up on The Anatomy of a Tooth.

When Your Child’s Tooth Turns Dark (Gray, Brown, or Black) After a Tooth Injury

When blood leaks out of blood vessels after a tooth injury, blood by-products such as iron can make their way into the small tubes inside the dentin layer of the tooth.  As the blood breaks down, it can make the tooth appear to be gray, dark gray, brown or even black.  This color change doesn’t usually occur until 2-3 weeks after the tooth has been injured and can occur after a tooth has turned red (see below.)

The book Paediatric Dentistry by Welbury states that “although the reaction is reversible to a degree, the crown of the injured tooth retains some of the discoloration for an indefinite period.  In cases of this type, there is some chance that the pulp will retain its vitality, although the likelihood of vitality is apparently low in primary teeth with dark gray discoloration.”

Basically, the author is stating that even if a tooth has a dark color, it may still be able to return to health.  Some experts have said that the darker the discoloration, the more likely it is that the nerve of the tooth has died.  For example, this study “found that 33 of 51 traumatized teeth with gray-black discoloration were necrotic.”  However, other experts state that the shade of darkness doesn’t reflect the health of the pulp.

If your child’s tooth has turned dark, the best thing to do is to have your child’s dentist look at it.  If there are other signs that the tooth is dead such as swelling or an infection that shows up on the x-ray, then your child’s dentist will probably choose to do something about it such as performing a root canal treatment or removing the tooth.

If there is no sign of infection in a dark tooth, the dentist may choose to not do anything and let the tooth eventually fall out on its own when the permanent tooth is ready to take on its role in the mouth.  A study by Sonis showed that 72% of darkened teeth fell out normally without any bad effects on the permanent tooth.

Also, if there are no other signs of infection, this study showed that there is no need to do a root canal.  The researchers concluded that “Root canal treatment of primary incisors that had change their color into a dark-gray hue following trauma with no other clinical or radiographic symptom is not necessary as it does not result in better outcomes in the primary teeth and their permanent successors.”

When Your Child’s Tooth Turns Red or Pink After a Tooth Injury

If a tooth is going to turn red after an injury it can turn red shortly after the injury, or it can wait anywhere from a few weeks to months before it begins to turn a pinkish red color.

Red and Pink Teeth Immediately After the Injury

If a tooth turns red shortly after being traumatized, it usually means that the blood vessels inside the pulp broke.  When the blood vessels rupture, blood leaks inside the whole pulp area of the tooth resulting in a reddish pink color.  This condition is known as pulpal hyperemia.

Sometimes pulpal hyperemia is difficult to detect.  You may have to shine a light on your child’s tooth and look at the tongue side of the tooth with a mirror to detect this color change.

The pink/red color may take a long time to go away or it may never go away and the tooth may start to darken to a shade of gray.

Red and Pink Teeth Weeks after the Injury

As a result of trauma, sometimes cells inside the tooth start eating away at the hard layers of the tooth through a process called internal resorption.  These cells are called odontoclasts and in certain cases they can eat away to the outside of the tooth within a few short weeks.  The tooth looks pink because as the pulp layer of the tooth gets bigger, its red color more easily shines through the thin layer of remaining tooth structure.

A man named James Howard Mummery first noticed this “pink spot” that appears on teeth, which is why it is typically referred to as pink tooth of Mummery.  Pink tooth of Mummery can start occurring anywhere from a few weeks to months after a tooth is injured.

These teeth are usually kept until the crown of the tooth is dissolved.  Then the tooth root can either be removed or it can be left to get dissolved spontaneously as the permanent tooth comes into your child’s mouth.

When Your Child’s Tooth Turns Yellow After a Tooth Injury

The dentin layer of a tooth under the enamel is normally a yellow color.  If a tooth reacts to an injury by laying down a lot more dentin, it is known as pulp canal obliteration (Also called calcific metamorphososis, progressive canal calcification or dystrophic calcification.)

The increase in the amount of dentin and the concurrent decrease in the amount of pulp gives the tooth a yellow, opaque color.

The book Pediatric Dentistry by Pinkham states that “although pulp canal obliteration is a pathologic process, it has no known deleterious effects and therefore does not necessitate any treatment except follow-up.”

It is important to regularly follow-up with your child’s dentist about any teeth that have turned yellow after an injury.  The book Paediatric Dentistry by Welbury notes that “a small percentage [of yellow teeth] demonstrate pathologic change many years after the injury.”

Conclusion

Many times parents want to rush treatment when their child’s tooth changes color.  It is important to understand that “in the primary dentition of a healthy child, color change alone does not indicate a need for pulp therapy or extraction of the tooth (Pinkham.)”

Basically, if your child’s baby tooth has changed color, often the best treatment is no treatment.  As long as an infection doesn’t develop, simply waiting it out and seeing what happens could mean that your child doesn’t have to go through unnecessary dental treatment.  And that’s a good thing, especially after they’ve already been through a traumatic tooth injury.

Do you have any stories, questions, or comments about tooth discoloration?  Do you still have a question that I didn’t answer?  Feel free to write your thoughts in the comments section below so that we can all learn from each other – Thanks for reading!

Submitted Photos

Krista from The Muminator blog shared the following photos of her daughter after she had an accident in 2012:

Here’s a photo not too long after her daughter was playing on the furniture and fell:

Dark Tooth Following Traumatic Accident

Here’s a photo a few weeks after that.  The tooth continued to get darker:

Dark Tooth Continues to Get Darker Following Accident

And a final photo of the tooth returning almost back to its normal color:

Dark Tooth Getting Light Again Following Accident

You can read all about her daughter’s experience on this thorough blog post that she wrote about the entire experience.

The following photo is from Jennifer, who has left some very informative comments below regarding her daughter’s dark tooth.  She states:

Its not white completely but is a lot better than what it was… The left side of the photo is around 3-4 weeks after the trauma.. and the right side of the picture was taken a few days ago, around 8 weeks after the trauma, It has also moved back into alignment a bit more as well, as it was knocked back with a blunt blow.
Dark Tooth Turned White Again

If you have a photo of your child who had an injury that caused a tooth to discolor, please send them to me using this form and I can post them here to help others who are going through this same experience.

9
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

Teeth Whitening or 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!

195
Baby Teeth and Adult Teeth Differences
©Timothy W. Stone/Shutterstock.com

Have you ever noticed that baby teeth look like they’re whiter than adult teeth?  Or maybe you knocked out a baby tooth when you were a child, but when you had a similar accident when you were older, your permanent tooth got chipped rather than getting knocked out.

The two scenarios above can be explained by the differences between adult and permanent teeth.

Baby Teeth and Permanent Teeth Comparison

There are many differences between baby teeth and permanent teeth, but before I get into all of the differences, take a look at the photo above of the little girl swimming.

Now, take a closer look at her teeth in the photo below:

Baby Teeth and Permanent Teeth Comparison

In the picture to the left, there are six permanent teeth that are visible.  Can you spot them?

They are the two top front teeth, the two bottom front teeth, and the two molars on the bottom in the very back of her mouth.

These permanent teeth stand out in more ways than one.  I’ll cover all these differences between baby teeth and permanent teeth below.

As you read, feel free to refer back to this picture to get a visual representation of some of the more noticeable differences that I talk about below.

The Differences Between Permanent Teeth and Baby Teeth

1 – The enamel and dentin are thinner in baby teeth, and the pulp is bigger relative to the rest of the tooth. This means that if your child gets a cavity, it will travel much faster to the nerve of the tooth. This is one more reason why it’s important to take your child to the dentist before they turn one year old and get routine checkups thereafter.

Not sure what enamel, dentin, and pulp are?  Read my previous article about the anatomy of a tooth.

2 – Permanent teeth are more yellow than baby teeth. Take a quick look at the picture above and you’ll see that the six permanent teeth that are visible  don’t look nearly as white as the other baby teeth.

3 – Baby teeth have shorter roots – because of this they aren’t anchored as well into the bone and may fall out more easily if your child falls on a hard step or hits their mouth on the coffee table.  The shorter roots also give the permanent teeth more room to develop underneath the baby teeth and make it easier to dissolve the roots of the baby teeth when the permanent teeth are ready to come into the mouth.

Find out what to do when a baby tooth gets knocked out.

4 – Baby teeth fall out – If you take good care of your adult teeth you can keep them for your entire life.  Just because baby teeth fall out, it doesn’t mean that they aren’t important.  If you’ve been staying up late at night pondering this question, click the following link to find out why baby teeth are important.

5 – Permanent teeth have mamelons.  Mamelons are the small bumps that give the permanent incisors a serrated look when they first come into the mouth.  If you look closely at the girl in the picture above, you can see the little bumps on the edges of her four permanent front teeth.  Mamelons quickly wear away as long as the teeth fit together properly.

Learn more about what mamelons are and what to do if you still have them as an adult.

Conclusion

As you can see, there are definitely some differences between adult and permanent teeth. These differences can not only affect the appearance of the teeth, but can also affect what happens to a tooth when you suffer an injury to the mouth.

Do you have any questions about baby teeth or permanent teeth? I’d love to hear what you have to say in the comments section below! Thanks for reading.

9
Ingredients in Toothpaste
©Ruslan Guzov/Shutterstock.com

Ever since antifreeze chemicals were discovered in toothpaste produced in China several years ago, people have been increasingly concerned about the ingredients found in toothpaste.  Luckily, anti-freeze is not found in toothpaste sold in the United States as it is illegal.

Toothpaste consists of several different ingredients that leave our teeth feeling fresh and clean.

So if you’ve ever wanted to know what’s inside that gooey paste that you smear against your teeth everyday, read on.

Toothpaste on a Toothbrush

The Ten Main Ingredients In Your Toothpaste

1 – Fluoride

Fluoride is the only active ingredient found in all toothpastes.  It wasn’t until about 50 years ago that fluoride was first added to toothpastes.  Fluoride only makes up about 0.15% of most toothpastes, although prescription-strength fluoride toothpastes contain more than 1% of fluoride.

To learn why fluoride is so important, read about the three ways fluoride protects your teeth.

2 – Abrasives

The abrasives found in toothpastes are what help scrape the plaque off of our teeth.  I think it’s important to mention that many whitening toothpastes contain too many abrasives, which can wear down the enamel or cementum on your teeth and cause your teeth to be sensitive.

Read this article to learn why whitening toothpaste isn’t making your teeth any whiter.

Some examples of abrasives in toothpastes are mica, calcium carbonate, calcium pyrophosphate, dicalcium phosphate, sodium bicarbonate, and hydrated silica.  The mineral mica not only acts as an abrasive, but can add an exciting glitter effect to toothpaste, making the urge to brush almost irresistible!

3 – Detergents

Detergents make people feel like the toothpaste is working by creating bubbles and making the toothpaste foamy.  The main detergent in toothpaste is known as sodium lauryl sulfate (SLS.)  Some researchers believe that sodium lauryl sulfate causes canker sores, but that’s a topic I’ll discuss in a future article.

4 – Flavors

Flavors are added to most toothpastes.  Some common flavors are bubblegum, fruit, mint, and cinnamon.  The purpose of the flavors are to mask any unpleasant tastes in the toothpaste and they can also help to freshen your breath by masking the bad odors in your mouth.

5 – Moisturizers and Humectants

A humectant is something that keeps a substance moist.  Humectants in toothpaste are what keep the toothpaste nice and smooth and help keep it from drying out.  Some commonly-used humectants are glycerin, sorbitol, and water.

Toothpaste Ingredients

6 – Antibacterial Agents

Certain toothpastes contain Triclosan, which is an antibacterial and antifungal agent.  It is commonly found in antibacterial soaps.  Not too long ago, Colgate started adding it to its toothpaste to create the Colgate Total brand that claims to protect teeth from plaque for up to 12 hours.

7 – Preservatives

Preservatives are added to toothpastes so that microbes don’t grow in the toothpaste and spoil it.  It would probably be frustrating if you had to refrigerate your toothpaste — especially if you have teeth that are sensitive to cold temperatures!  Thanks to preservatives, toothpaste is safe for many months at room temperature.

8 – Colors

Colors can give toothpaste an attractive appearance.  When I was a teenager, I remember my mom had bought some “natural” toothpaste.  Being a toothpaste junkie, I decided to try it just for fun to see how it worked.  It was a dark brown color and looked pretty gross and tasted even worse.  I never used that toothpaste again.  A little bit of color could have gone a long way in improving that toothpaste!

9 – Sweeteners

Toothpastes usually contain a substance to make them taste sweet so that we enjoy brushing.  Most toothpastes contain saccharin, aspartame, or xylitol to add a bit of sweetness.

10 – Thickeners

In case the toothpaste is too runny, manufacturers can add ingredients that thicken the toothpaste to form a nice, smooth consistency.  Carageenan and xanthan gum are common thickeners added to toothpastes.

Bonus Ingredients

Those are the main ingredients in toothpaste.  However, some special formulations of toothpaste can include other ingredients such as the ones listed below:

Conclusion

Toothpaste requires many ingredients to work the way it does and to have the appearance and taste that it does.  The ingredients I have listed are those common to toothpaste sold in the United States, however international brands may vary.  If you know of any ingredients I missed or have any questions or comments, I’d love to hear about them below.

Thanks for reading!

20
Dental Fluorosis Stains Teeth Chalky White
©Dozenist/Wikimedia Commons

Dental fluorosis happens when children swallow too much fluoride before their teeth have finished forming (usually before age 8.)  It was actually dental fluorosis that led researchers to eventually find that small amounts of fluoride can be beneficial for the teeth.

Dental fluorosis can range in severity from mild to severe.  The mild form appears as white specks on the teeth, as seen in the picture below.

Dental Fluorosis

The severe form of fluorosis is usually brown in color as seen in the picture below:

Severe Dental Fluorosis

It also looks like that person in the above picture has some cavities (the black spot on the tooth in the upper left of the picture and the other gray/white areas near the gumline)

Causes of Dental Fluorosis

Dental fluorosis is caused by swallowing too much fluoride.  This can happen in a number of ways, including:

  • Children being prescribed unnecessary fluoride supplements by their dentist (it does happen!)
  • Swallowing too much toothpaste when brushing
  • Babies drinking infant formula mixed with fluoridated water

How to Prevent Dental Fluorosis

You can reduce the risk that your child will get dental fluorosis by doing the following:

  • Not giving your child fluoride supplements if your child is not at risk for cavities
  • Using a fluoride-free  “training” toothpaste until your child can spit out all of the toothpaste when they’re done brushing
  • Mix infant formula with water that does not contain added fluoride

Conclusion

Dental fluorosis is a preventable condition.  By monitoring your child while they brush their teeth and taking steps to prevent unnecessary exposure to fluoride for your children, you can avoid this problem.  Remember, an ounce of prevention is worth a pound of cure!

Do you have any questions about dental fluorosis?  Please leave your questions and comments below and I’ll get back with you.

Tetracycline Teeth Staining Cause and Treatments
©Gordana Sermek/Shutterstock.com

When I was a little boy, I remember seeing my brother in the bathroom trying to bleach his teeth.  He tried many different formulations of bleaching agents to try to remove the staining on his teeth.

Tetracycline Teeth StainingI asked him about it recently, and he told me he wasn’t sure how it happened.  We suspected that my mom unknowingly took some sort of antibiotic that stained his teeth when she was pregnant with him or that he had taken something as a kid.  He couldn’t remember.

Tetracycline Teeth Staining Close-Up ViewThen, I called my mom.  She said that she didn’t take anything during her pregnancy and the discoloration came from a drug that was prescribed to him at a young age.  Whatever the reason, nobody likes to have discolored teeth.

To the right is a close-up view of the same patient in the photo above.  As you can see, the tetracycline has changed the color of his teeth.

Tetracycline Tooth Staining

Tetracycline can stain the teeth anywhere from a bright yellow shade to dark brown.  Usually the staining starts out as a yellow color.  Over time, as the tooth is exposed to light, a chemical reaction occurs and the yellow turns to a dark brown color.  For this reason, many people with tetracycline tooth staining have brown teeth in front (the teeth that are exposed to the most light) and yellow teeth in the back (where not as much light reaches.)  Under ultraviolet light, tetracycline staining can appear bright yellow.

However, it’s not just tetracycline that stains the teeth – there are many other drugs as well.

Other Drugs That Cause Staining of Teeth

Many of tetracycline’s homologues (similar drugs) are all associated with discoloration.  Chlortetracycline, demethylchlortetracycline and oxytetracycline can all cause brown/gray/yellow staining of the teeth.

Ciprofloxacin is an antibiotic that can be given intravenously to infants for treatment of a Klebsiella infection.  It can stain the teeth a green color, but the staining is usually more mild than tetracycline staining.

Minocycline hydrochloride is an antibiotic used to treat acne and rheumatoid arthritis.  It is believed that minocycline binds to the tooth and then oxidizes it, producing a discoloration.  Minocycline is able to stain teeth even after they are fully developed, unlike the tetracycline family of antibiotics and ciprofloxacin.

Prevention

Tetracycline can cross the placental barrier and incorporate into the developing tooth.  It should be avoided (if possible) by mothers who are pregnant and also in kids until they are at least seven or eight years of age.

The book Oral Pathology: Clinical Pathologic Correlations by Regezi says the following about how tetracycline staining is caused:

Because tetracycline can cross the placenta, it may stain primary teeth if taken during pregnancy. If it is administered between birth and age 6 or 7 years, permanent teeth may be affected. Only a small minority of children given tetracycline for various bacterial diseases, however, exhibit clinical evidence of discoloration. Staining is directly proportional to the age at which the drug is administered and the dose and duration of drug usage.

Since there are many other antibiotics available that are as effective as tetracycline without the discolored teeth as a side-effect, tetracycline is usually not prescribed to children except in rare circumstances.  Your doctor will be able to explain the reasoning if your child is ever prescribed tetracycline.

Treatment of Tetracycline Stained Teeth

It is very difficult to treat internal staining of teeth because it affects the dentin layer underneath the enamel.

For an overview of the layers of the teeth, check out this article on the anatomy of a tooth.

There are a variety of ways to treat tetracycline stained teeth depending on the severity of the staining.  The most conservative is bleaching the tooth.  If the tooth has undergone root canal treatment, it may be more effective to use an internal bleaching technique where the dentist puts a bleach inside the tooth to bleach it from the inside out.  Internal bleaching is not possible with teeth that have not undergone root canal treatment because there is still living pulp inside the tooth where the bleach would be put.

If bleaching doesn’t work, there are more invasive treatments.  The dentist can shave off the outer layer of the tooth and put an aesthetically-pleasing tooth-colored filling on the front-facing surface of the tooth.

Another treatment option is putting veneers (a thin layer of tooth-colored porcelain) over the teeth.

The most drastic treatment would be to cut around the whole tooth and put an aesthetic crown over the tooth.  This may end up being the most aesthetic option for severe tetracycline-stained teeth, but it is also the most expensive.  I believe my dental school would charge somewhere around $500 for this procedure, which means it is probably near $1,000 if you get it done in private practice.

Conclusion

I hope this article helped you to better understand why antibiotics stain the teeth and what you can do to prevent it.

Are your teeth stained due to a medication such as tetracycline?  Have you done anything about it?  Don’t hesitate to share your experience in the comments so others who have the same problem can see what worked for you.

If you have any questions or comments, go ahead and leave those in the comments section below as well.  Thanks for reading!

I want to thank Dr. James R. Donley, DDS for kindly allowing me to use his photos (the bottom two photos) in this article.

0
Teeth Whitening Defective Gel
©Kurhan/Shutterstock.com

Today, I watched a news report about a teeth whitening scam company called White Overnight. The news report was able to uncover some interesting facts about what this company does.

White TeethI have embedded the news report below, at the end of this article. Here’s some of the things that the Channel 2 News special investigative report uncovered:

  • The whitening trays that are included are bulky and do not form to the teeth very well. This type of tray has trouble holding the whitening gel right up to the teeth so the whitening isn’t very effective. Also, it can push the whitening gel onto the gums, which can cause a harmful burn. Finally, the whitening tray didn’t even fit on the new reporter’s back teeth, it was too short
  • The whitening system costs over $100 every two months. For the same results, you could just get a professional whitening from your dentist. This is potentially more safe since all of the whitening materials would be coming from reputable sources.
  • Although the gel claimed to contain 35% carbamide peroxide, a lab tested the gel that White Overnight shipped out and found that it contained only 14% carbamide peroxide. That’s two and a half times less than the advertised amount. This makes the gel weak and the whitening less effective.
  • The news reporter tried out the White Overnight system and even used a shade guide from a cosmetic dentist’s office to benchmark his results. Unlike the promises in the advertisement, he found that his teeth didn’t get much whiter after a week. However, the CEO of White Overnight seemed to think that the reporter’s teeth were pretty white!
  • The CEO’s of this teeth whitening scam company weren’t even trained in the dental field. They are former Los Angeles rockstars. Perhaps customers who want to whiten their teeth would be better served by those who have been trained in the care and maintenance of the oral cavity.
  • Although White Overnight claimed that their teeth whitening gel is approved by the FDA, the FDA groups teeth whitening gels with cosmetics and does not regulate them.

Teeth Whitening Scam Company Investigative Report Video

Here’s the video from Channel 2 News:

What do you think of these teeth whitening scam companies? Share your comments below!

96
Teeth Whitening Scam Lawsuit
©Zimmytws/Shutterstock.com
Teeth Whitening Scams: Their Advertisements
I found this block of ads today while browsing a popular news site. While I can’t speak for the nice mortgage rates, the top two ads both link to teeth whitening scam sites.

You’ve probably seen their advertisements online.  If not, I put some examples to the left.

They all go by different names, like Everbrite, Celebrity Smile, Celebrity White Smile, Dentasmile MD, Idol White, Clean Whites, and many more.  However, they have one thing in common.  They lure the customer in with a “Free Teeth Whitening Trial.”  Once you order, they start charging sometimes hundreds of dollars per month to keep sending you out a small supply of teeth whitening gel each month.

Fortunately, there is now a lawsuit against one of these companies known as Clean Whites.  If you take a look at the Clean Whites website, you will see that they are no longer accepting new orders, but they do say that they are continuing to “serve” their existing customers.  By “serve”, I assume they mean “charge their credit cards.”

If you don’t know how these companies work, I wrote about them a few weeks ago in an article called Yes, the $3 Online Teeth Whitening Offer Is a Scam.

What the Teeth Whitening Scam Lawsuit Means

Hopefully, with the filing of this lawsuit by the Florida Attorney General in the Broward County Circuit Court, there will be more publicity surrounding all of these similar teeth whitening scams.

The Florida Attorney General is asking for restitution to the Clean Whites customers that were ripped off.  Also included in the lawsuit is an injunction that will prohibit the owners of Clean Whites from starting similar companies to take advantage of people who simply want a good deal on teeth whitening products.

The Miami Herald states:

Complaints accuse owners…of billing customers’ cards up to $90 a month, similar to the results of a state investigation of the company. The suit accuses the pair of using misleading advertising and deceptive trade practices, among other issues.

You may also wish to view a similar article from South Florida’s Sun Sentinel newspaper.

Hopefully this lawsuit will succeed and we will see a reduction in these teeth whitening companies.

Of course, a successful lawsuit won’t mean the end of all scams, but it will hopefully make a difference in the lives of a few people who otherwise would have been conned into signing up for an unwanted monthly subscription to a teeth whitening service.

Is it Really a Scam?

My original article on these scams got a comment recently that made me think about this issue.  Here’s what Grant said:

Why do you call these sites a scam? People have eyes, they can read the screen. They know what they are buying. If they are dumb enough to think that the companies will just give away their product without making any money then they deserve what’s coming to them. Just a thought.

In my opinion, it is a scam.  A scam is when people intentionally being ripped off.  People who bought into the free trial of teeth whitening products simply wanted a good deal.  After all, that’s what the advertisements promised.  I’m sure nobody wanted to be billed a few hundred dollars for a “subscription activation” fee and hundreds of dollars a month to receive teeth whitening products.

In order to show that this is a scam, let’s compare this service with another service, cell phones.  Let’s say someone walks by a cell phone kiosk in a mall and wants to get a new phone.  They see an enticing advertisement that offers a “free” telephone with a two year service agreement.  This makes sense to the customer because they know that in order to give away the phone, the cell phone company has to make up their loss in the form of subscription fees.  It also costs them to provide mobile phone service to the customer.

The customer is satisfied paying a monthly fee because they know they are getting something of value each month.  The cell phone companies even make this monthly fee very clear by forcing the customer to choose a monthly plan and compare and contrast the different plans.

However, with this teeth whitening scam, the companies deceive the customer by acting like they are simply giving away the teeth whitening gel and pretending to only need credit card information to pay for shipping and handling.  In fine print, they do mention that they will be charging the customer hundreds of dollars each month.  This is where the scam begins.  Unlike the cell phone company, the teeth whitening companies are not offering a value to their customers.  They are charging many times more than what the product is worth, hoping to snare a few customers into their trap.

Comparing Teeth Whitening Scams to a Subscription Fruit Model

How would you feel if you went to the grocery store to buy a peach.  You pay with your credit card and sign the slip.  You failed to notice that on the credit card slip, you were signing up to an peach subscription agreement.  The agreement states that everyday for the next month, a peach will get delivered to your mailbox.  The grocery store charges you $19.95 per delivery.  Before you know it, you’ve racked up a $600 bill in a month’s time.

That grocery store would most likely face lawsuits and go out of business for their deceptive business practices.

This is exactly how these teeth whitening scams operate, and I think it’s unethical.  Do you?

5
Visit Dentist Before Teeth Whitening
©Ermolaev Alexander/Shutterstock.com

Everyone wants white teeth.  Let’s face it, a beautiful smile makes almost everyone more attractive!

Beautiful White SmileBut before you call the number on the latest infomercial at visit the teeth whitening kiosk at your local mall, you may want to visit your dentist.

Here are six reasons why:

1. You may have dental problems that you don’t know about. It is best not to whiten your teeth until your mouth is healthy.  Whitening a tooth that has reversible pulpitis (a reversible irritation of the dental pulp), for example, could irritate the dental pulp sufficiently to push that tooth over the edge requiring a costly root canal treatment.

11
Whitening Toothpaste Not Working
©Lana K/Shutterstock.com

Many people buy so-called “Teeth Whitening” toothpaste hoping to get whiter teeth.  For many people, these toothpastes do not provide whiter teeth.  Is this a form of false advertising?  Actually, it’s not.

ToothpasteThe confusion lies in the definition of teeth whiteningTeeth whitening in its strictest sense means to whiten the teeth to their natural shade.  Teeth bleaching, on the other hand means to whiten your teeth beyond their natural shade.

The reason there is so much confusion is because the phrase teeth bleaching isn’t very attractive.  So, companies that offer teeth bleaching, have started to refer to it as teeth whitening to make it more attractive to the average consumer.

In order for a toothpaste, mouthwash, or gum to be certified by the ADA as tooth whitening, it simply has to be able to remove surface stains off of your teeth.

How Teeth Get Stained

When our permanent teeth come in, they are a shiny white color.  However, as we grow older (and eat lots of teeth-staining foods), our teeth get more and more yellowish-brown.  Teeth Whitening toothpaste can remove tobacco stains, coffee stains, and other stains that we get as we go through our everyday lives.

Unfortunately, tooth whitening toothpastes can only return our teeth back to their original color. The toothpaste contains very gentle abrasives that rub against the stain and gradually remove it.

Why Teeth Whitening Toothpaste May Not Whiten Your Teeth

If you don’t drink coffee much or chew tobacco, there’s a good chance that your teeth aren’t stained at all.  In this case, if you use tooth whitening toothpaste, you probably won’t notice a difference in how white your teeth are.

Also, in the last ten years, it seems that all toothpastes are “teeth whitening”.  Chance are, you’ve already been brushing with “tooth whitening” toothpaste.  Continuing to brush with “tooth whitening” toothpaste isn’t going to make your teeth any whiter since you’ve already removed the stains with previous tubes of “teeth whitening” toothpaste.

How to Whiten Your Teeth

If you truly want whiter teeth, you will probably want to use a form of teeth bleaching.  Teeth bleaching is designed to whiten your teeth beyond their natural shade.

You should talk to your dentist about teeth whitening options such as in-office gels, Zoom teeth whitening, and take-home teeth whitening gels.

Have you been trying to get your teeth white with toothpaste?  Let us know in the comments.

119
Teeth Whitening Trial Offer Scam
©Scyther5/Shutterstock.com
Tooth Whitening Scam Advertisements
Are These Ads Legitimate or Scams?

Lately, it seems as if half of the advertisements on major news websites are advertising a cheap or free tooth whitening trial.  A lot of these offers sound too good to be true.  In response to a question posed to me by a reader, I decided to look into these offers that claim to charge only $1 to $3 in shipping for a month’s worth of tooth whitening supplies.

If they only charge for shipping and handling, I wondered how on earth they were paying for all of the advertisements that they’ve plastered on half of the internet.

After clicking on one of these ads, I came to a page that told me a nice story about a mom who discovered an amazing tooth whitening “trick.”  Here’s the problem: the story is a lie.