If a glance in the mirror reveals stained or discolored teeth that are detracting from your self-confidence, it's time to do something about it. The first step is to make an appointment for an office visit to find out how we can help you.

External (extrinsic) stains that form on the surfaces of teeth are usually caused by beverages such as red wine, tea, coffee as well as unhealthy habits like tobacco use. Extrinsic stains generally come in shades of browns, black or grays, but may even be orange or green from color producing bacteria.

Internal (intrinsic) stains are part of the structure of the tooth and cannot be removed by polishing. Among their causes are excessive fluoride levels or tetracycline antibiotics given in childhood and during tooth formation. Teeth do become more yellow and discolored as we age. Discoloration of individual teeth may be indicative of tooth decay, or teeth that have had root canal treatment and have literally lost their vitality tend to darken over time. Internal discoloration comes in a variety of shades and hues from yellows, grays, browns, and even some reds or pink.

Five Ways to lighten, whiten and brighten stained or discolored teeth

1. Change your habits. Reduce or stop consuming or using foods, drinks or tobacco if they are staining your teeth.
2. Improve your daily oral hygiene. Make sure to brush your teeth well, twice a day. Change to a toothpaste that contains a mild abrasive. Some toothpastes also contain tooth whiteners.
3. Visit our office for a professional cleaning and polish. Routine scaling and polishing will remove most superficial external stain and discoloration. Sometimes ultrasonic cleaning (by high frequency vibration) and polishing with slightly abrasive pastes may just do the trick.
4. Treatment for internal stain and discoloration. Brown colored decaying teeth need to have the decay removed and the teeth restored. Stained old and leaking fillings may also need to be replaced.
5. Tooth whitening by bleaching. Bleaching or tooth whitening is a safe and effective way to brighten stained teeth. Internal tooth bleaching can whiten even discolored root canal treated teeth. Ask us for more information about this technique.

If your mirror tells you that your smile needs attention, there's no time like the present to get started. Get back your bright, white smile and your self-confidence as well.

Contact us today to schedule an appointment to discuss your questions about tooth staining and its treatments. You can also learn more by reading the Dear Doctor magazine article “Tooth Staining.”

What causes stains on teeth?

Staining can occur on the outside surfaces of teeth and is caused by foods such as red wine, coffee, and tea, as well as by tobacco use. They can also be developmental, affecting the structure of the teeth due to excessive fluoride levels or from tetracycline antibiotics given during childhood to name a few. Changes in a tooth's enamel or dentin during tooth formation, or as teeth age, can also cause discoloration.

What is going on inside a tooth's structure that makes it look stained?

Most of a tooth's covering (95 percent) is composed of highly mineralized enamel. The crystals of enamel are contained in a framework, or matrix, of organic matter. Dentists believe that various organic compounds that get into this matrix can cause staining.

How do whiteners work?

Tooth whiteners or bleaches expose the teeth to a peroxide compound. This creates reactive oxygen that breaks down highly colored organic compounds within the tooth's sub-surface matrix, making the tooth look whiter, but without changing its internal structure.

What professional in-office whitening techniques are available?

During treatment, a high concentration of peroxide solution in the form of a gel is applied directly on the teeth, often with activation by a heat or light source. These systems use custom tailored trays fitted to an individual's mouth. Silicone barriers or protective gels are used to keep the peroxide gel away from the gums or sensitive membranes in the mouth.

How are professional home whiteners different?

Home whiteners involve a less concentrated solution of peroxide in a gel form. It is delivered to the tooth surface by a bleaching tray that is custom-made in your dentist's office. Over-the-counter whiteners such as whitening strips or paint-on formulas can also be used, but they take longer and they're not as effective — the more diluted solutions are used for safety.

Can toothpastes really whiten teeth?

Mild abrasives in toothpastes clean surface stains but cannot change the underlying tooth color or remove significant staining.

How long do the results last?

Usually, the results last from six months to two years, but effects will diminish over time. You can make them last longer by avoiding the foods and habits that cause staining.

Are teeth whiteners safe to use?

Teeth whitening products are safe if used according to our recommendations or the product manufacturer's directions. Peroxide products may be toxic if used in excess of recommended intervals and amounts.

Read more about teeth whitening in the article “Teeth Whitening, Brighter, Lighter, Whiter...” Contact us today to schedule an appointment or to discuss whether tooth whitening is right for you.

If you are pleased with your smile except for that one front tooth that appears darker, then we have good news for you. Often a tooth appears darker as a result of trauma that may have occurred years ago. Your tooth may need root canal treatment or may have already had root canal treatment in the past. Regardless, you can whiten this tooth via a process called internal bleaching. And as the name suggests, the tooth can be bleached from the inside out. Here's a brief summary of how this entire process works:

1. Performing an x-ray exam: The first step is to take a radiograph (x-ray) to make sure that your root canal filling is intact adequately sealing the root canal and the surrounding bone is healthy.
2. Making an access hole: To apply the bleaching agent, a small hole will need to be made in the back of your tooth to apply the bleach. However, before doing that, the area must be thoroughly cleaned and irrigated.
3. Sealing above the root canal filling: This step is critical to prevent the bleach from leaking into the root canal space.
4. Applying the bleach: To obtain the whitening needed, it typically requires between one and four office visits for additional bleaching.
5. Applying a permanent restoration: Once your tooth has lightened to the desired color, a permanent filling will be placed over the small hole to seal your tooth's dentin. This is then covered with tooth-colored composite resin (filling material) so that the access hole is undetectable to the naked eye.

To learn more about this procedure and see amazing before and after images, continue reading the Dear Doctor article, “Whitening Traumatized Teeth.” Or, you can contact us to discuss your questions or to schedule an appointment.

Teeth whitening is a great way to improve your smile. For best results and to ensure your safety, teeth should be bleached under professional supervision. We can help you choose the whitening method that's right for you, and monitor the effects of your treatment. Here are some answers to frequently asked questions about this relatively inexpensive cosmetic procedure:

Is teeth whitening safe?
A lot of research has been done on teeth whitening, so we know that specific bleaching formulas, from a reputable source, are safe if used as directed and after a proper dental examination. You should be aware that tooth sensitivity is a common side effect of bleaching, but brushing with a desensitizing toothpaste containing potassium nitrate for two weeks prior to bleaching can reduce sensitivity. Using potassium nitrate during the bleaching process can also help.

Is it effective?
Professional bleaching is very effective. Peroxide goes through tooth enamel (the outermost layer) and the dentin (middle layer) to the pulp (the innermost layer) in 5 to 15 minutes. The bleach actually changes the color of the enamel and dentin, and removes stains.

How is teeth whitening done?
Basically there are three options: in-office whitening (done by a dentist), at-home bleaching with custom-made flexible plastic trays (with prescription bleach), and over-the-counter (OTC) products. Not all OTC products are equal, and the results will take longer to achieve than with professionally supervised procedures.

How long does it take?
That depends on what method you choose and, in the case of at-home whitening, how conscientious you are about following through with your course of treatment. One study found that a six-shade change required either: three in-office applications of 38% hydrogen peroxide; one week of 10% carbamide peroxide used at home nightly in a custom-made tray; or 16 daily application of 5.3% hydrogen peroxide on a whitening strip.

Will it last?
It really depends on the individual. No bleaching method can whiten teeth permanently, though some people's teeth remain white for over 10 years with no touch-up treatment. More typical results vary from six months to two years. Keeping up with your regular oral hygiene routine at home and your professional cleanings at the dentist's office will help maintain the results; so will avoiding tobacco and beverages that stain, such as red wine, tea and coffee. You can also consider a bleaching touch-up once or twice a year at home or here at the dental office.

I want to go for it! What's the first step?
Step one is a pre-bleaching dental examination to determine the cause of your tooth discoloration. We want to make sure that your discoloration is not the result of an oral health-related problem. For example bleaching will mask but not resolve issues such as abscessed teeth, decay, and root canal problems. We want your teeth not only to be beautiful, but healthy, too!

If you are interested in learning more about teeth whitening, please contact us today to schedule an appointment for a consultation. For more information on teeth whitening, please see the Dear Doctor magazine articles “Important Teeth Whitening Questions Answered” and “Tooth Whitening Safety Tips.”

Having a whiter, brighter smile can do wonders for improving self-confidence, career opportunities, and interpersonal relationships, as demonstrated in numerous scientific studies. In fact, according to a poll conducted on behalf of the American Academy of Cosmetic Dentistry (AACD), the following was revealed:

• 99.7% of Americans believe a smile is an important social asset.
• 74% feel an unattractive smile can hurt chances for career success.
• 50% of all people polled were unsatisfied with their smile.

These statistics demonstrate why you should have a solid understanding about any cosmetic procedure — even teeth whitening — before making your decision to proceed. To help you ensure that you have the facts, we created the following list of questions.

• Am I a good candidate for tooth whitening?
• How much will the entire process cost?
• Does my insurance cover the cost (or any portion of the cost)?
• How does teeth whitening work?
• Is bleaching teeth safe?
• Will the bleaching agents damage tooth enamel?
• Can whitening treatments make my teeth sensitive?
• How does your professional bleaching differ from home whitening?
• What type of bleach and strength will you use?
• How long can I expect the results to last?
• What will the bleach do to my gums, filings, crowns, veneers, and/or bridgework?

Please note that we may cover most or all of these questions during your initial consultation; however, we encourage you to bring this list with you to ensure you get the answers you need so that you can make the best decision. To learn more now, continue reading the Dear Doctor article, “Teeth Whitening: Brighter, Lighter, Whiter....” Or, you can contact us to discuss your questions or to schedule an appointment.