People, these days, are influenced by the media for their portrayal of a perfect white smile. TV and OTT have raised the self awareness about discoloured teeth and therefore, tooth whitening has become one of the most frequently requested dental procedures. The demand for whiter and beautiful smile has made way for professional as well as many commercial whitening products.
It is, however, important to understand that all tooth stains are not same. Some can be externally acquired (through tea, coffee and tobacco) and some are inherent (deficiencies, genetic factors). The treatment for different types of stains differs and all discolourations cannot be corrected by whitening procedures.
Tooth whitening lightens the colour of the teeth. Most products that are used to whiten the teeth use hydrogen peroxide or it’s precursor carbide peroxide. There are many options to lighten the colour of the teeth.
- Natural home remedies are slow and erratic but free of side effects.
- Over the counter whitening products are also effective but the results are not consistent.
- Professional help yields the quickest and the most reliable results, under expert guidance.
Natural Remedies
Certain natural ingredients that are easily available at our homes are very useful for lightening the stains on our teeth. These ingredients do not have any side effects and can be used by anybody at their own comfort. However, these agents do not guarantee results and are often not reproducible.
- Squishing sunflower/sesame/coconut oil in the mouth for 15-20 min, yields whiter teeth over a period of time. Coconut oil contains lauric acid which helps to relieve inflammation as well.
- Baking soda is a mild abrasive and can scrub away surface stains from the teeth. It also creates an alkaline environment and prevents growth of bacteria.
- Strawberries contain mallic acid that removes the discolouration. When used in conjunction with baking soda, it buffs away the tooth stains.
- Pineapple contains Bromelain enzyme, which is also present in some toothpastes.
- Activated charcoal is mildly abrasive and also absorbs tooth stains to a certain extent.
- Banana peel is rich in minerals like potassium and magnesium and is believed to whiten the teeth as the minerals are absorbed into the surface enamel.
Over The Counter Products
- Whitening Toothpastes may have one of the three ingredients as the active ingredient: 1. Mild Abrasive (magnesium carbonate, hydrated aluminium oxide and calcium carbonate) can scrub away the surface stains that could cause yellowing. 2. Hydrogen Peroxide in low doses 3. 3. Carbamide Peroxide is a precursor of hydrogen peroxide. It produces results more quickly compared to hydrogen peroxide, over a period of 14 days.
- Whitening Strips and Gels: These are thin layer of peroxide gel on the strips, shaped to fit the facial surface of teeth. Strips are applied twice daily for 30 min for 2 weeks and lightens tooth colour by 1-2 shades.
- Whitening Rinses: For effective results, the mouth rinses are used twice daily for 60 sec, each rinse for atleast a period of 3 months. It lightens the tooth colour by 1-2 shades.
- Tray based whiteners: Trays are available OTC and the lightening material is applied in the tray by the individual and they are worn either 2-4 hours a day or overnight for a few days.
Professional Procedures
Dentist supervised whitening procedures are more reliable and consistent with the results. These procedures cater to vital as well as non vital teeth.
| Concentration of Product used | Suggested wear time | Advantages | Disadvantages | |
|---|---|---|---|---|
| Power Bleaching | 25-30% Hydrogen Peroxide | Activated by either light or heat for 30-60 minutes; They require at least 2-3 sessions for the required colour. | Results achieved are better and quicker. | There are chances of teeth sensitivity due to the heat exposure. |
| Night guard Bleaching | 10-20% Carbmide Peroxide (CP) | Bleaching agent is filled in the tray and is worn by the individual for either 8 hrs/day (10% CP) or 3-4 hrs/day (15-20% CP) | 1. Fewer side effects 2. Low cost | 1. Increased dropout rates 2. It can lead to thermal sensitivity in case of over zealous patients. 3. Chances of gingival irritation |
| Walking Bleach for non vital teeth | Sodium Perborate | It is sealed into the pulp chamber following endodontic therapy, and is followed up after 1-2 weeks | More patient compliant | 1. Could damage the root at the gum level 2. Chances of re-discoloration |
| Inside-Outside Bleaching | Sodium Perborate & Hydrogen Peroxide | Internal bleaching of non vital teeth followed by home bleaching methods | — | — |
Newer approaches are also being developed for in office use. It includes a battery operated tray based system which is used to deliver the bleaching agent to the facial surfaces of the teeth and is activated with the help of the battery generated electrochemical ionisation process. It is claimed that good results can be obtained with three cycles of 10 min duration each.
With the increasing cosmetic demand, tooth whitening has emerged as the most sought after dental procedure. There are so many options available in the market to get that perfect pearly white smile. However, I would recommend that in order to achieve the best results possible, it is important to get a professional consult and then follow it up with the OTC products, in accordance with expert advice.
Dr. Pooja Chaturvedi 