Cosmetic Dentistry Teeth Whitening
Modern dental technology has made teeth whitening methods affordable and effective more than ever before. This billion-dollar-a-year- industry claims to help people all over the world happier with their perfect teeth…
But not all teeth whitening methods are safe and/or effective.
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What makes teeth look yellow? Teeth look yellow due to smoking, bruxing (grinding your teeth), staining foods and drinks, and aging enamel. If you took tetracycline antibiotics during childhood, you may have yellow teeth.
There are two basic types of teeth whitening:
Extrinsic whitening: Extrinsic whitening is whitening teeth by using mild abrasives to remove stains from the outer surfaces of teeth. This reveals the color underneath but does not actually change the color of teeth.Intrinsic whitening: Intrinsic whitening is a teeth whitening process that uses a tooth bleaching agent to change the color of the enamel of your teeth. The only tooth whitening agent used widely is peroxide.
Some teeth whitening methods are most beneficial for preventing teeth yellowing or staining.
Let’s look at the best teeth whitening methods of 2020. We’ll break down the cost, type, pros, and cons of each option so you can make the best decision to brighten your pearly whites.
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1. Use whitening toothpaste
Whitening toothpastes generally use a combination of ingredients to remove stains from teeth, including:
Carbamide or hydrogen peroxideMild abrasives (including activated charcoal, baking soda, silica, dicalcium phosphate, calcium carbonate, sodium metaphosphate, zirconium silicate, and calcium pyrophosphate)Hydroxyapatite
According to a 2018 review, whitening toothpastes effectively whiten teeth and offer a brighter smile by removing surface stains.
Most whitening toothpastes, however, do not intrinsically whiten/bleach teeth.
However, hydroxyapatite (HAp) toothpaste is the only whitening toothpaste that can intrinsically whiten teeth from the inside out. It literally “fills in” the space in your enamel for a whiter, brighter appearance.
Cost: $5-30 per tube
Type: Extrinsic whitening and intrinsic whitening (HAp toothpaste only)
Pros of Whitening Toothpaste:
InexpensiveCan intrinsically whiten teeth, in the case of HAp toothpaste
Cons of Whitening Toothpaste:
I recommend only using an abrasive whitening toothpaste for 2-3 weeks at a time to remove tooth stains. However, hydroxyapatite toothpastes are safe for long-term use, as they don’t use strong abrasives.
Best Whitening Toothpastes:
The best whitening toothpastes for removing surface stains are Jason Powersmile and Hyperbiotics Charcoal Toothpaste.
The best whitening toothpastes to whiten teeth from the inside out are Boka and RiseWell.
2. Switch to an electric toothbrush
Electric toothbrushes remove surface stains from teeth more effectively than manual toothbrushes.
Oscillating electric toothbrushes are generally the best for teeth whitening compared to sonic-powered toothbrushes.
Electric toothbrush costs range greatly because of the “bells and whistles” they often add. There is no evidence that added features, like Bluetooth or specialized heads, improve brushing in a way that improves teeth whitening effects.
Inexpensive electric toothbrushes have similar teeth whitening benefits to those that cost hundreds of dollars.
Cost: $8-$300 (high-quality electric brushes usually cost $25-$80)
Type: Extrinsic whitening
Pros of Electric Toothbrushes:
Associated with no side effects or potential dangers to oral healthMay offer better protection against tooth decay than manual brushes
Cons of Electric Toothbrushes:
More expensive than manual toothbrushes
Best Electric Toothbrush for Whitening:
The best electric toothbrushes for whitening are the Goby brush and the Oral-B 7000.
3. Get a professional tooth whitening treatment
For teeth whitening at your dentist’s office, expect 1-3 sessions of 30-60 minutes each.
During each session, a high concentration of carbamide or hydrogen peroxide (20-43%) will be “painted” onto the teeth. A polymerization light is used to activate the gel, and it’s reapplied several times over the session.
Although hydrogen peroxide can be used, carbamide peroxide is considered the industry standard because it has a much longer shelf life.
Some dentists will finish by using a UV light to accelerate the chemical reaction and the whitening process. You may also be offered the option to do just one 2-hour session, which will always include UV light.
Cost: $650-1250 for each session
Type: Intrinsic whitening
Pros of Professional Teeth Whitening:
Whitens teeth from the inside outWhitens teeth fast (you’ll see whiter teeth after just one treatment)Treatment and supervision by your dentist reduces the risk of damage to your teeth or gums compared to home teeth whitening systems
Cons of Professional Teeth Whitening:
Some of the whitening effect goes away 2-7 days after treatmentAdded whitening effect of a UV light rebounds after 7 days or fewerExpensiveRequire a visit to your dentist (can’t be done at home)
Best Professional Whitening System:
No one professional whitening system is particularly better than another. Just avoid UV light!
Find a dentist you trust who is concerned about the health of your teeth as well as the aesthetics.
4. Get a custom whitening gel tray
The best, longest-lasting, most sustainable way to whiten your teeth is with custom whitening gel trays. These whitening gel trays are made and custom-fitted by your dentist based on unique impressions of your teeth.
You can keep your tray indefinitely, as long as your teeth stay in the same place. You’ll purchase whitening gel to use at home (it keeps in the fridge) anytime you want to whiten your teeth.
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To use a custom whitening gel tray:
Remove the whitening gel from your refrigerator.Squirt the peroxide gel into the tray.Gently place the tray over your teeth, being careful to allow the fit to protect your gums from being exposed to the gel.Leave the tray on for 1-3 hours. Do not leave it on overnight, which may cause tooth sensitivity.
Take care of a whitening tray like you would a retainer, night guard, or any oral appliance — store it in water with baking soda when not in use. (Find more details here.)
Most people achieve the results they want within 2-3 weeks of daily use, although it may take 6-8 weeks for more stubborn yellowing. Don’t whiten for multiple weeks more than once per year.
Don’t purchase over-the-counter gels above 10% concentration to use at home. Otherwise, your teeth may become very sensitive.
$250-500 for custom tray$20-40 for each peroxide gel refill
Pros of Custom Whitening Gel Trays:
Best professional results at a much lower cost than professional whitening systemsWith 10% peroxide gels, you shouldn’t experience tooth sensitivityWon’t damage your sensitive gum tissue because the tray protects soft tissue in the mouth
Cons of Custom Whitening Gel Trays:
Higher peroxide gel percentages (over 10%) may result in tooth sensitivity or even damage to the tooth pulpRequire 2 initial visits to your dentist
Best Custom Whitening Gel Trays:
Most trays are made with similar materials. The best bleaching products to use in your custom whitening tray are Venus White or Opalescence.
5. Apply whitening strips
Whitening strips are small pieces of a flexible plastic coated with a whitening gel.
To use these products, like Crest Whitestrips, a strip for the bottom and one for the top are molded around the teeth and left for 5-30 minutes. Most whitestrips are intended for use over a few weeks, but some Crest Whitestrips can whiten teeth at home in one day.
Because peroxide and the adhesives in most whitestrips can damage or irritate sensitive gum tissue, it’s best to cut the strips down before use.
Some more “natural” whitening strips do not use bleaching products but use other whitening agents to remove stains. These other agents do not whiten teeth intrinsically.
The gel in whitestrips shouldn’t come into contact with tooth decay, so it’s best to use these teeth whiteners shortly after a dental visit to ensure you have no untreated cavities.
Cost: $13-60, depending on strength and brand
Type: Intrinsic (peroxide-based whitestrips) and extrinsic whitening (non-peroxide whitestrips)
Pros of Whitening Strips:
Readily available at drugstores and on AmazonEasy to useCreate results within a few days or weeks
Cons of Whitening Strips:
May cause uneven whitening results if not applied perfectly (especially if your teeth aren’t straight)Can increase tooth sensitivityMay cause excruciating pain if applied to a tooth with an open cavity
Best Whitening Strips:
For intrinsic whitening, try Crest Whitestrips. Do not use more than once every 3-5 years to reduce the potential for soft tissue damage.
For a less toxic, extrinsic whitening alternative, try Lumineux’s peroxide-free strips. They use natural ingredients to gently remove stains, and while the results won’t be as drastic, they don’t cause any of the same risks listed above.
6. Use baking soda toothpaste
Baking soda (sodium bicarbonate) is an effective home remedy for yellowing teeth.
Research indicates that toothpastes that contain baking soda remove stains from yellowing teeth more effectively than other pastes. The higher the concentration of baking soda, the better the results.
While you can look for toothpastes that include baking soda, the easiest way to implement this is to DIY it:
Mix 2 teaspoons of water with a teaspoon of baking soda.Dip your brush in the mixture.Brush your teeth as normal.
Cost: $1-$30, depending on the brand of baking soda or baking soda toothpaste
Type: Extrinsic whitening
Pros of Baking Soda:
InexpensiveWidely available for purchaseNon-toxic to the mouthOnly mildly abrasive, especially compared to most whitening toothpaste abrasives (contrary to popular belief)
Cons of Baking Soda:
Best Baking Soda:
Most brands of baking soda will work effectively in DIY toothpaste. Many brands of toothpaste contain baking soda for its whitening and plaque-busting benefits.
7. Try oil pulling
Oil pulling may remove some surface stains from teeth, but it isn’t a very effective teeth whitener. However, it will balance the oral microbiome and reduce inflammation of bleeding gums/gingivitis.
Coconut oil does have the ability to bind to bacteria on the teeth and, therefore, remove some surface stains. But oil pulling will not “whiten” teeth any more than swishing your mouth regularly with water.
However, since oil pulling is so good for oral hygiene in general, I include it on this list as a combo method of stain removal and stain prevention.
Type: Some extrinsic whitening, preventative
Pros of Oil Pulling:
Beneficial to overall oral healthReduces the risk of plaque buildup on teeth, which could cause teeth yellowingNo known common side effects
Cons of Oil Pulling:
Can’t actually whiten teeth; more a “preventative” measure to avoid plaque buildupCan clog water pipes if spit into the sink (always spit used coconut oil into the trash can)
Best Oil for Oil Pulling:
Coconut oil is, by far, the best oil for oil pulling. Georganics oil pulling mouthwashes are great for a positive oil pulling experience, especially if it’s new to your oral hygiene routine.
8. Practice good oral hygiene
Everyone’s teeth yellow somewhat over time — it’s a normal part of aging. However, the best way to prevent your teeth from changing color rapidly is good oral hygiene.
A word of caution: Any oral hygiene routine that involves antibacterial products is bad for the oral microbiome. Avoid or greatly limit your use of antibacterial mouthwash, antibacterial toothpaste, essential oils, and hydrogen peroxide mouth rinses.
The best oral hygiene routine involves:
Flossing at least once a dayOil pulling with coconut oil
Type: Extrinsic whitening, preventative
Pros of Good Oral Hygiene:
Healthy teeth age slower than unhealthy teeth with weakened enamel, which means they yellow at a slower rate.Brushing teeth not only keeps them healthy on the inside, but the outside (preventing surface stains from forming).
9. Don’t skip dental checkups
Getting a teeth cleaning every 6 months is a very important part of preventing tooth stains and yellowing.
Your hygienist will remove tartar from your teeth, which can’t be removed at home. This tartar could otherwise lead to cavities, gum disease, and even painful tooth abscesses. Plus, removing tartar improves the color of your teeth.
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In addition to your bi-yearly cleaning, your dentist will examine your teeth for issues. He or she isn’t just looking for white teeth — they’re making sure you have no oral disease that could age or otherwise harm your dental health.
Cost: $100-200 per visit, depending on your location (usually covered by dental insurance)
Type: Extrinsic whitening, preventative
Pros of Dental Checkups:
Important for overall oral healthRemoves yellow tartar and plaque buildupAllows your dentist to catch oral disease that could otherwise yellow or damage teeth