The television and movie industries have fostered an ever-increasing trend toward the look and feel of health and youth.  People are spending more time and discretionary income on exercise and cosmetics to accomplish their ideal look.  Many see their smile as an integral part of achieving their best appearance.  Almost everyone I ask what he or she would like to change about his/her smile replies, “I wish I had whiter teeth.”  The reality of accomplishing this, for many people, is easier than one might think.

Before you can create a brighter smile, one must first identify why a smile is not as bright as it potentially could be.  One reason your smile may appear dull is due to existing cavities and old fillings or wear of the teeth’s outer layer.  These problems may be corrected by bonding of a tooth-colored filling.  More elaborate procedures, such as veneering or capping of the tooth, may be necessary it the size of the problem is significant.  Trauma is another reason teeth might appear darker than usual.  Trauma discolors teeth by a process of the nerve dying and byproducts of the necrotic nerve penetrating the inner tooth layers.  This discoloration, many times, is the first sign that the tooth has been damaged.  Usually, removal of the nerve debris itself will bring back the natural shade.

Certain medications or ingestion of excessive amounts of fluoride during tooth formation can cause some internal tooth discolorations, yet the most common cause of a dull smile is staining.  Coffee, tea, and tobacco are just a few of the products which cause external discoloration.  Meticulous brushing and flossing and regular professional cleanings will keep these products from permanently discoloring one’s teeth.  Mild-to-moderate internal discoloration or stubborn external staining may be treated by a procedure known as bleaching.

Bleaching is a very conservative process in that no tooth structure is removed.  Bleaching may be achieved through an “in the office” or “at home” method.  The “in office” procedure is comprised of three-to-six appointments of 45-minutes-to-one-hour duration.  The teeth are first isolated and conditioned with an acidic gel or liquid which causes the enamel pores to open up.  Hydrogen peroxide is applied to the teeth and warmed with a light.  The process, researchers believe, works by enamel oxidation whereby the molecules which causes the discoloration are released.  All patients will notice an instant brightening effect which will fade over the next few days, with a net effect of lightening.  Bleaching is repeatedly done until a satisfactory result is achieved.  At the last appointment, the teeth are polished.

The “at Home” bleaching technique is a relatively new treatment option.  This technique involves the use of a different form of peroxide gel or solution placed in a custom tray much like that of a football mouthguard.  The tray is constructed to fit the teeth which are to be lightened.  The patient wears the tray 1-1/2 –to-two hours per day for six-to-eight weeks with the dentist’s monitoring at specific intervals.  Bleaching may require annual or biannual touch-ups to renew the result.

A brighter smile is possible through a variety of means, depending on the patient’s specific needs and diagnosis.  Predictability of any dental treatment depends highly on understanding how the teeth became discolored, patient expectation, level of oral hygiene and food and drinking habits.  A change in the esthetics of one’s smile exponentially heightens self-concept and confidence.