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Teeth Whitening Myths

By Dr Sofia Stavropoulou (DMD)



Contents

• Myth #1 : Extra White Teeth

– Teeth Whiteness – Tooth Structure

– Natural Smile

– Artificially Beaming Teeth

– Teeth Discoloration

• Myth #2 : One Whitener for All

– Internal Discoloration

1. Enamel

2. Dentin

– External Discoloration

1. Direct Staining

2. Indirect Staining

• Myth #3 : DIY Teeth Whitening

– Internal Discoloration Treatment

– External Discoloration Treatment

1. Deep Enamel Discoloration

2. Superficial Enamel Discoloration



Myth #1 : Extra White Teeth

Extra White Teeth are not necessarily the bestaesthetic option for the unique YOU…



Teeth Whiteness

How White Is White Enough?The first myth I’d like to dissolve is that

about extra white shinning teeth. It looks likein most cultures shinny white teeth are closelyrelated with nobility, higher social status,exceptional beauty and attractiveness.Poems and songs have been written for rice-white teeth or pearl like ones.

But our DNA’s designer, a top class artist if

we judge by the results, had wisely devised anorm of harmony and affinity between onetrait and another. There are as many whiteteeth shades as people on the planet, andon one person’s mouth we will find manydifferent shades of teeth colors - canines arealways a tad darker than incisors for

example- and even on a tooth alone thereare different zones of dental tissues’ densityand transparency that cause a visualmanifestation of gradient opacity in mostcases.

These deviations from a uniformappearance, practically are the ones that

define BEAUTY and UNIQUENESS in everyperson’s smile. And again, us Dentists, -andmore often Cosmetic Dentists- take a seriesof steps prior picking the most suitable tooth-color when using cosmetic restorationmaterials. An empirical rule has been -apartfrom the adjacent teeth’s color- the exactshade of patient’s eye’s white.



Tooth StructureHaving a look at our tooth’s anatomy,

we can see that the outer white visiblepart of it, -the crown- is built by twolayers of slightly different materials :enamel (the external one) and dentin(beneath enamel, the internal one).

Both substances are consisted of

micro-tubules and have a “crystallinearchitectural structure”. On the outer surface of enamel, a protective “film”seals the enamel tubules and enhancesits smoothness.

So, you can imagine enamel, which isthe outer substance of our teeth, having

a micro-porous surface which allows toexternal agents to enter once they areincorporated in its protective “film” or ifthe “film” is destroyed. Also at theenamel-dentin junction border, agentscan move through enamel or dentintubules to any of the two directions.

Dentin, the inner substance of tooth’scrown, through its tubules allows theentrance of internal agents that comefrom an infected or traumatized pulp toits zone or even their further diffusion toenamel.



Natural Smile White teeth are synonymous to abright smile, and smile is the absolutedistinction between human beings andanimals, on a primary level. On asecondary level –and more essentialone- it is a universal communication

friendliness-key.Nobody can resist the charm and

attractiveness of a beautiful smile. In atruly heartfelt smile magic lies into theeyes. Eyes can smile too ☺

A nice smile with a “good morning”

or a “hello” are more than enough tomake someone’s day, while whatmakes or breaks a major business dealmay be a simple smile.

Smile on a psychological level signifiesacceptance and invitation to connect.

Although aesthetic standards mayvary from culture to culture and on anindividual basis, we all agree that themost natural the smile, the better ☺



Artificially Beaming TeethOn the other side of a natural smile

stands an eye-popping artificiallybeaming one.

Sometimes, when I see celebritiescarrying around a smile like this, I don’tknow if I should laugh or feel pity for their poor sense of aesthetics. Because I’msure that they are the ones who push their Dentist to do such a horrible job.

This kind of ULTRA-WHITE in perfect order teeth, is a stylish crime I would never doeven to a horse.

Each tooth in a mouth has its ownunique beauty and even if it deviates abit from being perfectly aligned or if it’slightly more twisted around its axis than it

should be, if its color reflects the lightthrough diverse tones and shades of whiteor white-ish crème, it may as well be thetiny part of your smile that adds the mostto your personal allure.



Teeth Discoloration I tried hard to keep this report as

understandable as possible, and Ialso tried to include the least uglyand disgusting images on the topic.But believe me, teeth discoloration

can be a very scary image incertain cases.

To understand when and how wecan actually try to whiten our teethalone, we need to comprehendTEETH DISCOLORATION, its types and

their causes.In Medicine, it is a fact that

treating the cause instead of thesymptom, is the ONLY right way togo. Aesthetic (Cosmetic) Dentistry isnot the exception to this rule.

So lets see one by one the typesof the problem and their true andsometimes deeper causes.



Myth #2 : One Whitener for All

Not all discoloration conditions are created equal,and most of them require special dental

treatment…



Internal Discoloration

Numerous systemic or external

factors ranging from metabolicdisorders, systemic syndromes,dentin defects, tetracycline stains,fluorosis, enamel hypoplasia andtrauma, to Dental malpracticewhen an endodontic treatmenthas not taken all necessarymeasures to protect the dentintubules from getting stained bythe residues of therapy, may beresponsible for causing Internal

Teeth Discoloration.



1. Internal Enamel DiscolorationDon’t get confused by the medical

terms I’m listing below. There was noalternative way to name these specialconditions. Just keep in mind that,enamel can get discolored either during its formation at the fetus stage,or later on due to metabolic systemicdisorders or trauma.

• Amelogenesis imperfecta• Enamel hypoplasia• Trauma (capillary vessels of the tooth

are broken and blood substances suchas hemosiderin and hemoglobin enter dentinal and enamel tubules)

• Systemic syndromes causing pitting ofthe enamel

• Fluorosis due to excessive fluoride

intake• Alkaptonuria• Congenital erythropoietic porphyria• Congenital hyperbilirubinemia• Tetracycline Staining can affect both

enamel and dentin



2. Internal Dentin DiscolorationThe conditions affecting Dentin, can beeither common with those affectingEnamel, such as :

• TRAUMA• Tetracycline

Or they can be categorized intoDentinogenesis Imperfecta Classes, andDentinal Dysplasia Classes.

• Dentinogenesis imperfecta I, is acongenital condition associated withosteogenesis imperfecta, the teeth are

opalescent, but the aesthetic problem maynot be as severe.

• In Dentinogenesis imperfecta II, both theprimary and permanent teeth are affectedbeing opalescent when trans-illuminated,and have a brown or bluish color.

• In Dentinogenesis imperfecta III, teeth arealso opalescent.• In dentinal dysplasia type I, the primary and

secondary teeth may have an amber translucency.

• In dentinal dysplasia type II, a brown

discoloration is sometimes observed.



External Discoloration

Tooth-decay (dental caries)

caused by plaque acids and the

demineralization effect they haveon the enamel are among themain reasons of teeth discoloration.But here we will focus ondiscolorations where dentalsubstance is not actually lost.

External discoloration can becaused by an array of externalfactors. Foods we eat, hot or coldbeverages we drink, medicines wetake, habits like smoking may have

a gradual discoloration effect ofvarious degrees on our teeth.



1. Direct Staining

Direct Staining is usually caused

by substances –usually food or

drinks- containing organiccompounds that get incorporatedin enamel’s outer protective “film”.Typical example of such type ofstaining is coffee, tea or smokingdiscoloration.

This type of discoloration can easilybe treated by Dental Cleaning.

Systematic oral hygiene, withdiligent brushing using toothpasteswith whitening ingredients –such asbaking soda etc- and flossing canhelp prevent this type of staining.



2. Indirect Staining

Have you ever thought that your mouthwash could be a teethdiscoloration factor? Yes, that’strue for chlorexidine rinses, whichare quarternary ammoniumcompounds characterized as non-metallic factors causing indirect

teeth staining.Women who may be taking

metallic salts such as ironsupplements –men with anemiamay also take these supplements-

can have their teeth indirectlystained as well.



Myth #3 : DIY Teeth Whitening

Unless you visit and consult your Dentist FIRST,don’t try to use any “At Home Teeth Whitening”

System…



Internal Discoloration TreatmentIn most cases of Internal Teeth

Discoloration, a Dentist has to removeexternal tooth substance and

proceed with aesthetic (cosmetic)restorations, or perform a thoroughendodontic treatment (root canaltreatment) using chemical agents thatclean dentinal tubules.

Composite or porcelain veneers area premium cosmetic option whenprosthetic is necessary.

Internal “bleaching” using aHydrogen Peroxide solution for dentinal tubules cleaning, is the other

way to go when an endodontictherapy –root canal- or the repetitionof a failed one is consideredmperative.



External Discoloration Treatment

To a great extent, External TeethDiscoloration can be treated

ONLY by the Dentist.But in this type of Discoloration,

especially the Superficial EnamelDiscoloration, the hugetechnological and scientificadvances embraced by Major

Dental Materials Brands, havebrought quite remarkable andreliable solutions right to theconsumer’s hands.

At Home Teeth Whiteners are anew trend in personal-care, butyou should ALWAYS consult your Dentist before you experiment withany of them.



1. Deep Enamel Discoloration

The Dentist can proceed with a

range of options in case of DeepEnamel Discoloration. Each onehas its special indications,advantages and disadvantages.

• Etch-Bleach-Seal Technique : Can’tremove very deep stains.

• Microabrasion With DentalBleaching: Goes deeper, but asmall amount of the stain mayremain unremoved.

• Composite Veneers /PorcelainVeneers: A thin layer of enamelneeds to be removed and replacedby the cosmetic restorationmaterials.





A few wordsI hope you’ve got a clearer idea on teeth

whitening now, and the next time you’lldecide about your smile’s brightness you’llknow better what can be done by you andwhat can’t.

In any case, my best advice – the one I

would give to my dearest friend- is to talk toyour Dentist before you do anything byyourself. Us Dentists have a more “artistic”view of a smile because we’ve learned torecognize natural beauty and have an

“eye” for harmonious perfection. You maybe surprised to hear that your not-so-extra-white teeth are absolutely stunning and their color is ideal for your face.

The last thing you want is to damage your teeth enamel, or to waste your money and

time over a futile purpose.

Smile A Lot ☺

Dr Sofia Stavropoulou (DMD)

http://DentistSays.com



http://DentistSays.com



Resources• Dr Daniel Ravel’s Site:

http://dentalresource.org

• Publication on Brazilian DentalJournal :http://www.scielo.br/scielo.php?pid=S0103-64402009000400008&script=sci_arttext

• Article on “Dental Fluorosis” athttp://fluoridealert.org :http://www.fluoridealert.org/health/teeth/fluorosis/

• Wikipedia Article on “ToothBleaching”:http://en.wikipedia.org/wiki/Tooth_ bleaching

• Publication on Journal Of AmericanDental Association on “Fluorosis”:

http://jada.ada.org/cgi/content/full/140/3/278

Documents

Mitovi o izbeljivanju zuba