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Teeth whitening: what colour should my teeth be and is it safe to whiten them?

Tooth colour varies between individuals and even between teeth belonging to one individual.  The variation of tooth colour between different people can be due to tooth form, developmental defects (such as fluorosis or tetracycline staining), diet (frequent consumption of dark-coloured food and drink), and lifestyle factors (smoking and poor oral hygiene).  In addition, our teeth will naturally darken and become opaquer with age.

Teeth whitening is a safe and effective procedure to restore or improve the shade of your teeth.  This is a common and popular procedure in cosmetic dentistry.  Since teeth whitening is non-invasive and affordable, it is often the first step in cosmetic treatment before any other cosmetic work is considered, such as the placement of veneers or crowns.  However, it is not recommended for pregnant and breastfeeding women, or people with allergies to peroxide.

The active ingredients in teeth whitening, carbamide peroxide or hydrogen peroxide, and the associated oxygen molecules break down the stained substances in the tooth structure.  Results can vary between individuals depending on the initial tooth shade, the type of discolouration and the method of whitening used.  In most cases, you will see an improvement of 6-8 shades.  Frequent touch-ups will likely be required to maintain the level of improvement, and we recommend you avoid or minimize exposure to dark, staining food and habits that may have caused the initial staining.

It is important to have a thorough dental check-up and clean before any whitening procedure to ensure you have good oral health to start with.  Active dental diseases, such as cavities, can be aggravated, and tartar and plaque deposits can reduce the effectiveness of whitening treatment. It is important to note that whitening is only effective on natural enamel; this means that the shade of restorations such as fillings, veneers or crowns will not be altered.  Therefore, if there is a significant shade change of your natural teeth, new restorations may be required to match the whitened teeth.

In-chair and at-home whitening treatments prescribed via a consultation with and supervision by a dental professional are safe and often very effective.  Any adverse effects are temporary and reversable, usually resolving within a few days.  These can include sensitivity during and after the whitening procedure and minor gum irritation.  With accurate custom-made trays for home whitening and adequately placed safety barriers during in-chair whitening, the risk of gum irritation should be significantly minimised.

Over-the-counter whitening products and whitening toothpastes have a lower concentration of the active ingredient than those prescribed by your dentist.  They can take longer and may not be as effective since they are often designed to remove surface staining only.  Some over-the-counter products can be abrasive and may cause damage to enamel, increasing the risk of sensitivity as a result.

Most of the adverse effects are due to inappropriate or incorrect use of whitening products.  Therefore, to minimise the risks and to ensure safe and effective teeth whitening, we strongly recommend consultation with and prescription by your general dentist.

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