Everything you need to know about teeth whitening so you can keep on smiling.
Wanting your teeth to be whiter than they are right now is common and totally understandable (as is liking your teeth as they are!), but knowing how to whiten your teeth can be pretty confusing. Between over-the-counter options, professional methods, and even natural alternatives, there is a lot to consider if you’re looking to whiten your teeth. To help guide you in the process, we spoke to dental health experts who outlined the benefits of the available teeth whitening methods, as well as the potential risks and factors to consider before you decide how to go about your teeth whitening journey.
Why Does Tooth Discoloration Happen Anyway?
The reason you may want to whiten your teeth is that, somewhere along the way, they have gotten discolored or stained — which may make them appear yellow or white-stained for example. “Tooth discoloration can be from everyday foods and beverages such as coffee, wine, tea, pasta sauce, and curry,” explains Joyce Kahng, D.D.S., an Orange County, California-based dentist, who runs the popular Instagram account @joycethedentist. “Teeth can also discolor due to smoking and tobacco use, poor oral hygiene, and certain medications that can cause permanent stains inside the tooth.”
Tooth staining can be classed into two categories: extrinsic stains and intrinsic stains. “An extrinsic tooth stain is staining on the surface of the tooth,” explains Sam Jethwa, B.D.S., a leading UK-based cosmetic dentist at Bespoke Smile. “This happens when pigmented residue from things like food, drink, and tobacco build up in the protein layer of protein on the tooth enamel.”
Meanwhile, Dr. Jethwa explains, intrinsic stains are deeper into the tooth. “These can be caused by a number of things, including tiny cracks in the tooth enamel, some antibiotics, bleeding within the tooth, tooth decay, weakened tooth enamel, or too much fluoride,” he says.
Over-the-Counter Whitening Products
When you first notice tooth discoloration, your first instinct is probably to turn to over-the-counter solutions for whitening such as toothpaste, strips, or gels, since these are often more affordable and less time-consuming than professional treatments. Let’s take a closer look at how these at-home treatments work and whether they are a smart choice when it comes to teeth whitening.
Dr. Kahng breaks down the available options for us. “Whitening toothpastes actually don’t whiten the tooth at all, but they target the surface stains on the tooth and help to prevent those stains from absorbing into the tooth,” she says. As such, they are a helpful tool, but can’t be the only thing you use if you’re looking for a thorough whitening.
“Over-the-counter whitening strips usually contain a low percentage of hydrogen peroxide, around 6-10%, which is the same active ingredient that we would use in a dental practice but at a lower level,” says Dr. Kahng. “It is a great starting point for whitening, but with deep stains may not be strong enough. They also lay on top of some of the gum surfaces and may cause some irritation for sensitive gums.”
While whitening strips that contain hydrogen peroxide may not be the be-all-and-end-all of teeth whitening, they are a great option. “The best candidate for at-home treatments is anyone looking to improve the appearance of their teeth quickly and without the cost and hassle of going into an office for treatment,” says Jeffrey Sulitzer, D.M.D., chief clinical officer at SmileDirectClub. “For those of us who regularly drink coffee, tea, and wine, it’s a quick way to brighten your teeth, whether preparing for a job interview, an important meeting, a wedding, a date, or simply a step to add to your routine to give you a confidence boost.”
Professional Teeth Whitening
If you’re looking for lasting, in-depth results, in-office teeth whitening is typically your best bet. “Professional whitening solutions usually boil down to 2 options: a one-hour, in-office whitening session and a custom whitening tray,” explains Dr. Kahng. “The in-office teeth whitening session is a process where the dental team blocks off all of the soft tissue, such as the gums, from directly contacting the whitening gel.” She continues, “This is the fastest someone can whiten their teeth in the shortest amount of time; however, it may still take multiple sessions to see great results because it takes time to remove micro-debris in the tooth through the oxygenation process.”
Dr. Kahng highly recommends the whitening tray option for several reasons. “Custom trays are a great investment for patients because they help maintain whitening results at home but can also help people whiten their teeth to the next level more efficiently than over-the-counter options,” she says. “They are plastic trays fitted for the patient, and patients can use the professional grade whitening solution with higher concentrations than found at a drugstore. Using the ‘strong stuff’ will help patients get results more quickly and since it is fitted to their teeth, it is also appropriate for those with sensitive gums.”
Both Dr. Kahng and Dr. Jethwa stress the importance of involving your dentist in assessing whether your teeth are suitable for teeth whitening services or products. “For safe and effective teeth whitening, it’s vital to have a thorough assessment and monitoring by a qualified and experienced dental professional,” says Dr. Jethwa, who also notes that your dentist will be able to work with you to determine the exact shade you’d like your teeth to be for a natural, healthy look. He also says that for lightly discolored teeth, a hygienist cleaning is often extremely helpful, and teeth whitening may not be required at all.
Natural Teeth Whitening Remedies
There are many at-home alternatives to teeth whitening which are touted on the internet, but the experts are skeptical about their safety and effectiveness. “There are lots of ‘natural’ teeth whitening solutions on social media platforms such as TikTok, or ‘TeethTok.’ I would advise avoiding these,” says Dr. Jethwa. “While something like baking soda may whiten the teeth, and is used in some toothpastes, this is done in very specific amounts.” If you apply it directly to your teeth, it may be damaging to the enamel, the expert adds.
For Dr. Kahng, using activated charcoal for teeth whitening is also not the best idea. “I don’t recommend activated charcoal overall because it can be abrasive for the enamel,” she says. “At first patients will notice that their teeth are brighter, but with continued use, the enamel will wear down and expose the second layer of the tooth, which is yellow.”
A third popular “natural” teeth whitening option is oil pulling, whereby you swirl around coconut or sesame oil in your mouth to improve overall oral health, including potentially whiter teeth. However, Dr. Kahng cautions, “There is no science on oil pulling [for whiter teeth], but I encourage patients to do so if they are seeing great results and as long as they are also brushing and flossing. It won’t hurt.”
Considerations and Potential Risks
Of course, you should always consult a dental professional when embarking on an in-office teeth whitening process, but it is also recommended before using over-the-counter whitening products for best results and to avoid any potential risks. “It’s extremely important to consult with a dentist before embarking on any sort of teeth whitening because they can carry out a thorough oral health assessment and establish which type of whitening is best for you,” advises Dr. Jethwa. “When performed by a qualified and experienced dentist, teeth whitening is safe; however, because of the chemicals used to perform this, it’s vital that the right strengths and quantities of hydrogen peroxide are used in order to avoid damaging the tooth enamel and causing inflamed gums.”
Meanwhile, Dr. Kahng explains that certain factors might mean at-home teeth whitening doesn’t work for you. “For example, those with tetracycline staining would not benefit at all from a Crest White Strip,” she says. “Some patients have a dark tooth that they don’t realize has gone necrotic or has a root canal — a whitening strip will not help in that situation.” She adds that if you have gray-toned or translucent teeth, whitening might be more difficult, and a dentist can work with you to find the best solution.
How to Maintain and Maximize Teeth Whitening Results
Once you have undergone a teeth whitening treatment — whether at home or professionally — you can expect your teeth to slowly become stained again; however, you can slow this process down by following certain lifestyle habits. “For prolonged teeth whitening results, it is best to reduce exposure to dark liquids or foods as much as possible to prevent extrinsic staining,” says Dr. Kahng. “For those who drink coffee, adding a splash of milk can help reduce staining due to the casein.” She cautions that plant-based milk would not have the same effect, and adds that drinking through a straw may be another helpful alternative for avoiding coffee staining.
Of course, you also need to continue properly caring for your teeth and oral hygiene. “I also recommend a good oral hygiene routine, with flossing and brushing with a mild to moderately abrasive toothpaste,” Dr. Kahng adds. “In general, I don’t recommend using a whitening toothpaste. It can be more on the abrasive side.”
If after consulting with a dental professional you determine that at-home or in-office teeth whitening will not work for you for any reason, there are more involved options available to you. “Dental veneers and tooth bonding are all great ways to manage tooth discoloration and can be managed safely and effectively in the dental office,” says Dr. Sulitzer. “It is important to note that these options are more permanent and come with significant additional costs and other risks to the teeth and supporting structures, which can be explained in great detail at your local dentist’s office.” By the way, according to the Journal of the American Dental Association, “a veneer is a thin covering that is placed over the front (visible) part of the tooth.” Meanwhile, bonding is a technique whereby “the dentist attaches or ‘bonds’ materials directly to your tooth,” according to the ADA’s consumer website.
For Dr. Kahng, teeth with tetracycline staining need to be treated with a system called KOR Whitening. “However, if that is not an option, the only way to brighten these teeth up is to cover them with a porcelain veneer or dental bonding,” she says. “Another scenario where a tooth may not respond to teeth whitening is if it has had a root canal in the past.” She adds that a tooth with a calcified nerve would also need to be treated with a veneer or bonding.
For dental professionals, the only worthwhile options for teeth whitening are at-home treatments that contain hydrogen peroxide, or professional treatments such as in-office whitening or take-home whitening trays. To figure out which option is best for you, it’s always recommended to consult with a dentist, who can give you personalized advice as to how to achieve the best teeth whitening results for your pearly whites.
Whichever direction you go in your teeth whitening journey, this process has the potential to greatly enhance your smile and boost your confidence, as long as you understand the different methods available to you and consult with a professional where possible.