5.29.16 in General
We have just finished our blog about creating esthetic and functional teeth by paying attention to size shape and position of the teeth. But another variable ranks higher on the list of most patients’ desires for their smiles. It’s shade.
The most common request I hear from patients, by far, when asked about satisfaction with how their smile looks is, “I would like my teeth straighter and whiter.” It’s clear that most people interpret whiter teeth with better looking teeth.
This is so true that whole industries exist and are dedicated to this cosmetic dilemma. So how can we change the shades of teeth, and make them “lighter” in shade?
Darkness of the shades of teeth is due to either extrinsic (surface) discoloration or intrinsic (within the tooth) discoloration. The first order of business in order to lighten teeth may be as simple as cleaning stains off of the surfaces. Various polishing techniques and polishing tooth paste can aide in this. Once we know that the tooth surface is as clean as it can be, we can address any remaining shade lightening issues.
Creating a whiter smile can be achieved by either masking the dark shade in view, or actually changing the shade of the tooth material itself.
Masking shades can happen by restoring the surfaces of teeth with, plastic or porcelain materials found in such things as bonded composite fillings, porcelain veneers, or all porcelain crowns. With these techniques a dentist can control the shade result precisely, as well as, the final shape and position of the teeth. However, it may require that some irreversible removal of tooth structure takes place. In contrast, often a patient and dentist will opt to whiten the existing teeth, especially after they have been placed in a proper position (for example, following orthodontics).
Whitening of tooth structure can happen quite easily in 2016. Whitening gels, which are peroxide based gels, have been found to be very effective and safe for whitening most enamel and dentin discolorations. These systems of whitening are often done at home by the patient over a period of weeks, and finishing when the patient decides that they are pleased with the result. The FDA has branded teeth whitening gels as a cosmetic, and so they can be purchased over-the-counter, and used without dentist or physician supervision. One should be aware though that while peroxide does not damage tooth structure, it will certainly burn the soft tissues of the mouth, such as the gums, cheeks, tongue and lips. For this reason I always recommend that a whitening system is deigned, created and monitored by our office. Temporary tooth sensitivity is also a common occurrence when using peroxide-based whitening gels. Yet another good reason to have your whitening endeavors monitored by a dentist.
And so, since every patient’s needs and desires are different, adhering to the axiom, “doing the least dentistry to achieve the desired outcome” is a good rule.