I’m Dreaming of a … White Smile

Are you among the many who may be dreaming of a whiter smile this holiday season? If you are, we’d like to help you make your dream a reality by educating you on what exactly teeth whitening entails. To do that, we’ve summarized the main points from a recent online American Dental Association (ADA) article, entitled, “Whitening.”

Extrinsic vs. Intrinsic Stains:

Before you can better understand the process of teeth whitening, it is important to know that your teeth can develop two different types of stains. Extrinsic stains are those stains that occur on the surface of the tooth. They are caused by substances such as tobacco and highly pigmented foods (i.e., red wine, tea or cola drinks).

Intrinsic stains are those stains that impact the tooth’s surface beneath the enamel. These can be related to aging (where thinning of the enamel allows more yellow dentin to show through), long-term antibiotic use (i.e., tetracycline), cavities, silver fillings, a nerve hemorrhage, or death of a tooth’s nerve.

Whitening Methods:

Mechanical interventions, such as brushing with whitening toothpaste or a professional dental cleaning, can help reduce extrinsic stains. Whitening toothpastes use abrasives to remove surface stains, though some also contain low levels of peroxide. When buying such products, look for those with the ADA Seal of Acceptance.

Instrinsic stains can only improve with “Whitening” or “Bleaching.” Bleaching products can be purchased over-the-counter or from your dentist. Over-the-counter bleaching products include whitening strips or gels that are painted directly on the teeth or are delivered in trays. These use only peroxide to whiten.

A bleaching product from your dentist is a gel delivered in custom-made trays that are fit to minimize the contact of the gel with the gums. Concentrations of the peroxide can range from 10 to 38 percent and the length of treatment is determined by the concentration that is used. Studies have found that daily treatment times range from 2 to 10 hours for periods of 6 to 28 days.

How Effective is Bleaching?

The extent to which bleaching works may be impacted by the type of intrinsic stain. For example, brown stains from tetracycline may be more responsive than white stains. Patients also need to know that only their natural teeth will change color; restored teeth, such as crowns and implants, will not change color. In addition, The American Academy of Pediatric Dentistry discourages full-arch cosmetic bleaching for children who do not yet have all of their permanent teeth. Finally, the type of stain also can impact the length and number of treatments needed to achieve the desired result.  For example, treatment for tetracycline stains may take up to six months.


Temporary tooth sensitivity is a risk with all forms of bleaching, possibly related to the inflammation of the pulp because of peroxide exposure. This sensitivity may develop within two to three days with the start of bleaching, but it usually resolves by the fourth day after treatment.

Gum irritation can be a temporary side-effect from gel-based products. However, this is usually due to poor fitting trays or the improper application of the protective barrier or gel. The good news is that gum irritation typically resolves shortly after the end of treatment.

So, if you are dreaming of white teeth this holiday season, you no longer have to just dream. While results may vary depending upon the whitening product used, as well as the type and severity of tooth stain, both mechanical means to whitening and bleaching agents have been shown to be effective. The good news is, if side effects do occur, they are temporary when whitening products are used correctly. So…have a happy holiday and a white smile!



“Whitening” – https://www.ada.org/en/member-center/oral-health-topics/whitening