Everything you need to know about Teeth whitening

Everything you need to know about Teeth whitening

Tooth whitening is either the restoration of natural tooth shade or whitening of teeth their beyond natural tooth shade.

Restoration of the underlying natural tooth shade is possible by simply removing stains on the surface (e.g. from coffee, tea, red wine and tobacco) & calculus (tartar). This is achieved by having the teeth cleaned by a dentist (commonly termed “scaling & polishing”).

The natural tooth is whitened via bleaching procedures. It is very common in cosmetic dentistry and different techniques are used by dentists.

Types of Tooth staining and discolouration

Teeth may be darkened by surface stains (extrinsic staining), which covers the natural tooth color; or the tooth itself may discolor (intrinsic staining).

Causes of extrinsic staining include:

  • Dental plaque

  • Calculus: hard deposits on the teeth, the color of calculus varies from grey, yellow, black or brown

  • Tobacco

  • Betel chewing

  • Certain foods- food products rich with carotenoids or xanthonoids.

  • Certain Drinks – like sports drinks, cola, coffee, tea, and red wine

  • Certain topical medications such as Chlorhexidine (antiseptic mouthwash) Metallic compounds.

  • Certain medication or other environmental exposure such as iron (black stain), iodine (black), copper (green), nickel (green), cadmium (yellow-brown).

Causes of intrinsic staining include:

  • Dental caries-tooth decay

  • Dental trauma-which may cause staining due to pulp necrosis or internal resorption.

  • Enamel hypoplasia

  • Fluorosis

  • Amelogenesis imperfecta

  • Dentinogenesis imperfecta

  • Hyperemia

  • Tetracycline and Minocycline- Tetracycline is a broad spectrum antibiotic, and minocycline is used for the treatment of acne.

  • Porphyria

  • Hemolytic disease of the newborn

Causes of both extrinsic and intrinsic staining include:

  • Bruxism-(clenching and grinding of the teeth)

  • Age: the tooth enamel becomes thinner over time, which allows the dentin (darker layer than enamel) to shine through.

Treatment options:

Bleaching agents : Bleaching solutions generally contain hydrogen peroxide or carbamide peroxide, which bleaches the tooth enamel to change its color.

Bleaching techniques

1. In office- can be more readily controlled and monitored by professional.

It reduces the risk of patients selecting and using wrong products, product misuse, inappropriate application procedures and effects of an undiagnosed disease.

2. Home bleach- easy to use, time-saving and cost-effective.

Home tooth whitening methods include chewing gums, rinses, toothpastes, paint-on films, bleaching strips, bleaching pen, bleaching gel, and laser tooth whitening.

The effects of both at-home and in-office bleaching are temporary.

Follow-up treatments have often been found to be necessary for between one and three years.

Both the techniques are effective but results may vary depending on factors like type of stain, age of patient, concentration of the bleaching agent, and treatment time and frequency.

  • Contra-indications

  • Pre-existing sensitive teeth

  • Acid erosion

  • Receding gums (gingival recession)

  • Sensitive gums

  • Sensitive to hydrogen peroxide

  • Defective dental restorations

  • Pregnant or lactating women

  • Children under the age of 16- Tooth whitening could irritate the pulp or cause it to become sensitive as pulp chambers are large at this age.

  • Persons with visible white fillings or crowns-Tooth whitening does not usually change the color of fillings & other restorative materials such as porcelain, ceramics, or dental gold. Bleaching may result in color mismatch of teeth with existing fillings or crowns.

Other cosmetic options or treatments to deal with such cases are the porcelain veneers, dental crowns or dental bonding.


The most common side effects associated are increased sensitivity of the teeth and irritation of the gums, which tend to resolve once the procedure is completed.

Hypersensitivity- increased sensitivity to stimuli such as hot, cold or sweet occurs. Use of desensitizing toothpastes may reduce discomfort.

Irritation of mucous membranes- Irritation, burning sensation, discoloration of gums and tissue damage (ulceration) may occur.

Uneven results- Results will settle evenly in with time. To reduce this, avoid consuming foods and beverages that stain the surface of your teeth post-bleaching.

Over-bleaching- Too much bleaching will cause the teeth to appear very translucent also called as bleached effect.

Damage to enamel- Home tooth bleaching products that contain fruit acids can damage enamel and brushing with abrasives such as baking soda.

Bleachorexia- When bleaching is abused & patient develops an obsession with whitening. The term whitening junky has also been used.


In order to maintain your whitened smile:

  • Brush or rinse mouth immediately after eating and drinking

  • Chewing gum

  • Dental Flossing

  • Whitening toothpaste once or twice a week

  • Drink harsh beverages through a straw

  • Do touch up treatments

Get a consultation with our experienced dentists to know more about teeth bleaching procedures or visit our dental clinic in kurla and dental clinic – Near J J Hospital, Byculla (South Mumbai).


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