—Self-Portrait with White Teeth and Sasha

Whitening toothpastes' efficacy and safety are questionable, so the first step is to talk with your dentist. Any procedure that whitens your teeth is purely cosmetic — no health benefits are associated with most whitening treatments. However, in our image-conscious society, many people find they feel more comfortable with a whiter smile.

A tooth has several different layers that can become discolored for various reasons. Things we eat and drink change the color of our teeth because the outermost layer of our teeth (enamel) contains pores that can "hold" these stains. Some products, such as tea, coffee, wine, and cigarettes, stain teeth more than others. The innermost part of our teeth, called dentin, yellows naturally over time. Certain medications or excessive use of fluoride can also cause the dentin layer to yellow. Because whitening toothpastes can only affect the outer enamel layer, they do not affect yellowing of the inner dentin layer. In fact, sometimes whitening toothpaste can make inner-layer discoloring more noticeable.

Whitening toothpastes contain strong abrasives or chemicals that can remove some stains on the outermost layers of a tooth. While these whitening toothpastes may be somewhat effective in removing stains from the outermost layer of your teeth, they can destroy tooth enamel in the process, particularly if used for extended periods of time. No toothpastes are effective for discoloration on the inner layers of your teeth.

Daily brushing (with non-whitening toothpaste) and flossing minimize discoloration, as can professional cleaning at your dentist's office. Dentists also recommend rinsing your mouth with water after having wine, coffee, or other potentially staining foods. If you decide you want to further whiten your teeth, dentists may recommend a number of different treatments. These procedures are fairly safe as long as your dentist follows particular safety guidelines. However, they can also be very expensive. You definitely want to check with your dentist to determine whether or not you really need the procedure. Some of the treatments include:

Tooth whitening

The dentist molds a custom-fitted bleaching tray to be worn over the teeth for a few hours daily for a brief length of time. The tray contains mild whitening gel that seeps into the outer and middle layers of your teeth.

Microabrasion

This is a cosmetic dental procedure that uses an abrasive and a mild acid to remove white and brown spots on the enamel.

Bonding

An enamel-like material is applied to the tooth's surface and then it is sculpted. After hardening, it is polished and results are immediate. This technique can also repair chipped or damaged teeth.

Porcelain veneers

Thin shells of porcelain are glued onto the outer surface of the front teeth. A small amount of tooth enamel needs to be removed from the teeth to make room for the veneer.

Crowns

These are recommended for those with a damaged tooth. A significant part of the tooth structure has to be removed to place a crown.

Bottom line? Talk with your dentist. Everyone's teeth yellow over time, so talking with your dentist will help you figure out what options make sense for you. If you are a student at Columbia, you can contact Health Services at Columbia at x4-2284 to learn about your dental health care coverage and options. Otherwise, you can consult your own dentist, a nearby dental school associated with a university, and/or your own health care provider for a referral. Whether you go with whitened or au natural, know that you can keep on smiling!

Alice

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