Those Pearly Whites

for those of you that don't know, i am a dental hygienist. yes, i know what you're thinking..."ew, how can she work in people's mouths?" my reply to you is.... "ew, how can I work in people's mouths?"

the only reassurance that i can give myself is that at least i don't work at the other end. i know you agree with me. i think the universe can even agree that its much more glorious to work where the food goes in rather than where the food goes out.

i have many stories i can tell about my job. like the one time the guy gagged and stuff flew all over my face (thank god for universal precautions like masks and eyewear), or that time when the guy tried to talk on the cell phone while my hands were in his mouth, or that time when a lady admitted that she brushes her teeth once a week. but those will be saved for rainy day.

instead, today i will discuss a topic that i get asked about the most while i'm at work: teeth whitening! woohoo! i know what you're thinking... "now i can finally get teeth like all the movie stars!"

i hate to burst your bubble, but no, your teeth will not be like the movie stars unless you are a movie star. and if you were a movie star, you would be paid to look like a star. and if you were paid to look like a star, then you wouldn't be bleaching your teeth, you would be getting a full smile of porcelain veneers

(for all intensive purposes, veneers are like a shell that goes on the outside of your teeth. they straighten the smile and they never stain. so uh, next time you want that movie star's smile, just be aware that they aren't their actual teeth. in fact, some of the veneers looks pretty bad. for examples of veneers you can googleimage george clooney, hilary duff, miley cyrus, tom cruise).

there are a few ways a common person can whiten their teeth. i'll begin with the least expensive/easiest and continue with the most expensive.

a few points to make, however, before we begin...

1. if you smoke, don't even think about whitening. it's pointless.

2. if you are an avid coffee, tea, or red wine drinker... good luck.

3. if you have cavities, you must get them fixed first.

4. if you are older than 60... how do i put it nicely? let's just say that as you grow in wisdom (and years), the second layer of your tooth grows as well. this second layer, the dentin, is yellower than enamel. so over time, though you gain wisdom and your hair gets whiter, your teeth will not. they will yellow from the inside out. there is nothing you can do about that. i'm so sorry to have to be the one to break the news. don't hate.

let's talk prevention. before you spend money on whitening products, know that your diet (aka what you eat), your habits, your genetic makeup, and your oral homecare, believe it or not, have a ton to do with the color of your teeth.

when you see me for a prophy (a cleaning), my job is to remove all the buildup that you so nicely accumulate for me during the six months or twenty years that you neglect your teeth. that buildup can be plaque, calculus, or stain.

• plaque- the soft white stuff that you scrape from your teeth with your fingernails. it's the stuff that makes your teeth feel fuzzy after you eat candy. cause: sugar.


• calculus- 'calc.' the chalky white/yellow stuff that you accumulate inside of your lower front teeth. this begins as plaque, is not disturbed (brushed/flossed) for a certain amount of time, and calcifies (hardens). this is the stuff i scrape off. this causes gum disease.


• stain- stain can be brown, yellow, black, or any shade in between. this stain is mostly on the outside of the tooth and is caused by smoking, tobacco use, medicines, dark drinks, and certain dark foods.

plaque, calculus, and stain are all colored. whitening products will not work when these items are on your teeth. therefore, your first job is to keep them off your teeth as best as possible. how will you do that, you wonder?? yes, that's right. brush, floss, brush. here's the very best homecare regimen that i give my patients:

1. brush twice a day with an electric toothbrush (for TWO WHOLE MINUTES each time).


2. floss properly every 24 hours. the alternative to flossing is to use a waterpik. and you don't have to floss at the same time you brush your teeth. keep it stuffed in your couch and floss during your fav tv show each night! what's wrong with that? for a video on how to floss properly go here


3. use an antibacterial mouthrinse each morning. for those of you that use scope... stop. scope and similar products are mouth fresheners and only leave you tasting good. read the labels carefully. listerine and crest prohealth are only two examples of good ones. oh and stop diluting listerine. the more you use it, the less it will burn. it doesn't work if you dilute it. so then you may as well be using scope. but don't do that either.


4. use a fluoride mouthrinse right before you go to bed. a good example is ACT. do not drink or eat after it. fluoride strengthens your teeth and is actually opaque, soooooo.... guess what? it's going to naturally make your teeth whiter!!


5. get a prophy every six months.

follow those five steps and your teeth will be the whitest and strongest that they can naturally be. now should you use a whitening toothpaste? it depends. products can claim they whiten your teeth if they have one of two things in them: an abrasive product or a chemical bleaching agent. (ps- if your teeth are sensitive already, stay away from whitening products and stick to sensitivity products).
for an example of an abrasive toothpaste, think crest. it's gritty. when used properly, it scratches off extrinsic stain from food and drink. but if you don't accumulate extrinsic stain, then there is no reason for you to use this.
for a toothpaste to be non-abrasive and to claim that it can whiten your teeth, then the only other option is to have some kind of bleaching agent in the ingredients (hydrogen peroxide or carbamide peroxide... check the ingredients). now remember, these agents will only work if you don't have any filth on your teeth (refer back to the three bullet points).
so if you are doing all of the above and you still want whiter teeth, then i'll move on to over-the-counter (otc) whitestrips. yes, of course, they work. most times, the more expensive the product, the higher percentage of bleach is in it, and the faster it will work.
BUT... i always recommend starting out with a product with the lowest amount of bleaching agent in it. it may take a few more days to achieve the same result, but there are two concerns with doing it too fast: sensitivity and overkill. you will become more sensitive when you bleach, that's a fact. so try to prevent some sensitivity and use the least amount of bleaching agent possible. also, overkill... noone wants to hang around someone with their teeth soooo white-that-they-look-blue and like they tried too hard. many patients are happy with improving 2-3 shades instead of 6-10. so take it slow.
if you decide you would like to use an otc product, be sure to use your fluoride mouthwash at night. you will have enhanced whitening results and decreased sensitivity. easy.
if you have crooked teeth, though, whitestrips won't be as effective because they won't get in the nooks and crannies. i'm not a fan of the whitening gels and anything else you paint on because saliva immediately waters it down and it becomes less effective. so, if you have crooked teeth, have a whitening tray fabricated (think flimsy retainer) at the dentist. this will be most effective for you. it will be more money up front, but because the bleach they give you is stronger (versus otc products), you will achieve the same result faster. the whitening tray will last forever, and you buy more bleach at the dental office when you run out.
most times, bleaching every day for a week straight will let you reach your desired result. after that, if you use the right homecare like we discussed earlier (refer to numbers 1-5 above), then you can touch up once a week, once a month, or once a season! it's great!
the last option is to do in-office bleaching. this should always be the last resort. you'll see dental offices advertising the ZOOM whitening system with the 'magic' light. it's expensive, time consuming, and there is no guarantee. this is great if you are going to prom tomorrow night, or getting married next week, or if nothing else has worked for you.
if you decide, however, to bleach at home, make sure you alert your hygienist. that way, she can monitor the health of your dentition better than you can. plus, you can ask her any questions that may come up.
if you still want to drink coffee and have white teeth, drink it through a straw. it's weird but get over it.
sidenote: there are whitening kiosks and shops in the malls now. this is a fad that will hopefully not last much longer due to the legality of it. but a word of warning: do not go to them. the employees manning those stands may have scrubs or white lab coats on, but that does not give them any credit or mean they are licensed. they are not dental professionals, know nothing about teeth, and could potentially harm you.
and lastly, i always get asked if bleaching is safe. the following is a summary of the latest research:
"People should be aware of the common side effects such as tooth sensitivity and irritation to the gums and note that long-term data on the use of such [whitening] products are not yet available."
this quote, to properly site it, was taken from a site called The Cochrane Collaboration. fyi: it's the best site for unbiased medical information.
i hope this helps. if you've got questions, feel free to ask! i'm mostly blogging about this stuff because i'm tired of getting out of breath explaining it to my patients. now i can say "just go to my blog." ok, seriously, i don't give my blog out to my patients.... that's really creepy to think about.

(If you are still reading this, then you are a hygienist or just plain kool.)

. . .

.with love.

.with hope.

(m)