October 29, 2010 – Having bright looking white teeth is every ones concern. For those with this deficient, a craving that leads one being prone to exposure to all manner of so called professionals. Tooth discolouration is the change in colour from the normal white enamel (the outer part of the tooth) to the darkening or brownish discolouration. Persistent tooth discolouration can also occur as a result of the gradual thinning of the enamel layer of the tooth. This thinning allows for more yellow -brown dentin formation underneath becoming visible a condition called amelogenesis imperfecta.

What causes tooth discolouration?

Several factors play a role in this process.

1. Exposure to some chemicals can also promote tooth discolouration in some individuals. In cases of amelogenesis imperfecta, the enamel is often absent and the exposed dentin (the inner tooth part) has a yellowish-brown discolouration. This condition is an inherited disorder with defective tooth enamel formation caused by various gene mutations. The condition is treated with resin veneers and jacket crowns for anterior teeth, as well as steel crowns for posterior teeth.

2. Habitual use of coloured foods such as coffee, tea, and cola cause tenacious brown to black discolouration.

3. Smoking marijuana causes a delineated ring discolouration around the ‘neck part of the tooth’. Smoking tobacco and or cigars lead to yellow discolouration. Chewing tobacco makes it worse with deeper discolouration.

4. Exposure to substances such as Fluoride is another cause. This can be due to fluoride from drinking water, tooth pastes, supplements, and infant formulas resulting in fluorosis – a condition of excess fluoride in the system. The excess fluoride interacts with mineralising tissues, causing alterations in the mineralisation process especially in the teeth. Fluoride in drinking water in excess of 1.5 parts per million causes colouration.

5. Some diseases an cause discolouration such as liver problems that cause jaundice or another condition called porphyria leading to brown teeth.

6. Vitamin deficiencies can also cause colour changes in teeth.

7. Trauma to the enamel leads to the exposure of denting that shows a yellow-brown colouration.

8. A tooth that appears pink (pink tooth of Mummery) indicates an internal tooth resorption.

9. Yellow to violet staining that fluoresces under ultraviolet light is normally due to exposure to tetracycline. It is advisable to avoid these drugs during pregnancy and up to 18 years of age as the teeth are growing and developing. Tetracycline also destroys the calcium deposits in bones and teeth.

10. It has been shown that regular use of mouthwashes that contain Chlorhexidine as their active ingredient increases the incidence of tooth discoloration.

How to bleach

The home based Bleaching Kits

This is a do-it-yourself method that you can use at home. The kit contains diluted dentist approved hydrogen peroxide (1% – 10%). Other kits may have carbamide peroxide (at 10% – 20%) gel. The gel is applied topically to the teeth and left for some minutes. The gel is a good whitener for teeth that acts by breaking the stains. It also enters the enamel and dentin of the Teeth where it bleaches the stained substances.

Steps in bleaching the teeth include:

1. Step one; Rinse the teeth with a mouth wash containing citric acid. The acid helps to remove the pellicle, an enzyme layer that dental plaque clings to.

2. After cleansing the teeth, use a cotton swab and dip in the hydrogen peroxide solution provided. Remember, it has to be in a concentration of 10% to 20%. You may also use the carbamide peroxide gel.

3. The kit comes with the whitening substance such as titanium dioxide paste. After the gel application, allow a few minutes then apply the paste and polish to the surface clearly.

4. Allow a few minute then rinse your mouth with distilled water

Please note that due to the lesser contact time of your teeth with the bleaching agents, the treatment results may not be displayed immediately. You may have to repeat this again till you get the result. If you are not comfortable with the kit, you may consult your dentist.

Dentist Supervised bleaching

This is a three step procedure that involves:

1. Cleaning of the teeth by the dentist to remove superficial stains. He may use the dental equipment to do this unlike what you use at home.

2. Application of the gel to the teeth to allow bleaching and removal of the plaque. The carbamide peroxide concentration used is about 35% – 44%. (references)

3. The dentist will then provide a dental tray that is to be worn for approximately one hour everyday. This can be done at night while sleeping or during the day, which ever is comfortable to use. Note that the tray does not interfere with your speech.

Studies show that dentist supervised bleaching is effective in about 90% of patients.