Since the moment I entered dental school friends, family and casual acquaintances frequently ask about the most effective ways to get a whiter, brighter smile. Over the last couple of years I’ve noticed that, not only is this a popular topic over cocktails, it’s constantly popping up on social media. Here I offer the thoughtful opinion as a dental professional who is neither trying to sell you something nor garner more Instagram likes.

How well a product or procedure will work for you is largely dependent on why your teeth are discolored. Stains from coffee or tea are removed relatively easily; discoloration that happened while the teeth were developing presents a challenge. It’s also important to remember that restorations like crowns or fillings will not whiten with the rest of your teeth. There are pros and cons to each type of product, and I’ll do a quick run through here and touch on some of the trendier options.

Whitening toothpaste
One product with a ton of social media buzz right now is NuSkin’s AP24. Several of our staff members have tried it. The general consensus between staff and patients is that while it does seem to do a good job of removing and preventing stains, it’s not a very dramatic change. You can check out the American Dental Association’s website for a list of stain-removal toothpastes from brands like Crest, Colgate and Tom’s of Maine. All of them have the ADA Seal of Acceptance and are priced much lower than the roughly $20-a-tube price for the AP24.

Social media has also popularized “at home” methods of whitening such as using activated charcoal or “oil pulling” (swishing oil, most popularly coconut oil, for 10-20 minutes a day). There is very little scientific evidence supporting either of these methods, and neither should replace brushing with a fluoridated tooth- paste and flossing. Activated charcoal could potentially be very abrasive and may damage teeth or gums.

At home whitening strips and gel
The next step up from a tooth paste in “bleaching power” is an over-the-count- er white strip or gel containing peroxide, generally either hydrogen peroxide or carbamide peroxide. These products can cost anywhere from $30 to $100. Twenty eight to 35 percent of carbamide peroxide is roughly equal to 10 percent hydrogen peroxide, and that’s about as high as you should use without the supervision of a dental professional.

Higher percentage products come with a greater risk of tooth and gum sensitivity which is why you should obtain them from, and be monitored by a dental professional. Any bleaching system with peroxide comes with the risk of tooth sensitivity, and I generally recommend patients should start using a toothpaste for sensitive teeth at least 2 weeks prior to bleaching. At home whitening systems can cost any- where from $10-100.

In office whitening
For a faster and more dramatic result, see your dentist for in-office whitening. At home whitening products are usually designed to be used over several days or weeks, where in-office whitening can usually be completed in an hour or so. A much stronger bleaching agent can be used because you will be monitored closely and precautions will be taken to protect your gums and cheeks. They may apply the agent several times based on the desired result. Again, sensitivity is the main possible side effect.

Our office uses the “GLO Science System” that contains an ingredient specifically to combat tooth sensitivity that is also used in products like Sensodyne. In office whitening can cost between a couple hundred to a thousand dollars.

One thing you can do that will cost you zero dollars to make your teeth healthier as well as look and feel better is to get whatever toothbrush and tooth- paste you have, set a timer for two minutes, and then to brush gently for the whole time. Most people think they’ve been brushing for two minutes but it’s really only about 40 seconds. If you’re a working mom with two little kids, you probably don’t always get to brush for two whole minutes … and you can probably tell the difference when you don’t.

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