Houston Lifestyles & Homes March 2010
Desire a Dazzling Smile
Explore an array of pearly whiteners
By Cheryl Alexander
Options abound for anyone who is interested in boosting the brilliance of their smile. So many choices are available for you to consider if the shade of your teeth doesn ’t satisfy your desire to dazzle. There is honestly a solution for every budget, time frame and disposition —from at-home bleaching kits to sessions in the dentist chair.
Yet despite the plethora of pearly whiteners on the market and the success stories claimed by all of them, according to the Consumer Guide to Dentistry, only a slight 15 percent of the population has actually tried this easy procedure, mostly due to misinformation on the subject. Here, we will offer you information to clear up some of your most common questions and put a bright, white smile back on your face.

What is tooth discoloration?
Tooth discoloration refers to the stains that accumulate on teeth. There are two categories of staining as it relates to the teeth: extrinsic staining and intrinsic staining.
Extrinsic stains appear on the surface of the teeth as a result of exposure to substances that stain the teeth. Most of these minor stains can be removed with brushing and regular trips to your dentist for cleaning. Stubborn extrinsic stains can be removed with more involved efforts, like teeth bleaching.
Intrinsic stains form on the interior of teeth. Intrinsic stains result from more profound experiences such as trauma or aging, or exposure to minerals during tooth formation and/or excessive ingestion of fluoride. Previously, it was thought that intrinsic stains were too resistant to be corrected by bleaching. Now dentists believe that even deep-set intrinsic stains can be removed with supervised take-home teeth whitening maintained over time.
What causes tooth discoloration?
Web MD reports several causes of tooth discoloration, including:
•Foods/drinks. Coffee, tea, colas, wines, and certain fruits and vegetables (for example, apples and potatoes) can stain your teeth.
•Tobacco use. Smoking and chewing tobacco stain teeth.
•Poor dental hygiene. Inadequate brushing and flossing which will remove plaque and other stain-producing substances (like coffee and tobacco) can cause tooth discoloration.
•Disease. Several diseases that affect enamel (the hard surface of the teeth) and dentin (the underlying material under enamel) can lead to tooth discoloration. Treatments for certain conditions can also affect tooth color. For example, head and neck radiation and chemotherapy can cause tooth discoloration. In addition, certain infections in pregnant mothers can cause tooth discoloration in the infant by affecting enamel development.
•Medications. The antibiotics tetracycline and doxycycline are known to discolor teeth when given to children whose teeth are still developing (prior to age 8). Mouth rinses and washes containing chlorhexidine and cetylpyridinium chloride can also stain teeth. Antihistamines (like Benadryl), antipsychotic drugs, and drugs for high blood pressure also cause tooth discoloration.
•Dental materials. Some of the materials used in dentistry, such as amalgam restorations, especially silver sulfide-containing materials, can cast a gray-black color to teeth.
•Advancing age. As you age, the outer layer of enamel on your teeth gets worn away revealing the natural yellow color of dentin.
•Genetics. Some people have naturally brighter or thicker enamel than others.
•Environment. Excessive fluoride either from environmental sources (naturally high fluoride levels in water) or from excessive use (fluoride applications, rinses, toothpaste, and fluoride supplements taken by mouth) can cause tooth discoloration.
•Trauma. For example, damage from a fall can disturb enamel formation in young children whose teeth are still developing. Trauma can also cause discoloration to adult teeth.

What are my teeth whitening options and what do they cost?
The Consumer Guide to Dentistry reports that there are three major teeth whitening options available today. All three rely on varying concentrations of peroxide and varying application times.
In-Office Whitening
In-office whitening offers the most significant color change in the shortest period of time. This choice involves the carefully controlled use of a relatively high-concentration peroxide gel, applied to the teeth by the dentist or trained technician after the gums have been protected with a paint-on rubber dam. Generally, the peroxide remains on the teeth for several 15 to 20 minute intervals that add up to an hour (at most). Those with particularly stubborn staining may be advised to return for one or more additional bleaching sessions or may be asked to continue with a home-use whitening system.
Southwestern Society of Oral Medicine Past President Dr. Ronada Davis, D.D.S., advocates that patients not do the in-office whitening procedure more than once every two years. “In my practice, most patients that have it done are so thrilled with the results they really keep their teeth clean and do not
repeat the process before five years, if ever.” (ddsassociates.com)
In-office teeth whitening usually costs $650 per visit (on average) nationwide.
Professionally Dispensed Take-Home Whitening Kits
Many dentists agree that professionally dispensed take-home whitening kits can produce the best results over the long haul. Take-home kits utilize an easy-to-use lower-concentration peroxide gel that remains on the teeth for an hour or longer (sometimes overnight). The lower the peroxide percentage, the longer it may safely remain on the teeth. The gel is applied to the teeth using custom-made bleaching trays that resemble mouth guards. This option can cost from $100 to $400.
Over-the-Counter Whitening
The over-the-counter option is the cheapest and most convenient of the teeth whitening options. A store-bought whitening kit features a bleaching gel with a concentration lower than that of the professionally dispensed take-home whiteners. The gel is applied to the teeth via one-size-fits-all trays, whitening strips or paint-on applicators. In many cases this may only whiten a few of the front teeth unlike custom trays that can whiten the entire smile. The cost can range from $20 to $100.
Generally speaking, the price of tooth whitening increases with the number of in-office treatments required by the patient. Dental insurance does not typically cover the cost of the procedure.

What are the risks associated with whitening my teeth?
Tooth whitening treatments are considered to be safe when procedures are followed as directed. However, there are certain risks associated with bleaching that you should be aware of:
•Sensitivity: Bleaching can cause temporary sensitivity to temperature, pressure and touch and is most likely to occur during in-office whitening, where higher-concentration bleach is used. Some individuals experience spontaneous shooting pains, called “zingers,” down the middle of their front teeth. If you have receding gums, significant cracks in your teeth or leakage resulting from faulty restorations, you may be at greater risk for sensitivity. Whitening sensitivity is usually gone after a day or two, and your dentist may recommend a toothpaste containing potassium nitrate to alleviate sensitivity.
•Gum irritation: Over half of those who use peroxide whiteners experience some degree of gum irritation resulting from the bleach concentration or from contact with the whitening trays. This type of irritation can typically last several days.
•Technicolor teeth: Restorations such as bonding, crowns or veneers are not affected by bleach and therefore maintain their default color while your surrounding teeth are whitened. This results in what is frequently called “technicolor teeth.”

What maintenance is required to keep my teeth white and bright?
To extend the longevity of newly whitened teeth, dentists recommend:
•At-home follow-up or maintenance whitening—implemented immediately or performed as infrequently as once a year.
•Avoiding dark-colored foods and beverages for at least a week after whitening.
•Sipping dark-colored beverages with a straw whenever possible.
•Practicing good oral hygiene by brushing and flossing after meals and at bedtime.
The long and the short of it is that tooth whitening works. Almost everyone who opts for this cosmetic treatment will see improvement in the brightness and whiteness of their smile. However, tooth whitening effects are not permanent and will require maintenance or “touch-ups” for a prolonged effect.
Designed With the Patient in Mind
Memorial Park Dental Spa
Dr. Nishano Thomas is a highly qualified dentist who earned her Doctorate of Dental Medicine with honors from the University of Pennsylvania. With her patients ’ needs in mind, Dr. Thomas helps people smile again. Her practice, Memorial Park Dental Spa, offers a variety of aesthetic and restorative dental services.
Dr. Thomas specializes in Lumineers, veneers and full-mouth restoration using the highest quality dental materials. The patient-centered office encompasses general dentists and dental care specialists who provide professional teeth cleaning, maintenance and gum therapy; cosmetic and restorative dentistry including dentures using high-quality lab work: teeth whitening and Advanced Invisalign. The practice also ensures that the patient will maximize their insurance.
Memorial Park Dental’s team members embody the same principles as Dr. Thomas; patient care is their highest priority. A registered massage therapist helps patients relax before, during or after treatment. A day spa is located within the practice and patients benefit with both free annual massages and teeth whitening services.
Experience the unsurpassed service Memorial Park Dental Spa has to offer.
Nishano Thomas, D.M.D.
6010 Washington Ave., Suite D
713-DENTIST (336-8478)
Warm Smiles, Friendly
Greetings with a Family Touch
Klein Family Dental
Klein Family Dental is a family based general/cosmetic dental practice located in West Houston. Dr. Aric Klein graduated from the University of Iowa and served as a Lieutenant in the Navy. Dr. Amy Klein is a native Texan with degrees from both UT and Texas A &M.
Drs. Klein practice a full scope of general/cosmetic dentistry. Their cosmetic expertise ranges from porcelain veneers to dental implants, crowns, bridges, whitening procedures, and even Invisalign treatments (clear braces system). They focus on preventative care; however, if the need arises Drs. Klein will manage root canals, oral surgery, bad breath, and prosthetic needs.
Klein Family Dental offers both nitrous (laughing gas) as well as sedation dentistry for the apprehensive patients. Drs. Klein treat pediatric through geriatric patients with an unsurpassed level of comfort and care. With warm smiles, friendly greetings and a gentle touch, they will make you feel like part of their family! Remember, “The journey from ordinary to extraordinary begins with a smile.”
1690 S. Dairy Ashford, Houston; 281-531-9258.
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