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Tooth discolouration can be separated into either extrinsic staining (surface stain) or intrinsic staining (internal stain). As we age teeth will become darker with age, often due to the build-up of surface staining or due to the removal of enamel which exposes a tooth’s darker under-layer (called dentine). Many people would prefer their teeth to be whiter and therefore consider various whitening and bleaching options.
Teeth can become discoloured when they are forming. For example if you have a childhood illness when your teeth are forming this can affect the colour of your tooth enamel. When the nerve dies within a tooth it can often go darker. Teeth also darken naturally with age as a result of progressive hardening within the tooth or because of the loss of enamel.
Many factors from our diets/lifestyles can stain your teeth such as tea, coffee, smoking, red wine etc. Medicines containing iron and heavily coloured foodstuffs can also be a contributing influence. Tartar (also known as calculus) which builds-up around the base of teeth will tend to pick up more staining than clean enamel. This type of staining can usually be very effectively removed by a dentist or hygienist.
Teeth which are non-vital (i.e. the nerve inside the tooth has died off) are often darker than the teeth which have a live nerve. Once the nerve within a tooth dies off the contents of the blood vessels within the nerve leach out into the body of the tooth leading to discoloration of the tooth. A tooth with a dead nerve often require root canal treatment and this type of discoloration can happen after the tooth gets root-filled. A tooth such as this can be bleached internally, whereby a dentist will place a chemical agent inside the tooth in order to bleach the tooth from the inside. In other cases the tooth’s colour can be masked with white filling material or a veneer.
How can you remove staining/discolouration?
Regular visits to the dentist or hygienist and proper tooth brushing are all an essential part of maintaining good oral hygiene and a healthy mouth. All of these actions will serve to keep your teeth as bright-looking as possible
Bleaching is the use of chemical agents to produce an oxidation of the discolouring molecules within the tooth. It is not a temporary process. A dentist using chemical agents can also remove superficial stains such as tobacco, tea and coffee.
Dentists can improve the colour of a tooth by applying a chemical (generally hydrogen or carbamide peroxide) to the surface of the tooth. This can be done in the surgery or via a home-kit provided by the dentist (with detailed instructions). Typically the dentist will take moulds of the mouth to create custom made trays. These will then be supplied to the patient along with a bleach solution. The patient will be instructed to place the bleach in the trays and wear the trays for a specific amount of time .A course of treatment usually takes two to three weeks and the teeth will gradually change to a brighter shade. The most common side effect is increased sensitivity of the teeth to temperature. These symptoms usually subside once the bleaching is ceased.
In-surgery systems usually involve a higher concentration of peroxide, which is used with a powerful dental light unit. A high concentration of bleach is applied to the teeth and a powerful light is used to activate it. This is done for 30-60mins in the dental chair.
Effectiveness of bleaching
Teeth with a yellowish hue usually bleach well, brownish ones less so; greyish teeth may not bleach well at all. Discoloured fillings will not improve with bleaching. They will show more if the surrounding tooth structure is bleached and they may have to be replaced. The dentist will be able to tell if bleaching is suitable, or not, and discuss other options such as veneers and crowns for improving the appearance of the teeth.
Whitening toothpastes generally only work on extrinsic staining. They contain abrasive additives which remove surface stains. However these additives can remove the surface of the enamel. Also these types of toothpastes cannot whiten the structure of the tooth itself.
Veneers can be used to cover discoloured teeth. Additionally they can be used to change the shape of teeth. Veneers can also be used to close small gaps when braces are not suitable. If one tooth is slightly out of position, a veneer can sometimes be fitted to bring it into line with the others. Here is how they work. Modern veneers can be very thin and thus can sometime be fitted with no or little tooth reduction, making them a very aesthetic and safe option. Below is the process required to place veneers:
As veneers are very thin they may not be suitable to mask very dark teeth. If you are unsure if veneers are suitable for you please contact us at Westdene and we will be happy to discuss them with you.
For more information on veneers please see the section titled broken teeth in the ‘I’m in pain/discomfort’ menu.
Composite bonding can be used to improve the shape, colour and general appearance of patients’ teeth. It uses the same resin material used for white fillings, and can be a conservative technique i.e. no drilling of the teeth is required.
There have been huge advances in the materials used in bonding dentistry in recent years, meaning composite bonding can be used for disguising minor imperfections in the front teeth, closing small gaps and hiding minor tooth rotations, with no damage to your teeth. As a result this type of material can be a useful solution to the problem of discoloured teeth.
Composite bonding is a pain-free experience that requires, in most cases, just one visit to the practice. Your dentist will be able to choose a shade of resin that closely matches the colour of your teeth, meaning that the results will look entirely natural.This is how the treatment works:
Although composite bonding will not offer as much longevity as veneers or crowns they can be a cheaper and more conservative option. It can also be repeated with no damage at all to your teeth.