Many patient's teeth are darker than they prefer. Many things contribute to a tooth's color. We have no control over some factors. We all inherit a certain tooth color. The darker our complexion is the darker our teeth tend to be. However a person with dark skin often appears to have light teeth because of the contrast in skin vs. tooth color. When women stopped wearing dark lipstick colors about 15 years ago we were nearly driven crazy explaining that their teeth had not darkened it was their lips that had lightened.

Other factors tend to make our teeth darker than they might be. Everyone's teeth darken with age. This can be a real problem if there is one porcelain crown among natural teeth. The porcelain does not darken and after 15 to 20 years will look too light as the teeth next to it darken. Other things that tend to darken teeth include smoking, coffee, tea, dark soft drinks and some foods. Lack of good brushing and flossing can cause a green brown stain that can be impossible for us to remove. Another problem we sometimes see is an effect of a child being placed on an antibiotic called tetracycline. Tetracycline will cause the enamel that is forming while this medication is in the body to be stained gray to brown and can be quite a difficult problem as this stain is within the enamel of the tooth.

In the past, we have had limited success in lightening dark teeth. Periodic cleaning and good brushing and flossing at home are important. There are some bleaching techniques that help but they normally took three appointments and could cost up to $500 and had to be repeated every couple of years. As a last resort, we would have to do a porcelain crown at $690 per tooth.

There is a new technique that is done primarily at home. We take impressions of your teeth and make a thin clear plastic tray. You use a special toothpaste twice a day and place a bleaching agent in the tray and wear it for an hour twice a day. I have tried this and found I could wear the tray in the office and no one seemed to notice.

This technique is reported to work well with teeth that are stained due to age, smoking and foods and less well on tetracycline stain. About 4 percent of patients in trials had problems. The tray tends to put a little pressure on teeth and can cause them to be slightly sensitive. The bleach can cause patients with sensitive teeth to become more sensitive. There have been reports of break down of gum tissue in patients that do not do a good job of brushing and flossing and a few patients seem to have tissue breakdown for no apparent reason. A few patients developed nausea, a sore throat, sore teeth or jaws. It has been reported that all the side effects resolved quickly when treatment was discontinued.

The chemical bleach is a carbamide peroxide. The long term effects and how long the lighter color will last is not known. In the studies I have read there is little or no effect to crowns or fillings. One type of plastic filling was etched microscopically but this could not be seen with the unaided eye. This treatment is not approved by the Food and Drug Administration. However, since it is a cosmetic procedure, FDA approval may not be necessary.

How long does this all take? I used it on my teeth. They lightened three shades and I could see a big change in 3 days. We do not think there is any reason to continue past 2 weeks. The cost of the treatment is $200 and is not covered by most insurances. Back to newsletter index