Cosmetic Dentistry 101: Teeth Whitening (Part I)

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By Dr. Salina Suy

Yes, it’s here and you asked for it. Whitening teeth is the most common thing patients talk to me about.

“Dr. Suy, I want my teeth whiter. What can I do?” Let’s answer your concern, but the answer is different for every patient.

This is the first segment in a series on teeth whitening. We will talk about different factors that affect whitening and June’s column will talk about different products.

What is first step?

The first step is to be examined and interviewed. Although most whitening products are harmless, the point is to cause no harm to your patient and to not waste time or money if something is not going to work.

Statistically speaking, there is actually about 5 percent of the population that won’t whiten.

Let’s go through the checklist:

Oral hygiene regimen

The recommended regimen for patients is brushing at least twice a day and flossing once.

Some patients will need to do more to maintain their health.

Toothpaste has different properties for whitening. I recommend usng a toothpaste that is suitable for brushing sensitive teeth for protection purposes.

Although we all like to think we brush perfectly, sometimes we are brushing wrong. Reviewing proper brushing technique is important — if you have been brushing wrong all along, you could potentially have whiter teeth by improving your technique, frequency or toothpaste.

Diet type and frequency

Where are my coffee lovers?

Yes, coffee and tea will stain your teeth, but anything with dark coloring will.

Snacking frequently makes the environment in your mouth more acidic. Beware of cavities from grazing.

Dental history

Have you seen your dentist lately?

First things first: If your oral health is not supreme, you should not be whitening.

The No. 1 prerequisite for whitening is a healthy mouth. Also important is a cavity-free environment, and you must determine what dental restorations you have and if they will whiten.

Also, the whitening agent will not affect the majority of those who use dental materials such as crowns and fillings.

Medical history

Some people are actually born with “soft teeth”— these are genetic defects of the parts of the tooth surface and are typically diagnosed at a young age.

This is no excuse in place of good oral care, but about 3 percent of the population actually has genetic defects.

If a patient has a certain pattern of staining, it might be an indication that they were on antibiotics when they were young and this affected developing tooth buds.

There are many other medical factors, and these are just a few examples.


Tobacco usage of any kind can cause outside and inside staining. This staining can be black, brown and sometimes grey.

Depending on the type and duration of the tobacco, it may or may not be easily removed. The main problem is if you whiten and then use tobacco again right after, how long is that going to last you?

Now what?

After you have gone through the checklist, you have to find the right whitening ingredients.

We will explore how to understand whitening products and find what is best for you next time in “Smile With Dr. Suy.”