Question for Dr Emma - "Teeth Whitening"

Dental Health

Dr. Emma

Q&A With Dr Emma

Hi Dr Emma, I was wondering just how effective all the different teeth whitening toothpastes are, and also those little kits you can buy where you put the gel in a rubber mouth guard and wear it before bed for a week. Do these things actually do anything or if you want slightly whiter teeth is the only real option to go to your dentist? Duncan from Victoria Park, WA.

Dear Duncan,

To understand how tooth whitening products work, you first need to know a little bit about tooth staining.
There are two main types:

  • Extrinsic staining: Brown, black or green staining on your teeth that comes from an external source. Most commonly this is from cigarettes, coffee, tea, and red wine, but there are also other causes.
  • Intrinsic staining: Brown, grey, green, orange, yellow or white discolouration of the actual tooth structure. This can be caused by taking a certain type of antibiotics in childhood, from ingesting too much fluoride as a child, significant childhood illness, or the natural colour of your teeth may just be yellower than you'd like.

Whitening toothpastes target extrinsic staining. The positive is that they help to remove tooth staining from food and drinks, and if used regularly will help stop it building up again. On the down side, they tend to be more abrasive than a regular toothpaste so are unsuitable for people with sensitive teeth or those who are concerned about tooth wear. They will not change the underlying colour of your teeth.

Whitening gels, liquids, strips and the like are used to correct intrinsic staining. They are usually peroxide based and will vary in strength depending on who sells it to you, (supermarket, pharmacy or dentist). The positive of the over the counter kits you mentioned is that they are inexpensive and may provide the desired result for some people. The negatives are that a dentist has not necessarily diagnosed your type of staining, ensured your mouth is healthy first, and then recommended the most appropriate whitening treatment for you.

Some teeth and types of staining will not respond to whitening treatment, so you may be wasting your time and money. There is also a risk of temporary tooth sensitivity, (particularly to cold), and damage to the gums and other oral soft tissues. This is because the trays are not custom fitted, so the gel is free to flow up over your gums as well as your teeth. There is also some concern about overuse as the treatment is not being monitored, and with excessive use the teeth themselves can be damaged.

So, to answer your question, over the counter whitening products may be helpful in whitening your teeth at home. You now know it depends on the type of staining you have, and your individual mouth. If you want to have the best chance at whitening your teeth, consult with your dentist who is able to diagnose, treat, and monitor your whitening, and can use a more concentrated peroxide product than is available over the counter. Then you can focus on enjoying your new whiter smile!


Dr Emma

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Important: This article is general advice only. For further advice or information on this topic, please consult your health professional.


Category:Dental Health

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