Brightening a Less-Than-Brilliant Smile

Advances in cosmetic dentistry have made it possible for people to maintain or restore their pearly whites. Dr. Larry Rosenthal, DDS, of the New York University School of Dentistry, explains what causes tooth discoloration and gives some advice on how to turn a smile from dingy to dazzling.

Rosenthal says teeth lose their whiteness for a number of different reasons. Some teeth are born dark, while others become stained over time with smoking or drinking dark liquids. The environment may also play a role. Although the fluoride in water makes teeth stronger, it could also cause discoloration. Some medicines, such as the antibiotic tetracycline, could also darken teeth.

There are a number of different whitening methods. A bleaching solution works on "aged teeth" or on "genetic discoloration." Rosenthal says it's the most conservative way to brighten teeth. The solution works by whitening enamel and the tooth's underlying layers. The most common element in bleaching solution is peroxide. It is available over-the-counter starting at $50.

Another option for whitening is the professional home bleaching method. It requires a dental tray, which can be customized to your mouth by getting a fitting from your dentist. The tray with bleach inside can be worn overnight or for an hour each day. A tray usually costs anywhere from $300 to $1000.

Laser bleaching is another whitening procedure. The laser light is used to accelerate the whitening solution. The entire process takes about 80 minutes and costs anywhere from $500 to $2500.

Porcelain veneers are another way to whiten teeth. This option works best for teeth that are discolored because of genetic, medical or environmental reasons. The procedure is done in the dentist's office. The tooth is roughed up, covered with glazed porcelain and then the porcelain is bonded to the tooth. This procedure can be used in conjunction with bleaching. This process costs $600 to $2000.

Whitening toothpaste is perhaps the cheapest option. The paste, however, stays on teeth for only a short time and usually does very little to whiten teeth substantially.

Rosenthal says it's important to remember that each whitening procedure carries its own risks. It is often difficult to determine the color your teeth will end up at the end of a procedure. Patients also sometimes suffer tooth sensitivity or gum irritation with whitening procedures. Too much bleaching can also make teeth too brittle or too sensitive.

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