Time was when grungy teeth were your destiny and there was nothing much that you could do about them. Today there are gaggles of low tech and high tech ways in which you can put the sparkle back in shades of white that you had only considered for your walls.

Know Your Stain

There are basically two kinds:

* Extrinsic or surface, discolorations which are brown or yellow due to staining agents such as tobacco, tea, coffee, cola, curry.

* Intrinsic or those that are part of the tooth's structure, which include white splotches on the enamel surface and bands of brownish grey across the teeth.

These may be due to faulty hardening of the tooth before birth or the interruption of normal enamel function by medications (eg. tetracycline given at birth or during pregnancy) or disease.

White, Whiter, Whitest

Find out which tooth whiteners offer the best and longest lasting results.

Chewing Gum (Trident, Orbit, Happy Dent)

Best for the most superficial food stains.

How it works Mild abrasives ease away the yellow.

The result: An imperceptible lightening, despite the yellow toothed TV bull!

Watch out for exhausted jaw muscles.

Rating * (The effect is lost with your next coffee)

Toothpaste (Close-Up, Colgate Whiteners)

Best for the most superficial food tobacco stains.

How it works Abrasives, i.e. micro crystals and silica, sandpaper the tooth surface. There is no FDA approval for adding bleach to toothpastes.

The result: A superficial lightening and smoothening action on the teeth. Watch out for tooth enamel erosion and gum tissue injury over the long term. Be especially careful about tooth powders that contain shells.

Rating * (The effect is barely noticeable despite the media blitz and bulging supermarket shelves.)



Strip (Crest)

Best for mild to moderate surface and intrinsic stains.

Not for teeth with existing dental work, white spotted teeth.

How it works A flexible piece of plastic coated with hydrogen peroxide which helps dislodge stains on releasing oxygen molecules. You paste the strip on your teeth for 30 + 30 minutes, twice a day. It's best to do this under dental supervision. The 6% solution needs 2 weeks to show results and the 10% solution one week.

Lasts for 1 to 2 years, depending on what you've done with the nasty habit that caused the discoloration.

Rating * * *

In-Clinic Bleaching

Best for mild to moderate deep yellow and brownish stains, both intrinsic and extrinsic.

Not for pregnant and nursing mothers, bonded teeth, decayed teeth, dead teeth, root canal treated teeth, porcelain crowns, tooth coloured fillings.

How it works Your dentist applies a bleaching solution or gel on your tooth and trains a plasma arc or, better option, laser, on them to oxidise away stains. The procedure may feel uncomfortable situation, like placing ice on sensitive teeth.

What it does In 1 to 2 hours your teeth go 3 shades lighter.

Watch out for tooth sensitivity to heat and cold for 24 to 48 hours. This is reversible.

Lasts for 3 to 7 years. Don't look at the high side if you hold on to the habits that triggered the discoloration in the first place.

Rating * * *

Chew On This

* Citrus fruit and juices, colas and antacids when combined with the bleaching agent can slow down the whitening process and irritate the mouth.

* Nicotine, tea, coffee and other foods will eventually undo the bleaching effect.

* Have you teeth professionally cleaned twice a year, to keep them sparkling.

At-Home Bleaching

Best for mild and moderate stains, and for those who are not candidates for In Clinic bleaching because of hypersensitivity.

You may need a combination of in-house and in-clinic bleaching.

Not for pregnant and nursing mothers, heavy smokers and others who are excluded from In-Clinic bleaching.

How it works Custom made trays filled with a bleaching solution or gels are fitted to the teeth overnight. Over a period of 5 to 10 days the pigments are oxidised away.

Watch out for tooth sensitivity; a burning sensation in the gums; soft tissue sores or ulcers; sore throat from swallowing the bleach. See your dentist immediately. You may do better with In-Clinic bleaching.

Lasts for 3 years, after which a touch up may be necessary.

Rating * * *

Composite Resin Bonding

Best for moderate to strong stains, tetracycline stains, white or brown spots, excessively worn teeth, discoloration due to amalgams.

Not for tooth grinders, very dark stains.

How it works Over 2 clinic visits, the teeth surfaces are etched with a mild acid and a durable coat of resin/plastic material is painlessly applied and then allowed to self cure or cured with a high intensity light.

Watch out for

* Gum irritation if the margins are not finished perfectly.

* Stains from food, coffee and nicotine at the junction between the tooth and the composite resin bond.

* Bond breakdown. Resins are not as strong as natural enamel, so avoid biting down on hard/objects, from bobby pins to chicken bones.

Lasts for 3 to 8 years depending on the skill of your dentist and your own efforts at Tender Loving Care.

Rating * * * *

Lamination

Best for every extrinsic and intrinsic stain, even drug induced and micro cracked.

Not for people with a significant overbite.

How it works: A thin veneer of pre¬formed porcelain is applied to the teeth in the same way an artificial finger nail is applied to a finger.

The procedure Over 2 visits, original tooth enamel is etched away to reduce tooth size and a veneer mold constructed, which is carefully fitted with the help of a thin bonding resin. 4 to 8 teeth can be treated simultaneously.

Watch out for

* Over whitening which will contrast strangely with your skin. Sensible veneers are a tad yellow at the gum line and transcluscent at the edges.

* Splintering. Veneers + hard foods are a no-no.

Lasts for 10 years.

Rating *****

Since porcelain veneers have the same porous quality of natural teeth, they are aesthetically pleasing and whiter.

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