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Question:
In-office Whitening: I had my teeth whiter in office about 3 months ago and the dentist used etching before the whitening gel.
My teeth got very white and also sensitive but the worst thing is that my teeth are porous and I had to stop drinking coffee and wine because every night they got full of black stains. The dentist polished them but it helped just a little.
I never had any problem in my teeth and I'd not recomend in office bleaching because after that my teeth are easier to stain. I think it was the etching gel for a long time. Is there anything I could do to have my healthy enamel back? ...Visitor from CA
Answer:
I'm sorry to hear about the problems that you are having. Let me clear up some common misconceptions about whitening teeth, and shed some light on how you can have your healthy enamel back.
Enamel is only stained during the development of the teeth. Systemic substances such as antibiotics (tetracycline) are incorporated into hard tissue when it forms. These stains are virtually impossible to remove via whitening.
The stains that people are familiar with are extrinsic (on the surface of the tooth) and intrinsic (in the fluid between the enamel rods). The extrinsic stains are removed by a proper cleaning and good home care. The intrinsic stains are removed through various oxidation processes which eliminate organic components.
Imagine holding a handful of drinking straws. They would represent the enamel tubules. The fluid inside the drinking straws is what becomes discolored over time. This fluid is what the whitening agent lightens.
Over the years the top of the straw becomes almost closed. This makes it very difficult for the whitening agent to penetrate into the fluid where the intrinsic stains are located. Etching the surface "opens" the enamel tubules. In addition to allowing the lightening agent to penetrate it also allows the fluid to move easily. The other end of the "drinking straw" has a nerve attached to it. Heat, cold and sweets cause the fluid to move which stimulates the nerve resulting in pain. Etching also roughens the surface of the tooth which increases the surface area and allows extrinsic stains to more readily adhere to the surface.
The surface of a tooth should be "shiney" when dried with air. If it has a frosted appearance it is not adequately polished. In addition the "top of the drinking straw needs to be closed again." This will take some patience on your part (several months). Custom fluoride trays used with WHITE OR NON COLORED fluoride gel used in conjunction with a WHITE desensitizing toothpaste (Sensodyne) should take care of the sensitivity and rapid staining which you have been experiencing.
Whitening is a safe procedure when properly done. I usually advise my patients to use Crest White Strips immediately after having their teeth cleaned. They are effective and reasonably priced. I am confident that you will enjoy your coffee and wine with in a few short months.
Editorial Staff
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