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    Does your smile dazzle and sparkle?

    A movie star smile is the first (well, maybe the second) attribute men and women notice about each other. Your smile is associated with health, personality and sexuality. What separates the Julia Roberts from the Hannibal Lechter smile? A major, but not exclusive factor is whiteness of their teeth. Unfortunately not everyone is blessed with pearly whites. Enter modern dentistry. There are two types of dull teeth. Extrinsic stains are caused by not brushing the plaque from your teeth. Plaque is a sticky film that forms on your teeth. It's loaded with bacteria, toxins and food particles. If you feel your teeth are wearing little fuzzy sweaters when you run your tongue across, then you have plaque. Foods, wine and tobacco cause this gooey mess to stain even darker. Fortunately, these types of stains can be removed by your dentist with a thorough polishing. Being a little more intense about oral hygiene can minimize its return.

    When polishing doesn't help, the problem is intrinsic (within the tooth). Enamel is the hardest substance in your body (great trivia question), but it is porous. Tobacco (smoking or chewing-how gross!!), red wine (it doesn't matter if it's $3 Thunderbird, or $100 Caymus), cola drinks, coffee, tea and certain foods will cause deep discoloration. Other factors include the natural shade of your teeth ---thank your folks and heredity for that one. Tetracycline use at an early age, or even if your Mom was given this antibiotic when pregnant, will cause a very gray shade in your teeth.

    Treating this problem is a little more complicated than surface stains. Bleaching teeth has become very popular in the past decade. This is an excellent, non-invasive technique to whiten your smile. Don't run down to the laundry room and put some Chlorox on your teeth. Tooth bleaching chemicals are a gel form of peroxide, with other ingredients to control it's pH (remember pH from chem 101?), to prevent softening of enamel and tooth sensitivity.

    Now you've decided that this stuff is for me. Do you go to your dentist (a few hundred dollars), or send away for the $39 kit advertised on late night TV? As in other aspects of your life, you usually get what you pay for. Non-professional bleaching kits are inexpensive, and you don't need a trip to the dentist. The downside is that the trays that hold the gel on your teeth are very bulky, and can dig into your gums. The gel is a low concentration that is not very effective on moderate to dark stains. A new product, Crest Whitening Strips, eliminates the trays by using what looks like pieces of bubble wrap to hold the gel. It is promising for light discolorations.

    What about whitening toothpastes? They only work on surface stains, the concentration of bleaching agent is very low, and does not stay on your teeth long enough to be effective.

    The Dentist-here is what you get for the big bucks. An evaluation to determine if bleaching will be effective for your type of staining, a custom made and fitted bleaching tray, high strength gel, help with occasional side effects that can occur, such as gum irritation and tooth sensitivity. The dentist will also evaluate the condition of your old fillings. If they are chipped or broken, they will need to be repaired. Bleaching gel getting under a defective filling is a no-no. If you have old discolored plastic fillings, these will not get lighter from bleaching, and should be replaced after the process is completed. Some dentists use in office "power bleaching" with very high concentrations of gel for a limited amount of time and/or "take home bleaching kits". The latest technique is to use a laser activated gel (how cool-a real laser). However, recent clinical trials fail to show any significant improvement over bleaching gel without the laser.

    If you think your teeth match the color of a yellow legal pad instead of a glossy photo of snow-call your dentist.


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