If you take a look around the toothpaste aisle of any drugstore in the United Stated, it's not hard to see that Americans have become obsessed with obtaining pearly white teeth. In fact, a study in 2013 found that almost 90 percent of orthodontists nationwide have had patients who specifically requested tooth whitening treatments. But between mouthwashes, toothpastes, and even chewing gums that claim to give you that smile you've always wanted, how do you know what really works? If you break it down, there are two types of discoloration: stains on the surface of the teeth and those below the enamel. The first are mostly caused by smoking and the absorption of food or beverages on the enamel surface. The others are related to the optical properties of the enamel and the underlying dentin, and how they interact with light. A number of things, including tooth decay, excessive fluoride ingestion, and aging can alter the intrinsic color of your teeth. So how do you remove the stains and get below the enamel? We talked to Dr. Gerard Kugel, a dentist at the Boston Center for Oral Health and Dr. Gianluca Plotino, a private-practice dentist in Rome to get to the truth.
Pre-brush mouth rinses
To whiten teeth, pre-brush rinses typically contain hydrogen peroxide. Twice a day, gargle the liquid for 60 seconds before brushing your teeth and the bleaching agent will make quick work of your intrinsic stains. The problem: Bleaching teeth takes time. "Hydrogen peroxide is so weak and unstable [for that] time of use that its effect is minimal," Dr. Plotino says. In 2006, a clinical trial showed that these special rinses are, essentially, no better than water at whitening your teeth. What's more, some users experienced increased gum sensitivity after using the rinses. "You get none of the benefit and all of the pain of hydrogen peroxide with the rinses," says Dr. Gerard Kugel, a dentist at the Boston Center for Oral Health in Massachusetts, who has conducted numerous studies on tooth whitening procedures, including the one above on pre-brush rinses. Yet, the placebo effect leads many people to believe these rinses actually work. "We saw no benefit, but about 30 percent of the participants said their teeth were getting whiter," says Kugel.
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