Do Traditional Methods for Teeth Whitening work?

I can advise that I have never seen good results from traditional or alternative whitening methods. There is certainly an abundance of evidence that shows that eating certain foods can cause staining, but the evidence on any foods causing whiter teeth is severely lacking. There are many websites and articles that purport to show teeth whitening results, but none of them stand up to scientific scrutiny. It is also wise to be cautious about using teeth whitening toothpastes as they can often be abrasive. Most contain no active whitening agent, and those that do, have it in very small doses.

Why do teeth get darker?

Teeth can appear darker for multiple reasons. It can be external staining, eg tea, coffee or red wine stains. It can be internal staining, eg yellow/brown (or rarer blue/grey) build up within the tooth. This can be a result of trauma or natural darkening with maturation of the tooth. Thinning of the white outer enamel also makes teeth appear darker as the darker dentine, which is yellow shines through. This is common as we age, due to natural wear and tear, acidic foods and drinks causing dental erosion, and overzealous brushing, but more acidic diets can mean it affects anyone at any age. Certainly having too much acidic foods and drinks will darken the teeth over time. I have had many patients who use lemon juice and abrasives to whiten. This damages the enamel and actually makes them darker over time. Using a low abrasive toothpaste and avoidance of acids is better long term for whiter teeth.

What is used to whiten teeth?

Hydrogen Peroxide, a bleaching agent is commonly used to whiten teeth. It is naturally produced in small doses by the body. Hydrogen peroxide, in appropriate doses, does not do any long term damage to the teeth, as far as we know. The soft tissues, eg the gums, are easily damaged, so for higher concentrations, hydrogen peroxide whitening should only be carried out by a dental professional or under their guidance. They will protect the soft tissues from any damage.

The teeth are slightly porous, so the hydrogen peroxide does enter and lighten the internal of the tooth. The biggest side effect of teeth whitening is sensitivity, which can be extreme for some people. This can be reduced with sensitive toothpaste or a remineralising agent, eg Tooth Mousse or CCP-ACP containing toothpaste. Tissue burn is the biggest risk with peroxide, but this is rare with dental professionals. It has occurred more commonly in beauty clinics, with insufficient dental training. For this reason, it has been regulated, including banning beauty salons in Victoria from offering teeth whitening, unless performed by a dental professional.

What about traditional Indian methods, like Ayurveda methods?

I am unaware of any effective Ayurveda methods for whitening. Sometimes recommended is mustard oil and basil, but I cannot see how mustard oil and basil would help, nor have I seen any real cases of it working effectively. I am aware of coconut oil pulling being recommended also, but the literature does not back it up and the science behind it is not consistent with current understanding of whitening or dental health. The use of oil pulling has not been shown to have any cosmetic or other health benefit. Perhaps further research will show a benefit, but it is not currently recommended.

Can eating certain foods help whiten my teeth?

Rather than certain foods improving appearance, it is the avoidance of certain foods that would help. Avoiding heavily stained foods and acidic foods and drinks will prevent discolouration of the teeth over time. Smoking is the biggest factor causing discolouration, but foods to avoid include tea, coffee and red wine. Acidic foods, such as citrus, vinegars, beers, wine, fizzy drinks etc can all dissolve the enamel. Rather than making the teeth darker, they gradually remove the whiter part, making the darker part more visible. They are best kept to a minimum. Some foods, such as pears seem sweet rather than acidic. They will still cause damage as their pH, their level of acidity, is still damaging. The sweet taste comes from their natural sugars.

The stimulation of saliva flow from these types of food is beneficial, but the reason it stimulates saliva is the bodies reaction to the damaging acid. Excessive consumption of acidic fruits, like pears, oranges, berries etc. will darken the teeth over time. You should not brush for 30-60 minutes after acidic foods or drinks.

How can I reduce the acidity?

Cheese, after meals, helps to neutralise acid, so helps reduce the acidity levels in the mouth and prevents enamel erosion. It is beneficial to have cheese with or after acidic foods or drinks. Traditional diets often finish with a cheese course and cheese is often consumed with wine, which helps reduce the damage to teeth. Drinking plenty of water and staying well hydrated also reduces the acidity as it maximises your own saliva. Avoiding acidic food or drinks can also help. For juices, topping fresh juice up with water helps bring the pH close to neutral.

I’ve heard additives, such as Bromelain, from pineapples, can help whiten teeth. Is this true?

Bromelain is theoretically an anti-inflammatory and is thought to help remove damaged tissue. Should this penetrate to the pulp, it is theoretically beneficial, but I am aware of no evidence that it does so. There is very little study on the dental effects, but the general medical effects have low supporting evidence. The pulp in the tooth has a poor blood supply, so any effect is likely to be seen elsewhere more clearly. If it cannot be found to beneficial elsewhere, it is unlikely to be beneficial dentally.

Unfortunately, alternative methods of teeth whitening are lacking in evidence. For this reason, standard methods with Hydrogen Peroxide are advised. Your dentist can discuss which is the best option for you as there are various techniques, using hydrogen peroxide, or slow release carbamide peroxide. This can be done quickly in-chair, or more slowly at home. The same results are achievable with both methods, but at-home takes longer. Due to being slower, there is also less sensitivity. It is a trade off between sensitivity and convenience for faster results. Dental treatment is generally more expensive than beautician or self treatment, but it is reassuring to know it is done safely. Prices at Darlinghurst Dental range from $150 for stock take home trays, up to $750 for in-chair whitening plus a take home kit. Prices correct at time of publication, but our fees are current fees are listed on our Zoom Teeth whitening information page and we run special offers for dental treatment, including whitening from time to time. You can join our mailing list to stay up to date.