SMILE – a curve that sets everything straight; relax the features into a pleased or kind expression, with the lips parted and the corners of the mouth turned up; the most wonderful expression of the human face.

Yes, the smile, the bright smile that symbolizes purity, elegance, happiness, peace and contentment is an expression that everyone wishes for at all times in our lives. It is this smile that adds up our face value, be it a child, a grandfather, an Olympian who’s just won a medal, Miss Universe, a man on the street, your prospective business partner……….a beautiful smile always connects.

A smile is always complemented by its brightness. Brighter our teeth, we tend to smile more. Brighter our teeth we tend to care for it better. Holding on to that brightness improves in many ways our perspectives in life whereby we can smile through all the ups and downs. By  maintaining that brightness, we also  brighten not just our teeth but our lives.

At this point, what can we do to brighten that smile of ours, looms over our minds. In order to get to the bottom of it all, first we should understand the main factors that decrease the brightness of our teeth, and then we shall find out their solutions. The causes are:-

1. Surface Stains

This is caused mainly by the strong discolouring agents such as coffee, tea, tobacco, colored food, red wine, extra strong turmeric laden food and so on. These stains can be easily managed with daily oral hygiene combined with regular visit to the dentist for professional cleanings. Along with this, years of staining from coffee, tea, cola and smoking can be erased by bleaching.

A surface stain that are trapped in the microcracks of tooth structure commonly due to excessive forces used in having hard stuffs such as ‘durkha’ and ‘supari’ may require treatment such as bleaching and bonding.

2. Plaque and Tartar

Plaque is a sticky white film that builds up on our teeth constantly, and, if not disturbed by means of brushing and flossing, transforms into a cement like substance, called Tartar. If we look around the inside of our lower front teeth, often we find dark areas around the gumline due to the presence of tartar. This also causes irritation of the     gum, causing it to bleed at times, receed and weaken the foundation of our teeth. These typically disappear after a thorough professional cleaning.

3. Internal Stains

These type of stains are actually the part of the tooth structure due to faulty hardening of the tooth before birth or interruption of normal tooth formation by medications or disease. The most common cause is the use of antibiotic Tetracycline, before the age of eight or the mothers taking it while pregnant. This drug now is restricted in children under eight and pregnant mothers. These stains are usually more difficult to manage, but sometimes a good results can be obtained by a non invasive technique such as bleaching or it may need other advanced procedure.

4. Stains due to a defective filling or decay

Old fillings, cavities cause the tooth to be unsightly at times, and, their simple management is their re-restorations. The white filling materials that mimic the shade and shape of the exact individual tooth structure are used in such situations.

5. Tooth surface loss due to aging, habits, diets, medications and disease

Some of us lose our tooth covering, enamel due to aging, wear and tear, consumption of acidic food, gastric problems, grinding, biting hard food such as durkha and supari, certain medications and so on. The visibility of the internal layer of our teeth which is usually darker in shade occurs in such situation. It may also cause teeth to be more sensitive. Their usual management is first, the prevention followed by the restoration.

Six Treatments of Stained Teeth

1. Professional Cleaning and Polishing
2. Bleaching
3. Bonding
4. Laminating
5. Veneering
6. Crowning

Most of us are familiar with the first treatment that is, professional cleaning and polishing since we are a regular visitors to the dentists. The explanation of all these other modes of treatments are out of the scope of this article. Hence, I would like to concentrate more on the second treatment that is non invasive and is of growing interest among us.

Bleaching / Whitening

This is a conservative and often a highly effective way to brighten our smile and uses a strong oxidizing agents to lighten the teeth. There are different types of bleaching, such as,

1. Bleaching on your own

Sometimes, we get these tooth whitening agents easily available in supermarkets, even in Kathmandu. These products are to be used with a great caution, since they may cause a bigger problem of gum irritation, sore throat and may not be effective, since the application is not concentrated to the desired area. Further, these systems of bleaching are not customized to our need and may not address the cause of our problem.

2. Dentist Assisted Home Bleaching

This is one of the most simple, effective and efficient way of bleaching, in which dentist takes the impression of your teeth and the dental technician fabricates a special bleaching tray, customized to your needs. The bleaching agent is applied on the tray and it is worn for the specific amount of time, usually for around 7 – 10 days for couple of hours, depending on the individual need. The main advantage of this system is that it is customized, within our control and is safe. The only disadvantage is that it is dependent on our personal handling and the patience. Sometimes, the sensitivity may occur, but it can be effectively managed by dentists.

3. Power Bleach

This is the technique where the dentists perform the procedure in the dental clinic itself. For half an hour to one hour, the concentrated bleach is applied on our tooth surface and sometimes activated with light. In most of the cases, we get a very good result with this technique. This technique along with the home bleach touch ups are the best way of getting the quickest, brightest smile.

For some, home bleaching alone whitens the teeth to a desirable level. For others, a combination of home and power bleach  yields the best result. One probably needs a touch up bleaching session every six months to 2 years depending on the diet and care.

Before any of these procedures, a thorough professional cleaning and elimination of any disease that is pre existing in our mouth is mandatory. It is not recommended in pregnant and lactating mothers. In adults, bleaching generally causes little, if any discomfort. Most discomfort occur within the first eight hours and subsides within 24 hours. Some teeth respond better than the others to bleaching. The predictability of bleaching varies between person to person. The internal stains due to Tetracycline or decalcified white spots may need further treatment.

Products and procedures that bring a gleam back to aging teeth are literally white-hot these days in the west and is picking up among Kathmanduites as well. It not only enhances our smile but gives us a reason to smile.

Besides, a bright smile, it also enhances our care for our teeth. We are living longer, our teeth are retaining longer. The main concern of today, besides, cavities and gum problem is the tooth surface loss and one of the main cause of this is vigorous brushing along with the wrong technique. It is observed that person who has white teeth tends to brush more gently, properly and visit dentists regularly than the one with the darker teeth. People with darker teeth tend to brush vigorously thinking that it may whiten. They also tend to use toothpaste that claim to whiten, which contains more abrasives. Hence, whitening is not just a cosmetic enhancement, but a preventive as well as a psychological uplifting exercise.