Teeth Whitening

The process of teeth whitening lightens the colour of the teeth. Teeth whitening can be achieved by either changing the intrinsic colour or by removing and controlling the formation of extrinsic stains.

Most of the teeth whitening products are peroxide-based and are capable of altering the colors of teeth. When peroxide diffuses into the tooth, it acts as an oxidizing agent that breaks down to produce unstable free radicals. For whitening treatment to be a success, the cause of staining should be correctly diagnosed. The time of exposure and concentration of the bleaching compound determine the tooth whitening endpoint.

We offer take-home bleaching in our office. The patient will wear a custom-made clear tray for both upper and lower arches filled with a special whitening liquid for part of each day according to the given written instructions and follow up with the dentist as required.

The cause of staining can be extrinsic and intrinsic.

Extrinsic Staining

  • Dental Plaque: Dental plaque is a biofilm of bacteria that forms in the mouth, particularly along the gum line, and it occurs due to the normal development and defences of the immune system. Although usually virtually invisible on the tooth surface, plaque may become stained by bacteria.Prolonged dental plaque accumulation on the tooth surface can lead to the formation of white spot lesions. Higher consumption of carbohydrates will promote de-mineralisation and increase the risk of developing white spot lesions.
  • Calculus: Neglected plaque will calcify, and lead to the formation of hard deposits on the teeth, especially around the gum line. Although the colour varies, it may be grey, yellow, black, brown, or darker colour. Also, it may become more tenacious and difficult to remove.
  • Tobacco: Tar in the smoke from tobacco products (smokeless tobacco as well) tends to form a yellow-brown-black stain around the neck of the tooth above the gum line. The nicotine and tar in tobacco, combined with oxygen, over time stain the teeth yellow.
  • Tannin: Tannin is present in coffee, tea, and red wine. It produces a chromogenic agent that can discolour the teeth. The consumption of tannin-containing beverages stain the dental enamel brown.
  • Foods:The dark colored foods such as beets or chocolate can cause extrinsic staining. Other foods likely to stain teeth are berries, candies, popsicles, turmeric and tomato-based curries.
  • Medications: Some medications can cause extrinsic staining. For example, prolonged use of antiseptic mouth wash, Chlorhexidine, and iron supplements can cause brown staining of teeth. Always use medications as prescribed.

Removal Of Extrinsic Staining

Extrinsic staining may be removed through various treatment methods:

  • Prophylaxis: This method of stain removal may only take place in the dental office.

Ultrasonic scalers allow a dental professional to remove a bio-film and extrinsic staining. This stain removal method can only be undertaken in a dental office, not at home.

Intrinsic Staining

Intrinsic staining primarily occurs for the following reasons.

  • Tooth Wear and Ageing
  • Dental Caries
  • Restorative materials:Restorations using amalgam also penetrate dentine tubules with tin over time; therefore, can cause dark stains to the tooth.
  • Dental Trauma: The tooth may become darker without pulp death.
  • Fluorosis: It is hypo mineralization of tooth enamel caused by ingestion of excessive fluoride during tooth development. The severity of discoloration depends upon dose and duration of exposure.
  • Tetracycline: Ingestions of tetracycline and its derivatives during the years of tooth development causes yellow-green discoloration of dentin, which is visible through the enamel.
  • Genetic reasons: Several genetic disorders can also result in abnormal tooth coloration. It includes, but no limited to, Enamel Hypoplasia, Enamel Hypocalcification, Amelogenesis Imperfecta, Thalassemia and Sickle cell Anaemia.

Prior to proceeding to tooth whitening due to staining or other reasons, it is advised that the patient comes into the dental office to have a comprehensive oral examination to assess whether the patient will be a right candidate to have teeth whitening treatment.

Internal Bleaching

Internal bleaching is a process which occurs after a tooth has been root canal treated. This means that the tooth will have had the nerve removed. It is common to have this internal bleaching done on an anterior tooth.


  • Brush and flush out mouth with water after eating and drinking.
  • Flossing.
  • Drink fluids that may cause staining through a straw.
  • Depending on the method used to whiten the teeth, re-treatment every six months or after a year may be required.

If you have any questions about teeth whitening, please contact us at Cusp Dental in Surrey. To make an appointment, call us directly at 778-574-3300 or book online.