Long in the tooth

It’s an old phrase but we all know what it means….. to be old!  So considering that this phrase has been synonymous with old age, isn’t it surprising that the mouth and teeth have been overlooked when it comes to anti-ageing treatments.

Well no longer! Andrew Parkman talks to Lesley about what ages a smile and one simple thing we can do, or can have done, to combat this and stop us looking long in the tooth.

Colour – Cleaning versus Whitening.

The first place to start is the colour of the teeth. As we age our teeth naturally get darker. This is due to internal, as well as external factors.

The main cause of darker teeth is external. It’s staining. And the good news is that this can be cleaned off! We can control staining by reducing the things which we eat and drink that cause staining. For example, if you drink either tea or coffee without milk, you will notice that by the end your nice porcelain cup will be quite stained. If you drink tea or coffee with milk you will notice that your cup has little or no staining.

Red wine is another example, although I wouldn’t suggest drinking red wine with milk! Perhaps having a glass of water and alternating with the red wine. Or switch to white wine.

Tip1. Reduce staining by having less of the things that cause staining.

As I said stains can be cleaned off. This can be by you or by a dental hygienist. You can reduce staining by cleaning off the soft deposits on the teeth called plaque. But plaque becomes hard over time and this is called calculus or tartar. Tartar is a porous hard deposit that loves to absorb stain onto its rough surface. When tartar builds up it needs to be cleaned off by a dentist or hygienist.

Tip2. Clean the soft plaque off your teeth twice a day.  DO NOT use an abrasive toothpaste. In the long run this will lead to more staining, as the enamel wears away and the tooth will be left with a rough surface which staining can cling to. There are now some really good charcoal toothpastes which help to absorb staining. They tend to be black so it can be a bit off putting but they do really work.

Tip3. Have the hard tartar cleaned off regularly by a hygienist. Don’t give the stain anywhere to cling to.

Tip4. Air-polishing. When the hygienist cleans my teeth, I get her to do something we call an “air-polish”. It brings the teeth up to as white as they can be without using bleach to whiten them.  The good news is it’s simple and quick and relatively cheap.

Now for the internal discolouration.

A tooth is made up of 2 layers of hard tissue. The top layer (the bit we can see) is the enamel. The layer underneath is called dentine. The general colour or shade of the tooth is predominantly determined by the dentine, firstly its colour and secondly its thickness or density. As we get older the colour of the teeth darkens naturally as the thickness and density of the dentine increases. You can see dentine if your gums have receded and some of the root is showing. The root of a tooth has no enamel and is only dentine.

The good news is that you can alter the colour of the enamel and the dentine. This is what we do when we do “tooth whitening”. We use a bleach to penetrate the enamel and even the dentine underneath and thus whiten the teeth. At this point I should point out that there are different forms of bleach. Some of them are safe to use in the mouth and some are not. Because of this in the UK it is the law that bleaching can only be prescribed and carried out by dental professionals. I have seen countless examples of people who have damaged teeth from having the wrong type of bleach used on their teeth.

Tip5. Have your teeth whitened only by your dentist. After all bleach is a poison! It is important that it is administered correctly and appropriately.

There are different ways of whitening (bleaching) teeth.

1.     Light or laser activated whitening at the dentist.  Good for getting a quick result – leave to go for lunch come back to the office with whiter teeth!  Down sides are less longevity, greater sensitivity and less control for you. From £450

2.     2. Whitening using whitening trays – sometimes called “home whitening”.   Good because there is less sensitivity. More control for you as a patient as to how much whiter the teeth go.  Greater longevity as it’s easy to top-up whitening in the future. From £395

3.     Or a combination of both. It depends on the time constraints, sensitivity and longevity.   By combining both methods you can potentially reduce sensitivity, speed up the treatment and achieve longevity. The down side is that this is the most expensive way to whiten the teeth. From £650

The big down side to whitening is the sensitivity. However, sensitivity means that it is working. It usually happens around day 3 of home whitening. It can subside, but occasionally stays for the entire process and for some days after. The good news is that it is usually simple to control and does go away.

The other down side to whitening is that fillings, crowns, caps, bridges and veneers will not change colour as the teeth are whitened. So, these may need to be changed after the whitening treatment to match them to your new tooth colour. Teeth that have had root canal treatments can be darker than your natural teeth. Root treated teeth may whiten with tooth whitening, BUT it is likely that the change in shade will be much slower in these teeth.

In conclusion

Teeth darken with age. Therefore, whiter teeth make a person look younger. Whiter teeth also hide any discrepancies in the shape, size and position of teeth.

Start simple and have the teeth cleaned, have an air-polish if possible. (I never whiten teeth that are not clean) You might be surprised at how white your natural teeth can look. Get rid of the outer stain and then keep them clean with good oral hygiene and using a good quality stain reducing toothpaste. Be careful what you eat and drink. Steer clear of foods and drinks that can cause staining.

Whitening: Have the teeth whitened by a professional. Make sure that they have checked that there are no fillings, crowns, etc that may not whiten. And that you have a plan for these teeth so that you have a good outcome. Follow your dentists’ advice and pick the whitening process that is the most suitable for you. 



Andrew Parkman. www.dentistry100.co.uk

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