Why Teeth Stain and How to Whiten Them

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Tooth staining will affect almost everyone to some degree, but your habits and genetics can determine the extent. The good news is that you can take measures to counter tooth discoloration. The type of staining you experience will in large part determine your treatment options. Your dentist will be able to tell you if lifestyle factors or an underlying dental health issue are causing your tooth discoloration.

Types of Teeth Staining

There are three basic types of teeth staining: extrinsic, intrinsic, and age-related.

An extrinsic tooth stain is staining on the surface of the tooth. It occurs when the enamel absorbs stain particles, such as pigmented residue from food or drink. Even though the enamel is the hardest part of the tooth, it contains pores similar to the skin. Highly acidic substances like coffee or wine are more prone to absorption, leading to stains on the teeth. Even healthy acidic foods can have a staining effect, including berries, citrus fruits and tomatoes. As a general rule, any food that could stain your clothes is also capable of staining your teeth over time.

An intrinsic tooth stain occurs when discoloration exists on the tooth’s inner layer, known as dentin. Even though it is beneath the tooth enamel, darkened dentin can give the entire tooth a discolored appearance. Intrinsic stains are more challenging to remove than extrinsic ones. Oral injury, prolonged poor oral hygiene, the use of certain types of medications, or overexposure to fluoride can cause this type of discoloration.

As you get older, your enamel thins, and your dentin becomes darker. This means you are more likely to suffer from a combination of extrinsic and intrinsic stains. Unfortunately, this type of staining is out of your control. How much age-related discoloration you experience is largely dependent on genetic factors.

Other Causes of Teeth Staining


Tobacco use is heavily associated with tooth staining. The otherwise invisible nicotine becomes yellow when it combines with oxygen, and the tar and tobacco in cigarettes are brown. Those colors seep into the pores of the teeth. Brushing alone cannot remove these stains. In mild cases, over-the-counter whitening strips or trays might work. In moderate cases, a professional whitening might be enough to remove them, but some traces may remain even after treatment if the staining is severe.

Medical Conditions

Several illnesses such as metabolic diseases, calcium deficiency, liver disease, eating disorders and celiac disease can affect the enamel and dentin, leading to tooth discoloration. In addition, certain infections in pregnant mothers can lead to tooth discoloration in their babies by affecting enamel development. Disease treatments such as head and neck radiation and chemotherapy also can cause teeth discoloration. Additionally, several types of medications can impact the tooth enamel, leading to changes in the color of your teeth. These include blood pressure medications, antihistamines, and psychiatric drugs such as antidepressants and antipsychotics.


Trauma to the teeth usually occurs as the result of an accident or sports injury. Significant injury to your mouth can alter the color of the affected teeth when it damages a tooth’s enamel. This is most common in children but can affect people of all ages. You should always see your dentist or orthodontist immediately after experiencing trauma to the teeth. Sometimes your neighboring teeth suffer an unnoticed injury that only a thorough dental exam can detect.

Orthodontic Treatment

The most common type of staining associated with braces is the development of white spots on the teeth. These chalky-appearing spots indicate the beginning of the decaying process. The white area shows where bacteria are beginning to erode the enamel, decalcifying the minerals in the teeth. This usually results from an extended period of poor oral hygiene habits. And because brackets or wires can cover them, they might not be visible until after braces are removed. However, the orthodontist is trained to look for white areas around the braces and often can inform the patient before they progress.

Methods of Whitening

Most teeth whitening systems use hydrogen peroxide as their active bleaching agent. The most common side effect you will experience from teeth whitening is sensitivity—either of the teeth, gums or both—which is usually temporary. Overusing whitening agents can also erode the teeth, so it is best to talk to a dental professional before starting any whitening regimen or procedure.

Whitening Toothpaste

Whitening toothpaste can help brighten your teeth by lessening mild surface stains. However, it will not treat discoloration of the dentin. The toothpaste often contains abrasive properties that polish the teeth and a bleaching agent. Whitening toothpaste can produce results in about six weeks if used at least twice per day. Toothpaste that contains blue covarine can have a more immediate effect. When selecting a whitening toothpaste, look for a brand with a seal of approval from the American Dental Association, which indicates that the toothpaste is safe and effective at removing surface stains.

Strips and Trays

Over-the-counter whitening kits come in strips or trays. Whitening strips are applied directly to the teeth and are usually peroxide-based. Trays allow you to fit a mouthguard filled with peroxide-based gel over your teeth. You can purchase these over-the-counter or have your dentist mold a custom guard. You typically will apply these treatments for a few weeks and should see results by the conclusion. Using strips or trays in conjunction with a whitening paste can give you the best results you can achieve without the help of a professional.


Veneers are thin, shell-like structures that the dentist fits over your teeth. Because these shells bond to your teeth, the whitening effects are immediate. Veneers are a good choice if your teeth are discolored naturally or because of medication or illness. Veneers are made from either porcelain or composite resin. Your dentist can help you decide which option is best for you. The benefits of porcelain veneers include durability and a natural-looking surface. They also do not stain easily. The benefits of composite resin veneers include easier placement and lower cost.


Bonding involves applying a resin composite to the teeth to achieve a whiter look and improve the shape. The process begins with etching the teeth, which involves coating them with a mild acid. After the etching is complete, the dentist will apply a thin bonding layer to the stained teeth and cure them with a special light. This allows for a faster process than applying veneers. Bonding involves applying a resin composite to the teeth to achieve a whiter look and improve the shape. The dentist will then buff and polish it to create the smoothest possible surface. The results are instant, but you will need to repeat the procedure to maintain the results because the resin wears down over time. 

Power Whitening

To power-whiten your teeth, a dentist will apply peroxide with a laser to give you immediate whitening. She will need to place a protective agent over your gums and lips to guard them against the high concentration of peroxide. The procedure is safe for your teeth and can last several years.

Are you ready to start orthodontic treatment? Contact us today to schedule your complimentary consult.


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