Which whitening options are right for you?

Woman and dentist

Dental whitening from a cosmetic dentist Bondi Junction is a bit more complicated than you might think. Just like any form of cleaning or hygiene, you really have to know what you’re dealing with before you can rectify it. Dental staining falls into two broad categories: intrinsic and extrinsic, and treatments work for one may not work as well for the other if at all.

dentist and patient

Extrinsic staining

Extrinsic staining occurs on the outer surface of the enamel and often involves materials that have a habit of firmly sticking themselves in place on the surface of the tooth. Often, it is plaque or its calcified form, tartar, that provides the original blemish that then later darkens with lifestyle choices like smoking or drinking coffee, introducing tannins and tars. And with that, it is impossible to remove this at home without the help of a dentist.

Intrinsic staining

Intrinsic staining involves a chemical change or the infiltration of a compound deep into the structure of the tooth. This used to be far more common in the previous century, with phosphorus staining resulting in tooth loss, ‘ phossy jaw’ and dark staining caused by exposure to high fluoride from contaminated water, which today is known as ’fluorosis’.

With greater environmental controls and more safety in the workplace, these stains have become extremely rare. There are still genetic causes of intrinsic staining like the dark purple staining associated with congenital erythropoietic porphyria (CEP), a genetic condition, as well as dietary staining for those taking megadoses of vitamins.

Abrasion methods

A good treatment method for extrinsic staining is abrasion. This involves grinding off any exterior material from the surface of the teeth using a rapidly spinning disc and a light abrasive powder usually suspended in gel. What distinguishes this from your standard scale and polish is that a small quantity of enamel is deliberately removed. Done well, less than 2 microns of enamel is lost for healthy teeth. It is unlikely to be noticed, but if patients were already suffering from dental sensitivity or have the signs of dental erosion, it would be inappropriate to use abrasion methods due to the risk of over thinning the enamel.

Chemical bleaching methods

Chemical bleaching alters the way light interacts with the compounds on and in the tooth. It does not remove these compounds and only alters their appearance, dramatically reducing their shade and sometimes completely obscuring it.

It is the approved treatment for intrinsic staining as alterations in the cover of the enamel itself can be corrected.

Whitening toothpaste and at-home whitening options

Whitening toothpaste primarily uses abrasion methods. They have small particles in them that remove staining as you brush your teeth, decreasing the amount of plaque and to a degree, some enamel is removed. Results vary widely on how diligently the patient uses their whitening toothpaste.

Home whitening kits use similar peroxide-based bleaching agents that are found in the clinic but in much lower concentrations. It does not limit the overall shade that can be achieved but significantly increases the time taken to do so. What may be possible within a few hours in the clinic would take many months of overnight home treatment.


Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.

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