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Brushing and flossing are everyday ways to keep your teeth bright, white, and healthy. Still, if you might feel like your smile is lacking some sparkle or is more yellow than it used to be, you’re not alone. When the American Academy of Cosmetic Dentistry asked people what they’d most like to improve about their smile, the most common response was whiter teeth. The American Association of Orthodontists also found that nearly 90% of patients requested tooth whitening.

Thinking about teeth whitening? Get the facts first. Here are five of the most commonly asked questions about the process.

Why Did My Teeth Change Color?

Over time, your teeth can go from white to not-so-bright for several reasons:

Food and Drink:

Coffee, tea, and red wine are some major staining culprits. What do they have in common? Intense color pigments called chromogens attach to the white, outer part of your tooth (enamel).

Tobacco Use:

Two chemicals found in tobacco create stubborn stains: Tar and nicotine. Tar is naturally dark. Nicotine is colorless until it’s mixed with oxygen. Then, it turns into a yellowish, surface-staining substance.

Age:

Below the hard, white outer shell of your teeth (enamel) is a softer area called dentin. Over time, the outer enamel layer gets thinner with brushing, and more yellowish dentin shows through.

Trauma:

If you’ve been hit in the mouth, your teeth may change color because it reacts to an injury by laying down more dentin, which is a darker layer under the enamel.

Medications:

Tooth darkening can be a side effect of certain antihistamines, antipsychotics and high blood pressure medications. Young children exposed to antibiotics like tetracycline and doxycycline when their teeth are forming (either in the womb or as a baby) may have discoloration of their adult teeth later in life. Chemotherapy radiation for the head and neck can also darken teeth.

How Does Teeth Whitening Work?

Teeth whitening is a simple process. Whitening products contain one of two tooth bleaches (hydrogen peroxide or carbamide peroxide). These bleaches break stains into smaller pieces, which makes the color less concentrated and your teeth brighter.

Does Whitening Work on All Teeth?

No, which is why it’s important to talk to your dentist before deciding to whiten your teeth, as whiteners may not correct all types of discoloration. For example, yellow teeth will probably bleach well, brown teeth may not respond as well and teeth with gray tones may not bleach at all. Whitening will not work on caps, veneers, crowns or fillings. It also won’t be effective if your tooth discoloration is caused by medications or a tooth injury.

What Are My Whitening Options?

Talk to your dentist before starting. If you are a candidate, there are four ways to put the shine back on your smile:

Stain
Removal kinds of toothpaste:

All kinds of toothpastes help remove surface stains through the action of mild abrasives that scrub the teeth. Look for a whitening toothpaste that has earned the ADA Seal of Acceptance for stain removal (it will tell you on the package). These kinds of toothpaste have additional polishing agents that are safe for your teeth and provide stain removal effectiveness. Unlike bleaches, these types of ADA-Accepted products do not change the color of teeth because they can only remove stains on the surface.

In-Office Bleaching:

This procedure is called chairside bleaching and usually requires only one office visit. The dentist will apply either a protective gel to your gums or a rubber shield to protect your gums. Bleach is then applied to the teeth.

At-Home Bleaching from Your Dentist:

Your dentist can provide you with a custom-made tray for at-home whitening. In this case, the dentist will give you instructions on how to place the bleaching solution in the tray and for what length of time. This may be a preferred option if you feel more comfortable whitening in your own home at a slower pace, but still with the guidance of a dentist. Out-of-office bleaching can take anywhere from a few days to a few weeks.

Over-the-Counter Bleaching Products:

You may see different options online or in your local grocery store, such as a paste or strips that whiten by bleaching your teeth. The concentration of the bleaching agent in these products is lower than what your dentist would use in the office. If you are thinking about using an over-the-counter bleaching kit, discuss options with your dentist and look for one with the ADA Seal of Acceptance. That means it has been tested to be safe and effective for teeth whitening. Get a list of all ADA-Accepted at-home bleaching products.

Are There Any Side Effects from Teeth Whitening?

Some people who use teeth whiteners may experience tooth sensitivity. This happens when the peroxide in the whitener gets through the enamel to the soft layer of dentin and irritates the nerve of your tooth. In most cases the sensitivity is temporary. You can delay treatment, and then try again.

Overuse of whiteners can also damage the tooth enamel or gums, so be sure to follow directions and talk to your dentist.