Just like we all have different hair and skin color, people also have different tooth color. Some teeth are more yellow than others, while others yellow with aging. Your natural tooth color can also be affected by many factors.

Surface stains and internal discoloration can be caused by:
• The natural aging process
• Using tobacco (smoked or chewed), drinking coffee, tea,
colas or red wine, and eating pigmented foods such as
cherries and blueberries
• Accumulation of plaque and tartar deposits
• Ingesting too much fluoride (more than 2 parts fluoride per million
parts water) when teeth are forming, which gives teeth a “mottled” look
• Treatment with the antibiotic tetracycline during childhood
• Trauma to the teeth that may cause a brown, gray or black color
There are many reasons for whitening your teeth, including:
• The boost to your confidence and self-esteem that comes from a great smile
• A younger appearance
• A special event such as a wedding, job interview or class reunion
• To make a positive first impression on others
• To simply reverse years of everyday staining and yellowing
Before beginning any whitening procedure, be sure to consult with your dentist. Only he or she can evaluate whether you’re a suitable candidate for a particular treatment.

One of the more common shade guides divides tooth color into four basic shade ranges:

• A (reddish brown)
• B (reddish yellow)
• C (gray)
• D (reddish gray)
Within each range are different levels of darkness — which results in a chart detailed enough for almost everyone to find their exact tooth color on the guide.
To use such a guide, simply match your current tooth color to the corresponding color on the chart. This gives you a starting point as you determine how much whiter you’d like your teeth to be.

How white should your teeth become? That depends.

There’s no one right way to whiten your teeth. Some people want an instant and dramatic change, while others prefer more gradual whitening such as the type that results from a whitening toothpaste or gel. Final results depend on your natural tooth color, how stubborn any stains are and the treatment you choose. Keep in mind that:

• A change of just two or three shades can make a noticeable difference in just about anyone’s smile
• While whitening can occasionally change tooth color nine or more shades, the majority of people who whiten their teeth see a change of between two and seven shades
• Each procedure has its advantages and disadvantages. Laser whitening and other in-office bleaching procedures, for example, may produce the most dramatic results, but cost significantly more.
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All whitening techniques work in one of two ways:

1.) Bleaching removes both deep & surface stains.

Bleaching procedures change your natural tooth color, usually anywhere from five to seven shades brighter. In-office (chairside) whitening and at-home (tray) whitening both rely on bleaching. Bleaches contain an active ingredient, most often carbamide peroxide or hydrogen peroxide in concentrations of 10-22%, which helps remove both deep and surface stains. There are significant cost differences between different bleaching procedures:

-A light-activated whitening session in a dentist’s office, sometimes called chairside bleaching, can cost $500 or more and results in instantly and often dramatically whiter teeth. However, after a year or so of eating and drinking normally (coffee, tea, soft drinks), your teeth become slightly discolored again and develop new stains. With chairside bleaching, you have to pay the $500 to have white teeth again.

-A custom mouthpiece created by your dentist for in-home bleaching costs around $300, and you typically wear it several hours a day or overnight for two weeks. When you notice new staining, you just wear the mouthpiece again for a night or two to take the stains off.

-Over-the-counter products for whitening teeth (those found in a drugstore) include boil and bite tray application, whitening gels applied with a brush, and whitening strips in a price range of $10.00 to $45.00.

2.) Abrasion removes most external stains.

Non-bleaching procedures work by physical and/or chemical action to help remove surface stains. All toothpastes rely on mild abrasion to remove surface stains between dental visits. Whitening toothpastes have special chemical or polishing agents that provide additional stain removal. A professional cleaning by a dentist in Annapolis or hygienist also uses abrasion and polishing to remove most external staining caused by food and tobacco.

Everyone responds differently to different whitening procedures. Some people respond well to whitening toothpastes, while people with gray teeth or other serious discoloration may require porcelain veneers or bonding (discussed elsewhere in this section) to achieve the smiles they’ve always wanted. Only your dentist or hygienist can determine what’s right for you.

Tooth sensitivity is something that affects a number of people. It is often caused by eating or drinking something hot, cold, sweet or acidic. Under normal conditions, the underlying dentin of the tooth (the layer that immediately surrounds the nerve) is covered by the enamel in the tooth crown, and the gums that surround the tooth. Over time, the enamel covering can get thinner, thus providing less protection. The gums can also recede over time, exposing the underlying root surface dentin.
The dentin contains a large numbers of pores or tubes that run from the outside of the tooth to the nerve in the center. When the dentin is exposed, these tubes can be stimulated by changes in temperature or certain foods. Here is an image of what the dentin tubes look like under the microscope:

What causes it?

Exposure of the dentin can occur due to a number of factors. Some of the more common reasons are:
• Gum recession due to age or improper tooth brushing
• Acidic beverages (such as soda) that cause enamel erosion and dentin exposure
• Tooth grinding – this may actually cause most or all of the teeth to feel sensitive
• Brushing with a very abrasive toothpaste, brushing incorrectly and/or brushing more than three times a day could result in a loss of enamel
• Gum disease, which can result in gum recession
• A chipped or fractured tooth may expose the dentin

In addition, some dental treatments can cause sensitivity. Treatments such as such as teeth whitening, professional dental cleanings, having braces put on or getting a filling placed have been known to cause sensitivity during or after the procedure.
What can I do about it?

The first step in doing something about dental sensitivity is to find out what the cause is – a dental professional can help you with this. If the sensitivity is due to exposed dentin, there are a number of steps you can take, as can your dental professional, to help reduce the sensitivity. These can include:

• Using a very soft bristle tooth brush
• Brushing correctly to help prevent abrasion of the enamel and recession of the gums
• Using a toothpaste specially formulated to help reduce sensitivity

The dental professional can:

-Apply a fluoride varnish on the sensitive areas to help strengthen the tooth

-Prescribe a high fluoride tooth paste to use every day

-Place a dental restoration to build up the areas that have lost enamel

In the end, whether you need an in-office procedure or over-the-counter products, the most important step is to see a dental professional so that he or she can determine the cause of the tooth sensitivity and help you find a solution that will work.

• Incisors— the sharp, chisel-shaped front teeth (four upper,
  four lower) used for cutting food.
• Canines—
  sometimes called cuspids, these teeth are shaped like
  points (cusps) and are used for tearing food.
• Premolars— these teeth have two pointed cusps on their biting
  surface and are sometimes referred to as bicuspids. The premolars are for
  crushing and tearing.
• Molars— used for grinding, these teeth have several cusps on
  the biting surface

Proper flossing removes plaque and food particles in places where a toothbrush cannot easily reach — under the gumline and between your teeth. Because plaque build-up can lead to tooth decay and gum disease, daily flossing is highly recommended.

To receive maximum benefits from flossing, use the following proper technique:

• Starting with about 18 inches of floss, wind most of the floss around each middle finger, leaving an inch or two of floss to work with

• Holding the floss tautly between your thumbs and index fingers, slide it gently up-and-down between your teeth

• Gently curve the floss around the base of each tooth, making sure you go beneath the gumline. Never snap or force the floss, as this may cut or bruise delicate gum tissue

• Use clean sections of floss as you move from tooth to tooth

• To remove the floss, use the same back-and-forth motion to bring the floss up and away from the teeth

What Type of Floss Should I Use?

There are two types of floss from which to choose:

• Nylon (or multifilament) floss

• PTFE (monofilament) floss

Nylon floss is available waxed and unwaxed, and in a variety of flavors. Because this type of floss is composed of many strands of nylon, it may sometimes tear or shred, especially between teeth with tight contact points. While more expensive, single filament (PTFE) floss slides easily between teeth, even those with tight spaces between teeth, and is virtually shred-resistant. When used properly, both types of floss are excellent at removing plaque and debris.

To keep your toothbrush and yourself healthy, make sure you let it dry out between uses. Toothbrushes can be breeding grounds for germs, fungus and bacteria, which after a while can build up to significant levels. After using your toothbrush, shake it vigorously under tap water and store it in an upright position so that it can air out.

To prevent cold and flu viruses from being passed between brushes, try to keep your toothbrush from touching others when it is stored. A standard toothbrush holder with slots for several brushes to hang upright is a worthwhile investment in your family’s health.

How often should I change my toothbrush?

Most dentists agree you should change your toothbrush every three months. Studies show that after three months of normal wear and tear, toothbrushes are much less effective at removing plaque from teeth and gums compared to new ones. The bristles break down and loose their effectiveness in getting to all those tricky corners around your teeth.

It is also important to change toothbrushes after you’ve had a cold, the flu, a mouth infection or a sore throat. That’s because germs can hide in toothbrush bristles and lead to reinfection. Even if you haven’t been sick, fungus and bacteria can develop in the bristles of your toothbrush —another reason to change your toothbrush regularly.

How can I protect my toothbrush when traveling?

A plastic toothbrush case will protect toothbrush bristles from becoming squashed or flattened in your traveling kit. After brushing, however, you should let your toothbrush dry in the open air, to help reduce the spread of germs.

Choosing a toothpaste can be confusing. When buying toothpaste for your child, look for one that contains fluoride and tastes good. Some toothpastes also are approved by the American Dental Association (ADA). The ADA Seal of Acceptance means that the toothpaste’s manufacturer has proven that the toothpaste is safe and effective. Some manufacturers choose not to seek approval. So toothpastes without the ADA seal also may be safe and work well, but the ADA has not evaluated them.

Children should use a small pea-size amount of toothpaste. Toothpaste needs to be spit out, not swallowed.

Toothbrushes

The type of toothbrush your child uses is important. The wrong kind can damage the gums. All children should use toothbrushes with soft nylon bristles. When your child is an infant, the toothbrush should be very small. As he or she grows, select a toothbrush that can fit easily in the mouth and brush one or two teeth at a time. Your child’s toothbrush should be able to reach all the teeth.

Replace toothbrushes about every four months, or when they begin to look worn and frayed. If a toothbrush wears out before three or four months have passed, you or your child may be brushing too hard.

Powered toothbrushes are fun and may remove more plaque than regular toothbrushes. That doesn’t mean you should run out and buy one. Regular toothbrushes work just fine. However, powered toothbrushes do make brushing easier. They can be especially helpful for children who can’t sit still long enough to properly brush their teeth with a regular toothbrush.

Water Irrigation Devices

Water irrigation devices can remove food from between teeth. Most children probably don’t need to use them. They might be useful for some children with braces or other orthodontics. These devices do not remove plaque that is firmly attached to the tooth. That still needs to be done with a toothbrush.

Mouthwashes And Fluoride Mouth Rinses

Mouthwash and fluoride mouth rinse are two different products. Mouthwash freshens breath, but does nothing to clean teeth. Many mouthwashes contain alcohol and are not appropriate for children younger than 6 years old. This is because young children can easily swallow the mouthwash. If your child has chronic bad breath, he or she should see a doctor. It could be caused by a health problem.

Fluoride mouth rinse coats teeth with fluoride, which helps to prevent cavities. You should check with your child’s dentist or dental hygienist to determine if your child needs to use a fluoride mouth rinse. It is typically used once or twice a day by children who are at a high risk for cavities. Children as young as 7 years old can use a fluoride rinse, if they know how to spit out a liquid without swallowing it. You can test your child to see if he or she is ready. Give him or her a half-cup of water. Ask your child to put some of the water in his or her mouth, swish it around and spit it out into a second cup. If there is a half-cup of water in the second cup, your child probably can spit out the mouth rinse. You should still supervise your child to make sure the rinse does not get swallowed.

Floss

Flossing is critical to healthy gums. Start flossing when your child’s teeth teeth start to touch one another.

Floss is available in many different sizes, coatings, flavors and forms. If you have trouble using the floss wrapped around your fingers, you can purchase floss holders in most drugstores and grocery stores. Some floss holders come in bright colors and are made to appeal to children.

Floss your child’s teeth once a day. Many people floss just before bedtime. But if another time is more convenient for you, do it then.

Move the floss up and down with light to firm pressure to skim off plaque from the tooth. Do not press so hard that you injure the gum.

With so many shapes, sizes and styles of toothbrushes on the market, deciding which kind to buy can be confusing. Here’s what you should look for:

• Most dental professionals agree that a soft-bristled brush is best for removing plaque and debris from your teeth. Small-headed brushes are also preferable, since they can better reach all areas of the mouth, including hard-to-reach back teeth

• When it comes to the type of handle (such as non-slip grip or flexible neck), shape of the head (tapered or rectangular) and style of bristles (such as rippled, flat or trimmed to a dome shape), pick whatever is most comfortable for you. The best toothbrush is one that fits your mouth and allows you to reach all teeth easily

• For many, a powered toothbrush is a good alternative. It can do a better job of cleaning teeth, particularly for those who have difficulty brushing or who have limited manual dexterity

How Often Should I Replace My Toothbrush?

You should replace your toothbrush when it begins to show wear, or every three months, whichever comes first. It is also very important to change toothbrushes after you’ve had a cold, since the bristles can collect germs that can lead to reinfection.