Is Whitening Toothpaste Worth It? Why You Might Want to Explore Other Options

All of us like the thought of having a mouth full of glistening white teeth. Along with being a sign of good oral health, whiter teeth can enhance your appearance and boost your self-confidence, among other benefits. Plus, you’re likely to smile more often when you have a set of shining ivories to back it up, and smiling comes with its own set of physical, mental, and emotional benefits. But are we risking our health when using whitening agents?

That brings us to how one can achieve a darling smile with whiter teeth. Since you use toothpaste on a daily basis anyway, shouldn’t you use whitening toothpaste so that you can kill two birds with one stone—better oral hygiene and whiter teeth?
The answer is yes and no. Whitening toothpaste can remove certain amounts of surface stains from your teeth. However, if used incorrectly, it can also damage the enamel of your teeth in the process. Therefore, it’s important to understand what you’re getting into when you pick that tube of whitening toothpaste off the shelf.
To decide if whitening toothpaste is right for you, it’s worth considering a few factors: how it works, how to use it, what damaged enamel entails, and what alternatives there are to achieve whiter teeth.

How Whitening Toothpaste Works 
Most toothpaste has gentle abrasives, fluoride, and other ingredients to keep cavities and gum disease at bay. Whitening toothpaste typically has more abrasives, similar ingredients, plus low levels of bleaching chemicals. Some of the most commonly used of these mild abrasives include hydrated aluminum oxides, silica, magnesium carbonate, calcium carbonate, and sodium bicarbonate (baking soda). These abrasives work to scrub surface stains caused by coffee, tea, tobacco, and so on.
Additionally, common bleaching agents used in whitening toothpaste include hydrogen peroxide and carbamide peroxide. These chemicals usually come in such a low dose that the whitening toothpaste is unlikely to cause sensitivity or irritation. However, any brightening of the teeth is relatively minor and takes a significant amount of time.

How to Use Whitening Toothpaste
It’s likely that how you use whitening toothpaste is more important than if you use it. Any ADA-approved whitening toothpaste you find on the market is considered safe for teeth, as long as you apply proper brushing techniques and frequencies.
For instance, it’s advisable to use a soft-bristle brush and not to brush too vigorously. Also, you should never brush your teeth more than the toothpaste label or your dentist suggests. Some people may feel the need to scrub harder than necessary, thinking that it will help remove more stains, when in fact this can lead to the erosion of your enamel.

What Happens When Your Enamel is Damaged  
Enamel is a substance on the outer layer of your teeth, and it’s your teeth’s first line of defense against chemicals from food, drink, and bodily fluids. Fortunately, it’s also the toughest tissue your body has. Nonetheless, it can still experience wear and tear over time, especially if you fail to brush regularly (or brush too hard and frequently with whitening toothpaste). Once the enamel has eroded, it cannot grow back, but proper dental hygiene can prevent erosion from escalating.
Short-term symptoms of tooth enamel erosion include discoloration, heightened sensitivity, and cracks. Long-term erosion can lead to stains, rough edges, and shiny spots on your teeth. The most advanced enamel erosion can result in severe tooth decay and fractured teeth.

Alternatives to Whitening Toothpaste
Whitening toothpaste, when used properly, can make teeth appear slightly whiter over time. But it’s important to remember that it can only remove stains on the surface of your teeth and that the results will likely not be very noticeable.
If you want your smile to be significantly brighter and reduce the risk of enamel erosion, you are better off to go with a teeth-whitening system. You have two primary options here: over-the-counter products (e.g., gel trays, strips) or those administered by your dentist. Whitening gel can be especially effective, as it flows through the enamel tubules to reach the dentin—the tissue beneath the enamel that absorbs most of a stain.
Both over-the-counter and dentist-administered whitening systems contain higher concentrations of peroxide than whitening toothpaste, and either can provide more noticeable results. Generally speaking, over-the-counter products have 5-15% peroxide and professional dental-strength products have 25-40%. Before choosing a whitening product, be sure to consult your dentist.

The Verdict
ADA-approved whitening toothpaste may not be harmful in and of itself, but it can lead to enamel erosion if not applied properly, and it likely won’t yield the results you’re looking for. When it comes down to it, there are safer, more effective options on the market worth considering. Come by South Charlotte Dentistry to discuss your options with our team!

Update on Fluoride: Just How Safe is Our Water?

Though previous studies have touted the positive attributes to the addition of fluoride to our water—such as its inclusion of whitening agents and the reduction of tooth decay—a 2019 study is the first to suggest otherwise. This most recent finding indicates some possible dangers to fluoride, especially in adolescents.

The Mount Sinai Hospital / Mount Sinai School of Medicine cited a study done in 2019 that had some troubling findings. According to the study, “exposure to fluoride may contribute to complex changes in kidney and liver function among youth in the United States, where 74 percent of public water systems add fluoride for dental health benefits.” This is big news, considering just about every one of us is exposed to fluoride through our tap water.
It’s important to note who this seems to affect the most: adolescents. Why this group over any other? Well, the kidneys accumulate most of the fluoride we put into our bodies. What we have found is an adolescent's body actually only excretes 45 percent of fluoride through the kidneys, whereas an adult secretes fluoride at a rate of 60 percent, meaning adults can likely pass the chemical without any negative side effects.
This research also indicates that "adolescents with poorer kidney or liver function may absorb more fluoride in their bodies.” With potential side effects like renal system damage, thyroid dysfunction, liver damage, tooth disease, and impaired protein metabolism, people—particularly those with children—are beginning to seriously question if our water is safe.
Sure, we all grew up feeling just fine and we drank right from the faucet. But, there are those who feel the risk isn’t worth ignoring. So what can be done? Plenty, actually.

The Berkey Water Filtration System
Just because your fridge may filter your water, or you have a separate water container with a built-in filter, fluoride is still most likely in your water. It’s tough to get out, and filters can be anywhere from $30 to $300.
One option, though it will cost a bit more upfront, is the Berkey Water Filtration System. These systems range in price from $250 to around $700, but they provide gallons of crystal-clear, and fluoride-free, water.
They usually come in two stackable metal cylinders. The top is filled with water and gravity pulls the water through the four filters. And these heavy-duty filters only need to be changed every few years—if even then. These are perfect for big families. Everyone gets a water bottle and keeps it filled. This is also a great way to cut back on your plastic use, and it only takes a year or so (depending on how much water you typically buy) to pay for your new water system. Then it's free, freshwater for everyone.
But, if you’re not feeling up to spending a few hundred for a new water filtration system, there are other, less expensive, options. Check these two out:

• Priced at $70, the Aquagear Water Filter Pitcher cleans fluoride, Lead, Chloramine, and Chromium-6 from your water. The pitcher is BPA free and easily fits into the fridge.
• You can also go smaller with a $35 water bottle that has a fluoride filter attached. The Seychelle Extreme Water Filter Bottle is great for camping, travel, hiking, or backpacking, and it removes bacteria, viruses, radiological contaminants, and fluoride. It holds 28 ounces of water.

Fluoride-Free Bottled Water
Even if you don’t feel up to buying special water filtration systems, there are plenty of bottled waters out there for purchase that are fluoride-free. Here is a list of some of the most popular ones:

• Arbor Springs Drinking Water
• Arbor Springs Purified Water
• Arbor Springs Spring Water
• Deer Park
• Diamond Spring Water
• Evian
• Fresh Market
• Glacier Bay
• Hidden Valley Natural Mineral Water
• Nestle Pure Life
• Oasis Pure Drinking Water
• Oasis Sparkling Water
• Perrier
• Poland Spring
• Volvic

Until more studies come out that can provide more information on the possible dangers of consuming fluoride in adolescents, it is important not to panic. There are plenty of options to keep your little ones fluoride-free, and you don't have to break the bank to do it.

As always, at South Charlotte Dentistry, we care most about your health. If you have concerns for your children, or would like to know more about the effects of fluoride, stop in and see us. We are always happy to help.

*Sources:
https://www.sciencedaily.com/releases/2019/08/190808091358.htm

Re-Growing Lost Gum Tissue & Other Repair Techniques for Gum Loss

South Charlotte Dentistry sees many cases of periodontal disease, ranging from early mild stages to late severe stages, but mainly those moderate cases of gum degeneration. Our patients, alongside half of all American adults, are eager to find out about how or if they can re-grow lost gum tissue, or otherwise repair gum loss. South Charlotte Dentistry delivers the latest news on exciting findings in the dentistry field, and discusses gum repair techniques available to our patients to ensure that they have the best information available for advocating for a healthy, happy smile.

In March 2019, the American Chemical Society journal, Nano released an article titled, "New technique could help regrow tissue lost to periodontal disease." This report discussed exciting new findings where researchers have found that the development of a membrane can help periodontal tissue regenerate when implanted into the gums of rats.

What are the takeaways from this study?

Scientists have been trying to regrow lost gum tissue and bone from periodontal disease for ages. They tried implanting pieces of polymers (a small piece of mesh-like material) at the root of the tooth, in the aims of generating new gum and bone cells.

So what was the issue? A second surgery was required to remove the polymeric membrane that could get in the way of the healing process. When scientists developed more biodegradable membranes, they didn't work as well for re-growing that periodontal tissue.

The current study featured a new, nano-fibrous membrane of poly(ε-caprolactone), a biocompatible polymer. This was coated in polydopamine (PDA), which is a synthetic polymer with sticky consistency that can attach to wet surfaces. When this new membrane was implanted into the gums of rats with periodontal defects, bones at those defected sites regenerated to normal levels within weeks, and the membranes degraded. Researchers are now working to add more components to the membrane that further aid healing and prevent infection.
 

Why is this study so important?

We're not just nerding out at South Charlotte Dentistry, honest! As periodontal disease is associated with age, and Americans are living longer and keeping more of their natural teeth, more and more adults are suffering from the effects of the disease. This means that for our practice and for dental practices everywhere, periodontal disease will become a more prominent issue for the overall health of our population.

What is periodontal disease?

Periodontal, or gum disease, is an inflammatory condition of the gum and bone support (periodontal tissues) surrounding the teeth, in which the gums, ligaments, and bone become infected. This damages the soft tissue and the bone that supports your tooth. "Periodontitis" literally means "inflammation around the tooth."

On a scale of common to rare, where does periodontal disease fall?

Periodontal disease is very common. In fact, the US sees more than 3 million cases per year. According to the US Centers for Disease Control and Prevention, about half of all Americans will have periodontal disease during their lifetime.

A study titled "Prevalence of Periodontitis in Adults in the United States: 2009 and 2010" estimates that 64.7 million American adults (42.7% of the adult population, or one out of every two adults aged 30 and over) have mild to moderate or severe periodontitis. Of that 42.7 %, 30% have moderate periodontitis, with 8.7% being mild, and 8.5% severe. Among adults aged 65 years and older, the rates of periodontitis increase to 70.1%.

What is the main cause of periodontal disease?

Periodontal disease occurs when bacteria and plaque build-up around the tooth, and as a result, the immune system launches into action against it.

How do I know if I have periodontal disease, and how do dentists diagnose periodontal disease?

An annually comprehensive periodontal evaluation is the best way to identify the disease.
This happens once a year during one of your scheduled dental cleanings. A dental professional will examine each tooth above and below the gum line. You may not have realized this was happening beforehand, but the hygienist or dentist will use a periodontal probe (a tool with a ball end, a colored band at 3.5-5.5mm, and another colored band at 8.5-11.5mm) and call out a number between 0 and 4 for each tooth, measuring how deep the gum line is. This is the standard clinical examination of the periodontium or gums.

What are the symptoms of periodontal disease?

• inflamed or swollen gums, and recurrent swelling in the gums
• bright red, sometimes purple gums
• pain when the gums are touched
• receding gums, which make the teeth look longer
• extra spaces appearing between the teeth
• pus between the teeth and gums
• bleeding when brushing teeth or flossing
• a metallic taste in the mouth
• halitosis, or bad breath
• loose teeth

Who is at risk?

Those who have a more weakened immune system or partake in the following risk factors are more susceptible to periodontal disease:

• Smokers
• Females undergoing hormonal changes (i.e. from puberty, pregnancy, or menopause)
• Diabetic people
• People with AIDS
• Cancer patients, or those undergoing cancer treatment
• People medicated with drugs such as antihypertensive, vasodilating agents, or immunotherapy, that reduce saliva and increase chances of gum disease
• People genetically predisposed to gum disease

What are the treatment options?

Good oral hygiene is part of both treatment and prevention. For moderate and severe cases of periodontitis, medicated mouthwashes and medications can be used to treat periodontitis, including:

• Prescription antimicrobial mouth rinse, such as chlorhexidine
• Antiseptic chip
• Antibiotic gel
• Antibiotic microspheres
• Enzyme suppressant
• Oral antibiotics

Periodontal scaling is a nonsurgical procedure to treat your teeth and gums against plaque, bacteria, and tartar deposits. The dental professional targets the area below the gum line and along the roots using an ultrasonic scaling device and/or manual instruments to gently remove plaque and tartar. Scaling can also involve delivering an antimicrobial agent into the pocket to treat and reduce bacteria.
Next, root planing goes deeper to remove cementum and surface dentin, smoothing out affected root areas in order to decrease gum tissue inflammation and allow your gums to reattach to your teeth. A properly planed root surface helps fight against bacteria, tartar, and plaque when they want to relocate under your gum line, and promotes root healing.

When good oral hygiene and non-surgical treatments aren't effective, sometimes surgery may be necessary. Those options can include:

• Flap surgery to lift and remove deep pockets, and remove tartar
• Bone and tissue grafts to regenerate bone or gum tissue that has been destroyed, using new natural or synthetic bone, which promotes growth
• Guided tissue regeneration (GTR), which as we mentioned before, uses barrier membranes to direct the growth of new bone and gum tissues to regenerate tissue and repair defects from periodontitis

Success in a periodontal treatment really can depend on how advanced the periodontal disease is, how well the patient adheres to a proper oral hygiene program, and other health and activity factors (i.e. smoking, or other preexisting conditions).

What happens if periodontal disease goes untreated? Can periodontitis kill you?

Because periodontitis is a chronic inflammatory disease, it has been associated with other chronic inflammatory diseases, such as diabetes and cardiovascular disease.

Is there a home remedy?

Sure there is! It may not be what you are picturing, it is not all that glamorous, and it definitely doesn't involve fancy polymers inserted in your teeth. Here it is:

• Brush your teeth with a suitable toothbrush and fluoride toothpaste at least twice daily for at least two minutes, carefully cleaning the chewing surfaces, sides of the teeth, and all of the hard-to-reach places (including—very gently!—on the gum line) around your mouth
• Consider using a manual or electric toothbrush with soft bristles, and replace this toothbrush every 3 to 4 months
• Do not share toothbrushes—bacteria can pass from person to person
• Floss every day! Consider using an interdental brush to clean gaps around the teeth and those small spots where a toothbrush cannot reach. Dental floss is great for small gaps, but a dental brush is really useful for larger spaces in your mouth
• Uneven surfaces are more susceptible to periodontal disease, so take extra care in cleaning around closely-packed teeth, crooked teeth, crowns, dentures, fillings, etc.
• Use an antibacterial mouthwash to help prevent bacteria from growing and reduce inflammatory reaction in the mouth. Plus, you'll be taking that extra step to freshen your breath after brushing and flossing!

What are the stages of periodontal disease?

There are two stages. First, gingivitis occurs. Gingivitis is basically gum inflammation, whereas periodontitis refers to gum disease, or the destruction of tissue and bone.

Gingivitis occurs when bacterial plaque builds upon the surface of the tooth and causes the gums to become red, inflamed, and susceptible to bleeding. With gingivitis, there is no irreversible damage occurring to the bone or tissue, just irritated and bothersome gums.

As gingivitis progresses, it leads to periodontitis. This is when the gum and bone pull away from the teeth and form large, deep pockets where debris and bacteria can collect. Bacteria between the gum and teeth leads to an infection, as the plaque is now below the gum line. But, it isn't just the plaque and bacterial toxins destroying bone and tissue—it's your immune system. Your immune system's response to the infection in the pockets is to fight the infection, all leading to the destruction of gum and bone.

What can periodontitis lead to?

Periodontitis can lead to serious medical issues and even death. For example, when someone with periodontitis chews or brushes their teeth, bacteria can potentially enter the bloodstream, which increases the clotting risk and risk of stroke. Healthy teeth and gums can also decrease the chances of cardiovascular disease, diabetes, preterm pregnancies, prostate cancer, and breast cancer.

Will I lose my teeth if I have periodontal disease?

Not in a mild or moderate case, but left untreated, this chronic inflammatory disease badly affects the gum tissue and structures supporting the teeth, leading to eventual tooth loss.

Can South Charlotte Dentistry tell me more about gum loss and gum repair?

Absolutely! Our team is always here at South Charlotte Dentistry, located conveniently in the Ballantyne area of South Charlotte to help you with any questions you might have. You may also be interested in our limited-time New Patient Special that includes a comprehensive dental exam and full x-rays for only $69.00. Our existing patients can tell you all about our friendly and welcoming team that ensures a low-stress, but high-quality dental experience.

If you're looking for a highly rated, clean, and patient-centered dentist in the South Charlotte area, then look no further! South Charlotte Family and Cosmetic Dentistry will provide you the best dental care in South Charlotte—whether you're in the market for gum regrowth and repair, or just a simple dental cleaning!


-Tayler Green