According to the American Academy of Cosmetic Dentistry, most adult Americans feel the appearance of their smile impacts career success and social interaction. Our smiles certainly affect how others see us and how we see ourselves. And though many aspects come together to create a winning smile, nothing makes or breaks it quite like the whiteness of our teeth. Perhaps this is why so many tooth whitening products and treatments exist in today's market, including whitening toothpastes, over-the-counter bleaches, professional whitening and an array of dental veneers. Deciding which one to choose often depends upon the source of the discoloration.

Types of Stains:

Tooth discoloration can be caused by staining which can be divided into two types, extrinsic and intrinsic. Extrinsic stains are those on the tooth surface caused by tobacco, wine, coffee, foods and routine wear. Micro cracks and fissures in the enamel can collect these stains over time. The least extensive extrinsic discolorations often can be removed through routine dental cleaning and good brushing habits. More extensive issues may require bleaching or other treatments. Intrinsic stains affect the teeth's interior and can be caused by the aging process, trauma, medications, excessive use of fluoride and other factors. Some believe some intrinsic stains can be treated through deep bleaching with bleaching trays over long periods of time, others believe more extensive measures, such as dental veneers are needed to improve the appearance of teeth with intrinsic stains.

Enamel Thickness:

Not all discoloration is caused by stains. The thickness of enamel plays a factor as well. The more dentin that can be seen through the enamel, the less bright the teeth will look. Factors that affect enamel thickness include genetics and age. Some of us are simply born with thicker tooth enamel than others, and as we age, that enamel thins, causing yellowing and graying of the teeth over time. Unfortunately, thin, translucent tooth enamel does not respond well to bleaching, therefore other measures must be taken to correct discoloration in these cases.

Base Whiteness:

Like variations in hair color, we are born with our own base tooth color. Some of us naturally have whiter, lighter colored teeth than others. This is why a dentist consults a shading chart before doing dental work, such as bonding or crown work; in which matching tooth color is important. Changes in the teeth's base color can be difficult to achieve through bleaching.

Due to the variety of factors that cause tooth discoloration, a consultation with a dentist before embarking on a tooth whitening program is a good idea. A dentist can assess whether at-home bleaching, for instance, will likely whiten your teeth and how much whitening one can expect. An excessively stringent whitening program can cause damage to tooth enamel and be counter-productive in some patients, as can excessive brushing in an attempt to attain a brighter smile. For some patients, routine brushing and dental cleaning is all that is needed to keep your smile white. Others may need to take more drastic measures, such as dental veneers, which can aesthetically correct tooth discoloration resistant to bleaching, as well as the appearance of cracks, gaps and broken teeth for a more thorough smile rejuvenation.