This is a question that patients wonder about all the time. It seems when you go to buy toothpaste nowdays, you can hardly find one that DOESN”T claim to whiten your teeth, so do they all do what they say? The answer lies in the origin of these products. Toothpastes that claim whitening properties started with formulations with different abrasive ingredients that were meant to remove surface stains, such as brown stains from tea, coffee, tobacco, and pigmented foods. These surface stains are the kind that might be removed during a professional dental cleaning, and these newer toothpastes were designed to keep those surface stains from coming back so quickly, and thus the teeth would be “whiter”. The first pastes that came out even had printed notes that they were effective against “extrinsic stain”, that is, surface stain that can be removed. This is not at all the same as changing the intrinsic color of the tooth to be less yellow. So, all whitening toothpastes (and you apparently can’t sell toothpaste in the US anymore that doesn’t say it whitens) work on this same surface stain reducing principle. Even those with peroxide and other ingredients besides the abrasives do not actually make teeth lighter. If your teeth don’t get a lot of brown or greenish surface stains on them, then whitening toothpaste won’t do much. Quite a few are pretty harsh toward the enamel, due to the greater abrasive properties.
So what’s a good paste to use? Well, one that is low in abrasion, does have a mild lightening action on the teeth, and also promotes reduced acidity in the mouth which is a by-product of plaque wastes and the acidic drinks that most of us consume. So a paste that promotes alkalinity is a very good choice. Have you guessed? Baking soda toothpastes check all those boxes. The abrasion index of an Arm and Hammer toothpaste is approximately half that of “regular” major toothpastes, while being composed of a minimum 50% bicarbonate. No other pastes come close to that level. These are the most frequently recommended pastes in our office.