Introduction: why Do Teeth Turn Yellow?

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The yellow colour seen in the teeth of some individuals is not necessarily indicative of poor health or hygiene – at least not in all cases. Whilst there are obvious hygiene-related causes that may exacerbate the yellow-ing of teeth over time, it is not uncommon for individuals to have teeth with an off-white hue. In fact, it is more uncommon for individuals to have perfectly white teeth than it is for them to be an ivory colour.

The reason for natural tooth colour is the presence of dentin in teeth – named after the original term ‘dental’. Dentin is related to the strength and resilience of teeth, meaning that there is no real reason for concern – this is why most dentists will not recommend tooth-whitening procedures without good cause. Mineral quality in the upper layer of teeth – enamel – is the reason that some individuals have incredibly white teeth: a strong, mineralized enamel is what gives the “Hollywood smile” its characteristic gleam.

Another natural cause for the yellowing of teeth is simply ageing: the mineral quality of all skeletal and integumentary (the teeth, nails and hair) tissues will decline. Combined with a lifetime of eating different foods and (possibly) allowing stains to develop, the ageing process is not kind on teeth.

Alternatively, the loss of minerals and development of plaque in the teeth can be associated with a yellow appearance in teeth. The loss of mineral can be the result of dietary problems and the individual may be responsible for their own degradation through lack of proper care. Brushing the teeth is the best way to reduce the impact of these eroding elements, but this alone will not restore the mineral content to the tooth enamel. This article will deal with the things that you can change and do to prevent the decline of tooth quality over time.

White Teeth

Dietary Measures

Diet should be the first place we turn when we need to adjust any cosmetic or performance aspects of the body. Altering the diet can reduce the short-term yellowing of teeth and provide a long-term improvement in the minerals.

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1. Sugar Intake

Sugar is the main cause of plaques developing on the teeth, resulting in the release of acid. This causes the development of both short- and long-term yellowing – the plaques themselves present as yellow substances on the teeth and the acid reduces the mineral content of the teeth, increasing the appearance of yellowness.

2. Vitamins and Minerals: Calcium

Calcium is a nutrient that has long-been associated with good health in the bones and other skeletal tissues. Calcium is also the primary mineral involved in the microstructure of teeth [1], meaning that a diet that is low in calcium will conduce to greater rates of erosion. We might assume, then, that a diet higher in calcium will both prevent decay of tooth enamel, as well as providing our body with the raw materials necessary to maintain tooth health. A diet rich in kale, spinach, collard greens, low-sugar dairy and similar foods will improve the mineral health of the body and strengthen teeth.

Clinical research also supports the superiority of calcium in addressing enamel-dentin issues. Comparisons of calcium-sodium toothpastes were significantly more successful in clinical trials at reducing dentin sensitivity and improving enamel resilience [2]. This suggests that there is not only a protective effect, but also potential for further research and results in the field of repairing poor enamel quality.

3. Vitamins and Minerals: Potassium

Potassium is the second most common mineral in the teeth and plays a role similar to that of calcium. Whilst Calcium is most common in the teeth, the bio-chemical role of potassium is important to the health of teeth: potassium is necessary for the proper health and mineral density of bones as it increases mineral density and the uptake of essential nutrients into the bones themselves. Strengthening bone tissues that are not the teeth require potassium, so it makes total sense that the proper intake of potassium will have a protective role on the enamel and deeper tissues of the teeth. Potassium is found in a variety of foods, primarily plant foods, and can be obtained fairly easily through the consumption of a single cup of kale a day.

4. Vitamins and Minerals: Vitamin D

Vitamin D is necessary for the proper absorption and utilisation of calcium in the body: it is a nutrient that many people are, in fact, deficient in. This means that some individuals with particularly weak enamel could be suffering from poor utilisation of ingested calcium – similar to the way that calcium absorption protects against osteoporosis [3]. If we increase our vitamin D intake (especially D3) through supplementation, we may be able to prevent any further losses and improve the strength and health of teeth through dietary interventions – especially when this supplementation is paired with increased intake of Sodium and Potassium through foods.

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5. Low Carb, High Fat Diet

The modern diet is incredibly high in refined carbohydrates, primarily refined sugars. The best way to protect the teeth, beyond proper brushing and maintenance, is to alter the diet to reduce the intake of refined carbohydrates. The adoption of the popular “low carbohydrate, high fat” diet template provides an easy way to achieve these goals, reducing the chances of consuming excessive sugars and increasing the intake of foods associated with the vitamins and minerals mentioned above.

Hygienic Factors

Personal hygiene is more than just a social custom and nicety when it comes to dental health: the proper maintenance of the teeth through intentional measures is an essential part of preventing enamel erosion (associated with yellowness) and providing an effective environment for the development of enamel and secondary dentin [4].

6.    Regular Brushing

Teeth Care

Regular brushing is the most important preventative measure and studies have shown the protective and nurturing effects of proper dental hygiene routines [2]. Brushing your teeth is something that you should have learned as a child, but for those who are unaware, brushing your teeth 2-3 times a day is essential for proper maintenance and the reduction of plaque and the acids it produces. The way that we brush can also affect the health of our teeth: a common misconception is that brushing should be moving back and forth in two directions: up and down or side-to-side. This results in abrasion of the enamel and can further weaken the pristine whiteness of a mineral-dense surface of the tooth. Rather, brushing in circles will prevent the breakdown of the tooth and help to maintain both the thickness of the enamel and the mineral content.

7.    Post-Meal Brushing

The best approach to improved, regular brushing is to focus on lower-duration brushing after meals. Whilst this is unlikely to have a restorative effect, it will increase the protection that we provide the teeth and the environment that we offer for the re-development of enamel and secondary dentin. Most meals should be followed by short periods of brushing at least 30 minutes prior to the consumption of any high-sugar or acidic foods (as the enamel will be more pliable during this time and can easily be damaged).

8. Bicarbonate Products

Bicarbonate of soda has been one of the most persistent wives’ tales regarding the whitening of teeth and it has some actual utility. The main thing to remember about bicarbonate is that it is an alkaline product – In this sense, it may be effective in the neutralisation of acidic foods, juices or the acids produced by plaque build-up. For example, bicarbonate may be effective immediately after drinking orange juice – though the whitening effects are not well-documented. Bicarbonate products have been used in combination with peroxide with excellent effects – though the concern here is whether this is natural. The term is very loosely used, but the combination of bicarbonate in a clinical toothpaste suggest that it may have some positive effects in regular use – though it should be used as well as a traditional toothpaste and not as a replacement!

Yellow Teeth – Bottom Line

Whether or not it is possible to whiten the teeth without clinical “bleaching” is something that is left open by the clinical evidence. The “natural” approach may not be able to whiten teeth in the same way that peroxide-based products can, but there are definitely a variety of methods we can use to give our teeth the best chance of both prevention and recovery. There are definite mechanisms for the improvement of bone mineral density and this provides us with a possible mechanism for the improvement of teeth through a mixture of dietary and hygienic methods, as well as some hope that it may be possible. This article has simply set out guidelines and methods, but there are no sure-fire ways according to the evidence.

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Reference

[1] Oliveira et al (2009): ‘Microstructure and mineral composition of dental enamel of permanent and deciduous teeth’. Microscopy research and technique, 73(5), pp.572-577[2] Pradeep and Sharma (2010): ‘Comparison of the clinical efficacy of a dentifrice containing calcium sodium phophosilicate to a dentifrice containing potassium nitrate and to a placebo on dentinal hypersensitivity: a randomized clinical trial’. Journal of periodontology, 81(8), pp.1167-1173[3] Tilyard et al (1992): ‘Treatment of postmenopausal osteoporosis with calcitriol or calcium’. The new England journal of medicine, 326, pp.357-362[4] Scott, R.G (2012): ‘Dental anthropology’ in Claire Smith (Ed.) Encyclopaedia of global archaeology, New York: Springer

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