By Dr. Joe Miskin, Ajax Dentist 3 Harwood Ave South 905-686-4343Routine brushing, with flossing and professional cleaning in the dental office, can lighten surface stains caused by tea, coffee, red wine and tobacco, but deeper stains, that come with age and damage of the tooth, require whitening agents or  veneers.You'll be bombarded by a ton of whitening products, from gels and strips to paint-on bleach when walking down the aisle of your neighbourhood drug store. Which is best?Cosmetic tooth whitening is a billion dollar industry, and it's getting bigger fast. It's easy to see why.  People tend to prefer the bright and white teeth of youth which dominates TV and social media than those that have yellowed by trauma or age.If you decide that you, too, want a whiter smile, it's hard to know where to start.When you're in the drug store you can easily get bewildered trying to figure out which option is the best.The dilemma isn't helped by our government regulators either because tooth whitening products don't need their approval before hitting the market because they're considered cosmetic. Most of these over-the-counter products are effective if used as directed, but some temporary tooth sensitivity during the whitening process can occur, but that goes away once the process is complete depending on which product is used. You have to be careful as some of the products can leak onto the gums causing inflammation and sensitivity to pressure, temperature and touch.A safer and quicker but more costly option would be to buy a take home custom-made tray from your dentist which is made just for you and is unlike the one-size-fits-all trays sold over the counter. The tray hugs the teeth and ensures the gel is kept where it should be and is evenly applied. The whitening process lasts from two to four weeks but the teeth usually start to look whiter after a few days.Whitening in the dentist's office is a lot more expensive (up to $1,000) but justs take an hour or two to complete because the peroxide concentrations used there are much higher which can lead to more sensitivity. In my opinion, the take home treatment is better because it lasts longer and what's a few more days. Also, insurance companies consider in-office teeth whitening "cosmetic" so the procedures are almost never covered.Not all stains are the same. Most stains occur on the surface of the teeth and are from drinking tea, coffee and red wine, eating foods with yellow spicey like turmeric and from smoking. Often surface stains may not occur if you follow a good routine of brushing, flossing and regular professional cleaning at the dentist's office.Some stains you just can't avoid by doing the above. This is usually caused by grinding and clenching your teeth at night which thins and wears down the tooth enamel which allows the dark inner core, called the dentin, to show through. The whitening agents won't work in this case because the enamel is so thin that the dark inner core shows right through. The only way to stop the wearing down and thinning of your teeth at night is to wear a special bite plate made by your friendly dentist. He will also check to see if you are a good candidate for whitening. Some discolourations just can't be whitened such as trauma to a tooth which can permanently discolour the tooth from the inside, and stains from certain antibiotics. In these cases, the only option for whiter teeth is a crown or veneer.All of these methods of whitening are temporary, requiring touch-ups at some point. After all we have to eat!Thanks for reading this, Dr Joe Miskin, your friendly dentist. Any questions just email me at  drjoe@drjoemiskin.com