Tooth Staining

Dr. Phillips,

Greetings from the 44 year old son of a dentist (passed away several years ago). I have been wearing braces since November 2010 to correct an overbite of about 75%; this is my second time in braces, first as an adult. My lower anterior teeth were chipping on the top due to this overbite (upper teeth were hitting them) so I investigated and the braces seemed to be the only real solution. The Invisalign does not seem to work so well with overbites. It has not been too bad but the elastic phase is proving challenging but I am getting in my required hours but maybe just not communicating as well as I can when wearing during the day!

Since early February of 2011, I have put my trust in your advice and followed your system, including all the precise ingredients. My father did a fair amount of out of the box thinking and I think he would think your system makes sense, and would not even think it out of the box. He understood the commercial nature of the ADA and really cared about his patients, even concerned when he knew he was not going to live long that his lower income patients be cared for. He was always troubled by patients that would say they were flossing and brushing and there seemed to be no stabilization or improvement. Your system I am sure would have intrigued him.

I travel for 2 nights/3 days a week on average but always to the same place and I leave my rinses and brushes there. I honestly have missed a brushing or two here and there but overall have been pretty good about it.

I have been going to my dentist every 3 months with the braces on to keep an eye on things. At my end of March 2011 appointment (about 6 weeks on the system), she noticed staining on the teeth (not just at the gumline) and noted there was a lot of staining between the teeth. She never noted this staining before.

Today I went to the dentist again for my June appointment and she was shocked at how much staining there was all over the teeth, front and back and much more than the gumline. I have been going to her since my father passed away in 2002 so she knows a good amount of my oral history. I have my records back since I was 5 and there has been no staining noted in there. I started with the Oral B brush in 1992 (and continue with it to this day) and some plaque improvements were noted at that time but other than that I have had some fillings, the last one about 2 or 3 years ago. They usually follow periods of stress coupled with not going to the dentist for too long. I have fortunately not needed crowns, etc.

Anyway, today she worked hard to remove most of the stains and was able to somewhat get between the teeth due to the spaces created by the braces. She said she will check over it all again at the end of the year when I hopefully will be done with the braces. I am scheduled to go back in September but if things look good then, maybe I will wait until later in the year when I anticipate the braces will be off.

My gums are in good shape, other than some exposed roots on the top back two molars, which was the result of bone loss from my wisdom teeth coming out at around 39. I did not have this before the wisdom teeth came out and it has been pretty stable for the past 5 years.

With all that as background, do you recommend I continue with the rinses/regimen or wait to start again until the braces come off? Do you think the staining is done for now or do you think it will continue, in terms of what others have experienced? I did have a cleaning in March and it came back but I was only on the system six weeks so maybe the staining process was not complete?

Any advice you have to give would be welcomed. You are performing a valuable service to lots of people.

Thanks and regards,


Hi D,

Thanks for your message.
You have only been on my system for 4 months so this is very normal:

The staining is likely dead bacteria – and the recommendations I would make are:
Stay on the system – ENSURE you use the rinses twice a day -and always at night before sleeping.
Once a day is not enough to control bacteria – in a high risk mouth ( which you have because of your braces and possibly dry mouth).

Increase the xylitol that you have.
You should be somewhere around 8-10 grams a day to eradicate bacteria in a high risk mouth.
I suggest you put a teaspoon of granular in water and sip this during the morning – then have mints and gum after meals and drinks for the rest of the day.

Probiotics may help you to stabilize your mouth by adding healthy bacteria.
It seems you are getting infected ( and it is like a cycle) cleaning, growing more, then killing them off, then getting re-infected again.

You may want to ensure your toothbrush is disinfected often – every day swish in Listerine, rinse out and dry completely.

Bacteria die when they dry. I wonder if you are somewhere where it is humid – is your toothbrush drying out completely?

My advice is to wage a more powerful war on these harmful plaque bacteria.
Ensure you clean your teeth twice a day, clean your brush, increase your xylitol consumption.
Add probiotics ( or an active organic yogurt) to your diet – do you use mineral supplements? May be helpful.

Finally you may want to think about if there is anyone with whom you share life that could be infecting you.

Maybe get family and friends on the system if you can.
Here is the time line for you to see what happens:

I feel that stepping up the program to a higher level will get rid of this annoying stain. Once the harmful bacteria have gone, you will establish a healthy biofilm and it should not return. Original Listerine appears to work slightly better to rid the mouth of plaque ( use it for 60 secs as part of the system).

This rinse is powerful and helpful to whiten teeth and get rid of almost all the bad critters that damage gums.

Let me know how this goes,

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