Dear Doctor, Over the last three months I have noticed that my teeth are not as white as they used to be. Right now, they are not particularly brown or yellow, but they have an off-white look. I use Colgate Herbal, which I’m told is great (Aquafresh was my preferred toothpaste) but I do not see any changes and I am not a smoker. What is causing this and how do I get my teeth back to a healthier colour?Janet, 27 Dear Janet I understand your concern. Teeth are the most visible part when one smiles. Clean sparkling teeth add to one’s face value and personality. Apart from smoking, there are many other factors that can cause discolouration of teeth. Chronic tobacco use is of course one of them. Drinking a lot of tea, coffee, dark coloured juices or even cola drinks can cause discolouration of the teeth due to chronic staining. Poor dental hygiene is a very big reason for teeth to lose their shine and whiteness. Poor hygiene causes plaques to be deposited around the teeth which are visible if located on anterior aspect. This can result in repeated bacterial infections, which affect the teeth as well. A diet poor in calcium and phosphorus results in enamel of the teeth breaking gradually and making them look less white. With advancing age, as degeneration occurs everywhere, teeth lose their enamel and start becoming discoloured. Poor dental hygiene hastens this process. Drugs like tetracyclines, antidepressants, e.t.c. cause permanent discolouration of teeth. The first option to improve the colouration of teeth is good dental hygiene. Brush teeth regularly at least twice every day, once in the morning and once before sleeping. If possible brush after eating anything, if not, rinse mouth adequately with fresh clean water. Rinse the mouth also, after drinking tea, coffee or drinks that can stain the teeth. Use of dental floss is very beneficial in removing the plaques deposited over teeth. Eating crunchy food items like apples and carrots after food helps in keeping the teeth clean by removing particles of other substances sticking there. Taking a diet rich in calcium like yoghurt and cheese helps to strengthen the enamel of the teeth, thus maintaining it for long. Regarding tooth paste, my dentist colleagues tell me that no tooth paste is better than the other. Mostly tooth paste serves as astringent that is to give the feeling of freshness to the mouth. Many natural substances applied locally have been recommended for improving whiteness of the teeth. These are soda, table salt, paste of basil, olive oil, e.t.c. They are useful for a short time. Professional service of a dentist can be sought for improving teeth colouration, where a bleaching substance is used and applied professionally and correctly and the effects last longer. Dr. Rachna is a specialist in internal medicine at Ruhengeri Hospital.