While hygiene standards have improved over time, the motivations for cleaning one’s teeth and mouth were presumably the same for the ancients as for 21st century adults: a desire for fresher breath, smoother-feeling teeth, a healthier mouth, and shinier, less yellow teeth. The Romans, for example, reportedly coveted white teeth and used eyebrow-raising substances like human urine in an attempt to brighten them.1 In more modern times, slogans such as “You’ll wonder where the yellow went, when you brush your teeth with Pepsodent” (1930s) captured the imagination of Americans and highlighted the growing availability of cosmetic self-care products for a more engaging smile.2
Now in the current era of ubiquitous social media and selfie culture, an appealing smile is nearly universally the goal. Rightly or not, a white smile is often perceived to be synonymous with a healthy smile and conveys youth and vitality. In a survey by the American Academy of Cosmetic Dentistry, nearly 100% of adults reported the smile is a key social asset, 96% said an attractive smile boosted one’s appeal with the opposite sex, and “whiter and brighter teeth” was the top response when asked what they’d like to improve about their smile.3 Not surprisingly, the demand for cosmetic dental procedures has grown exponentially.4 Professional or self-administered tooth whitening and whitening toothpastes are extremely popular.5 One thing, however, has never changed: the fact that a bright, healthy smile starts with basic, economical oral hygiene: the daily clearing/removal by the patient of odor‑causing food debris, dental plaque, and superficial, dulling stains for enhanced esthetics and a fresher mouth and breath.