Americans with white and perfect teeth?

How do Americans get such white and well aligned teeth? Are these mostly done with cosmetic dental work? with all the stains from food and work we put our teeth through, it's still hard to keep them nice even with daily brushes 3x/day.
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so I guess there is a lot of whitening use. do you feel that it takes away your enamel and cause dental problems, like cavities?
Americans with white and perfect teeth?
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