Whitening

What affects the color of teeth?

The color of teeth may be affected by many factors and of course some people have yellower teeth  than others. The teeth may have surface stains (extrinsic) or internal (intrinsic). Surface stains are caused  by tobacco, coffee, tea or red wine, highly pigmented foods or tartar. Internal stains can be caused by tetracycline (antibiotic), aging or dental trauma.

How is the whitenning process ?
There are two main types of bleaching. When the bleaching is done in a tooth that was treated endodontically (the nerve is not alive) - Non-vital bleaching. When the tooth is alive - vital bleaching.


Preparation:
If the patient has cavities they should be treated before bleaching. Should also do a scaling.
Note that if the roots of the teeth are exposed they will not whiten as they are not covered by enamel. If the patient has restorations, they will also not bleach  so it may be necessary to replace  them after bleaching.


Bleaching non vital
The vital bleaching may not enhance the appearance of a tooth that has undergone root canal treatment. In this case the dentist uses a different procedure that whitens the tooth from within. The bleaching agent is placed inside the tooth and a provisional restoration is made. This is left for a few days repeating the procedure until the desired color is achieved.


Bleaching vital
The most common vital bleaching is done at home. Place a whitening gel (usually containing hydrogen peroxide) in a tray done from the model of the patient. This tray must be thoroughly adapted  to the teeth for the whitening agent to be in contact with the teeth but not with the gum (the whitening agent is irritating to the gums). The tray is placed in the teeth for a few hours every day.

The vital bleaching can also be done in the office. The number of consultations will depend on each case and the desired color. A gel is applied to protect the gums followed by the whitening agent. Some whitening agents need to be activated with ultraviolet light.

 

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Clinical Cases: