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teeth whitening

Teeth whitening is an aesthetic dentistry treatment that aims to remove dental stains and make the teeth look whiter and brighter. The current popularity of aesthetics has made this dental procedure one of the most requested in recent years.

It is especially important that dentists are trained in the management of bleaching agents, following an appropriate protocol for diagnosis, planning of the procedure and maintenance of the results. For this reason, it is vital that the professional thoroughly knows both the indications and contraindications of teeth whitening techniques in order to transmit them to patients.

On the other hand, the population must conceive of this treatment as a medical process that must be performed under the supervision of a dentist, and only performed in the dental clinic.

Causes of darkening of teeth

Following inadequate oral hygiene and the consumption of certain products can cause alterations in dental staining. There are different types of dental stains that we can classify as intrinsic or endogenous stains and extrinsic or exogenous stains.

Among the intrinsic or endogenous stains are those that affect the teeth in their formation phase, before they erupt in the oral cavity, caused by the consumption of certain medications such as tetracyclines, enamel hypoplasia, vitamin deficiency or fluorosis. Also classified in this group are those spots that appear after the dental eruption, produced by blows, fractures or due to the passage of time due to aging of the dentition, which acquires a darker shade.

Extrinsic or exogenous stains are produced by contact of the teeth with pigmenting agents, present in certain foods, beverages such as wine, tea and coffee, and other products, such as tobacco. These stains can also occur after prolonged use of certain oral mouthwashes and Chlorhexidine-based toothpastes.

Types of teeth whitening

The classification of teeth whitening depends on the tooth to which the procedure is applied.

Whitening of vital teeth

This type of whitening can be of two different types:

Teeth whitening performed at the dental office. It is carried out in the dental clinic by applying a bleaching agent based on 35% hydrogen peroxide, which can be activated by a light source. It is necessary to previously perform adequate prophylaxis and check that the oral cavity is healthy. After this step, the area to be treated is isolated, so that contact of the bleaching agent with periodontal tissues is avoided and the bleaching agent is subsequently added. It is essential to follow the instructions of the manufacturer of the bleaching system for the results to be satisfactory.

This is a very effective method, since a high concentration of the bleaching component is managed under the control of a dentist.

Outpatient whitening with the supervision of a dentist. In this type of bleaching, the concentration of carbamine peroxide is 10%. This method is performed at the patient's home, under the direction of the dentist. In the same way as in the previous whitening, it is necessary to carry out prophylaxis and an oral revision before treatment. A custom splint is made for the patient in which the bleaching agent will be applied, in order to avoid any possible contact with periodontal tissues.

Whitening of non-vital teeth

The reason for discoloration in non-vital teeth is usually due to the presence of blood or bacterial products within the ducts (pulp necrosis). This type of whitening is performed in the dental office and involves the removal of all bleaching agents and existing necrotic tissue from the pulp chamber in endodontic teeth.

There are two methods for whitening non-vital teeth.

Immediate technique. It consists of activating the mixture of sodium perborate with 35% hydrogen peroxide through a hot instrument. The result obtained is observed instantly.

Outpatient technique. The mixture made with sodium perborate (Amosan powder) and 35% hydrogen peroxide (Superoxol) is applied, brought to the cavity of the pulp chamber and a temporary filling is placed on the surface. It is a longer process.

A combination of both techniques can also be carried out.

Teeth Whitening Risks

However, in addition to knowing what teeth whitening is, we must know that this treatment is not without risks. Teeth whitening is a treatment that, despite generally obtaining satisfactory results, carries a number of risks. It is the obligation of the dentist to inform about them so that they are considered prior to the teeth whitening.

Possible risks of teeth whitening include cervical resorption, gingival sensitivity, and post-operative tooth sensitivity.

To potentially reduce adverse effects, it is necessary to comply with the necessary biological safety measures, using the appropriate concentrations according to each technique and following the appropriate exposure times.

What do you think?

Have you ever had teeth whitening, what has been your experience? Leave us your opinion in the comment box.

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Dr. Armellini received her dental degree from the Central University of Venezuela. She received an MBA from the University of Michigan and embarked on a clinical fellowship in Implantology Prosthodontics at the Hospital for Sick Children in Toronto.


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