Whitening including individual teeth is quite common. The most common cause of tooth discolouration is dead tooth and lack of correct root canal treatment, or incorrect treatment. Sometimes it is possible to carry out the whitening process which is satisfactory to the patient and sometimes prosthetic treatment can be a performed e.g. all-ceramic crown or a veneer.
However, it is important to remember that incompetently conducted whitening can cause internal resorption and may lead to losing the already whitened tooth. Here are the photos before and after treatment with microsurgical resorption.
Whitening method which would be effective in all cases of tooth discolouration has not been invented yet. For instance, tetracycline stains or white patches associated with enamel hypoplasia are highly resistant to whitening. The best documented methods are chemical teeth whitening. However, even these methods are not effective in case of all patients. On average, every fourth patient will not be able to receive effective whitening treatment. Our patients are treated using instant whitening method (in-office method), or using an overlay (matrix method) placed on teeth for a few hours. Both methods allow patients to whiten their teeth a few shades lighter. The recommended overlay method is relatively safe and gives nice translucency result (half-translucency). However, it requires cooperation and patience on part of the patient. Pregnant patients should refrain from whitening procedures until after the birth.
Nowadays teeth whitening is becoming increasingly popular, however, in Western Europe this type of treatment has been performed for at least fifty years. Nearly all biological phenomena associated with teeth bleaching are already known. Whitening procedures used in our office are based on products by reputable companies such as Opalescence of Ultradent. The products we use contain carbamide peroxide or hydrogen peroxide and are not harmful to your health. These substances do not cause chemical changes in the tooth structure, weaken their resistance to caries or do not cause inflammation of the tooth pulp. Some knowledge of basic chemistry is a key to understand how it works. Most of the tooth structure is minerals - oxides, and the active whitening agent is atomic oxygen.
People with sensitive teeth may experience a feeling of hypersensitivity a few hours after whitening treatment. This may happen especially after instant whitening method with the use of concentrated formulations. The sensitivity disappears after a few hours. If the problem arises during bleaching at home, take some Aspirin and the next day, consult your doctor. It is not recommended to bleach children’s teeth. Therefore, we do not perform this procedure for patients under 13. Whitening children’s teeth is more risky, because the pulp chamber - the soft tissue within the tooth which contains the ends of nerve branches, is much bigger than in adults. Also, dentine tubules are much broader and the thickness of hard tissue separating pulp from whitening agent is less than in adults. Gum irritation caused by whitening formulation can be another unwanted side effect. This can happen especially when the patient applies too much of the product onto the overlay. The formulation not only comes in contact with tooth surface, but it also flows out to the gums and remains there for many hours. Such cases are very rare and, if they occur, gum irritation (burning) heals within a few days.
Whitening toothpaste contains abrasives: silica, diamond dust or baking soda, which polish the teeth surface and remove surface tartar. However, this type of toothpaste should not be used for too long, as this may cause irreversible damage to your tooth surface, which usually manifests in cervical defects. People with cervical area exposed (those places that are no longer covered with enamel) have to avoid using abrasive types of toothpaste sold as whitening toothpaste. On the other hand, professional in-office whitening is a controlled, chemical process focusing on tooth discolouration which not only works on tooth surface, but, also, penetrates the tooth tissue. As a result of aging and bad habits tooth micropores attract organic substances from coffee, tea, wine, fruit juices, etc. Whitening preparations trigger breaking down the organic compounds causing discolouration to carbon dioxide and water. As a result, whitening process is safe and predictable and the main aim is achieved: teeth become whiter.
First, dental impressions are taken, and, then, transparent custom trays are prepared. The trays are about 0.5 mm thick. The patient can collect them on their next visit together with a set of syringes with the whitening gel (10% or 15% concentrate depending on their tooth sensitivity). The trays are tried on and the patient receives all the necessary information on how to apply the gel. Bleaching should be done preferably at bedtime; the trays can also be used for several hours during the day. The difference is visible after only 2 applications. The standard amount of gel is usually sufficient for 2 weeks. In case of increased tooth sensitivity and, if necessary, you can fill the trays with special post-treatment teeth preparation. After a year, the patient can buy one more syringe with the preparation and repeat whitening (1-2 applications are sufficient to maintain the results.) As means of tooth decay prevention fluorine-containing formulations can be used in the trays. However, before proceeding with this treatment, please consult your dentist.
Before the treatment, the patient’s teeth need to be thoroughly cleaned. Due to strong formulations used in this method, it is recommended to protect gums and soft tissues using light-cured gel or rubber dam. The formulation containing approx. 30% hydrogen peroxide is applied to patient's teeth. The procedure takes approx. 40 min. Sometimes in order to achieve the desired results the treatment needs to be repeated.
It is recommended to avoid foods and beverages of intense colour for at least 2 weeks. The areas where discolouration used to be should soon be filled with mineral substances which reinforce enamel. They are contained in saliva or can be provided from toothpaste or mouthwash.
The average durability of treatment results are difficult to determine. If patient improves their eating habits, they may want to have the treatment repeated only after a few years. Otherwise whitening will have to be repeated every year. The follow-up sessions are much shorter and less expensive.
Other popular methods are laser and LED lamp whitening. These are usually instant bleaching methods. They are based on components which, when exposed to light, form 30% hydrogen peroxide, which is the active substance. Another factor contributing to whitening process is heat. It is the same hydrogen peroxide that is formed during carbamide peroxide breakdown, the same as in our formulations. These lamps are wrongly called lasers and the treatment is no different to others. The only difference may be the price and the mistaken impression of the patient that an advanced technology is used.
Yes, but if discoloration has been caused by ingestion of specific preparations, the teeth require a different type of bleaching: internal. Please be aware that porcelain bridges, crowns and fillings will not be bleached. That is why we recommend replacing the front, visible fillings to lighter ones. This can be done not earlier than 2 weeks after whitening, because after such period the colour (translucency) of teeth begins to stabilize.
Before placing bleaching trays in the mouth, thoroughly brush your teeth and, then, floss.
Use a small amount of the gel. Apply it to the trays to the labial part (it is recommended to use a drop of a diameter of 2-3 mm per each tooth).
The tray should then be placed in the mouth in the correct position. If the preparation flows out on the mucous membrane, remove it with a dry toothbrush, tissue or your finger.
Place the trays in the mouth for, depending on the gel concentration, 4-8 hours during daytime or night time.
When wearing trays with the bleaching preparation drinking, smoking or eating is not allowed.
After removing the trays, clean your teeth of any residual gel and rinse your mouth well.
Clean the trays under running water. Use a toothbrush and toothpaste to remove any gel residue. Dry out and then tore the trays in a dry container.
In case of significant teeth hypersensitivity, stop the treatment and consult your doctor (usually hypersensitivity disappears after approx. 1-3 days).
If the bleaching trays exert pressure on the gums, ask your dentist for a correction.
Around the time of the treatment you may notice increased tooth sensitivity to cold and hot food. It is recommended not to consume foods which can discolour the enamel, for example red wine, coffee, strong tea, beetroot, berries, soft and fizzy drinks, fruit drinks or citrus juices.
The final whiteness stabilizes within approx. 2 weeks after the treatment.