Welcome to the eighth issue of YOUR DENTAL CARE News.

In our seventh issue we discussed Teeth bleaching 101. If you missed this issue please visit our website http://www.procarefamilydental.com.au/news.

This article is the final of 2 articles on teeth bleaching. In the first article we discussed the nuts and bolts of tooth colour, in this article we will be looking at the ways teeth can be bleached along with the pros and cons of these techniques.

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How to bleach teeth…

Teeth come in many different shades of yellow. Some are a lighter yellow whilst others can approach a grey or even brown undertone. Most of the colour we see is inherent in the tooth structure.

A discoloured tooth or teeth can be made to look better in many ways. Bleaching is not the only course of treatment, or appropriate choice in some cases. Often the cause of tooth discolouration will dictate the course of treatment.

Besides the ageing process, which is a natural physiological process, trauma to teeth leading to the death of the pulp (the blood vessels and nerves residing in the middle of the tooth) will often cause the tooth to darken. Root canal treatment, amalgam (silver metal restorations), dental caries (decay) and some antibiotics (tetracycline) taken in childhood, are some common causes of tooth discolouration. In some cases poorly positioned teeth which are tilted inwards will appear darker due to the shadow cast on to it from the lip.

Prior to any tooth bleaching a thorough dental examination must be performed to determine why the teeth have discoloured. Most importantly any cracks or active dental disease must be addressed prior to the bleaching process. Some teeth shades are more difficult to bleach and may not lighten in colour. Other shades may take a longer time to change colour, like the grey shades. In these stubborn cases a longer regime of bleaching is necessary and even ramping up of the concentration used over several weeks may be necessary. In cases which are not suitable for bleaching other forms of treatment are used such as crowns, laser application and veneers.

The concentration of bleach is very important. Any bleaching material used must be at least 10% Carbamide peroxide or 3% Hydrogen peroxide. Anything less and the process may not work or it may take a very long time to achieve any real change. Currently only dentists are allowed to prescribe these concentrations of bleach gels and those who do carry out bleaching with these and higher concentrations without being a registered dentist are breaking the law!

Bleaching gels are applied to teeth in custom made trays which are worn from 30 minutes to overnight. Individuals who want to speed up the process can consider having higher concentrations of peroxide applied whilst in the dental chair and then continue the bleaching process at home until the desired result is achieved.

There are some side effects to bleaching. These include increased sensitivity of teeth to cold and hot beverages. Discomfort to the gums if bleach is left on the gums. These side effects are more likely when higher concentration of bleach is used. All of these side effects are transient and will get better as soon as the bleaching process is stopped. The use of desensitising tooth paste can also help reduce the effects of increased sensitivity.

Commercially available bleaching products are in abundance at retail outlets. Some do have some effect on the teeth but others are a waste of money. Care must be taken to avoid any products which have acid in them because this will destroy the tooth just like acidic drinks and acid from bacteria. Placing something acidic on tooth structure will make the teeth appear lighter in colour initially due to the etching process on the enamel. But this is not permanent. Poorly fitting appliances which come with these products can also be a problem as the bleach must be in good intimate contact with the teeth for as long as possible in order for it to work.

Picture courtesy of SDI. Polanight whitening gel manufactured and distributed by an Australian company.

Bleaching is a very conservative and safe procedure. It involves no destruction of tooth structure and is not harmful to the surrounding soft tissues in low concentrations. But application of bleach on teeth with active dental disease or structural defects is not advisable. Misuse of these products like any medicament will lead to unwanted side effects.

Pola bleach system is one of the many reputable products used by dentists. Diagram courtesy of SDI.

I hope these articles have helped you understand a little about teeth bleaching. If you do have any questions please contact us at the surgery.

In our next article we will be discussing cosmetic dentistry and what we can do to give you the smile you’ve always wanted.

Till next time.

Roland Chong

Roland has over 20 years experience as a general dentist. Roland does all aspects of general dentistry with a special interest in prosthodontics (crown and bridge work) and cosmetic dentistry. A member of the International Team of Implantology, Roland is constantly developing his skills by collaborating with international experts.

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