Bleaching Flashcards
What is the mechanism of action for bleaching?
- The tooth is a semi-permeable membrane
- Peroxides have low molecular weight
- Peroxides penetrate the enamel and dentin quickly
How long does it take for peroxides to reach the pulp?
5-15 minutes
True or False: Peroxide levels are very high and you must be careful not to damage the pulp.
False, levels are low enough to not damage the pulp
10% carbamide peroxide is equivalent to _____ % hydrogen peroxide.
3.5%
True or False: Peroxides have high molecular weights.
False
True or False: Peroxides penetrates the enamel and dentin slowly.
False
Which is more stable: hydrogen peroxide or carbamide peroxide?
carbamide
Hydrogen peroxide is active for _______ mins.
30-60
How much carbamide peroxide is released in 2 hours?
50%
Peroxide breaks down _______ and leads to less color.
bonds in the chromafore (aka its a loss of color, not an addition of “whiteness”)
Bleaching is effective for ____ and ______ stains.
intrinsic and extrinsic
True or False: Cementum does not bleach.
True
Can patients with recession bleach?
Yes, there will be sensitivity and the areas of cementum will not bleach, but enamel portions will.
What type of peroxide is in whitening rinses?
hydrogen peroxide (low%)
What type of peroxide is in whitening toothpaste?
carbamide peroxide (low%)
What type of peroxide is in whitening gum?
NONE (mostly abrasive action)
What type of peroxide is in whitening paints?
carbamide or hydrogen peroxide (10-18%)
What type of peroxide is in white strips?
Hydrogen peroxide (5-14%)
True or False: Rinses, toothpastes, gum, and paints have minimal whitening.
True
Dentist prescribed whitening products will generally contain ______ carbamide peroxide.
10-35%
What percentage of carbamide peroxide is best for overnight wear?
10%
In office bleaching in commonly ______ % hydrogen peroxide and it requires gingival ______.
25-38%
isolation
True or False: The use of light when bleaching will dramatically improve the results.
False
How long does “in office” whitening usually take?
about an hour
What is the most common side effect of whitening?
hypersensitivity
What is the second most common side effect of whitening?
gingival irritation
What is the best way to reduce sensitivity associated with whitening?
two weeks of using toothpaste that contains potassium nitrate
True or False: There is always about 1/2 shade rebound one week after completing the bleaching process.
True
in office session: 2 shade rebound
trays: 1/2 shade rebound
What is the most important thing to discuss with patients prior to beginning whitening treatment?
realistic expectations (every tooth has a maximum degree of whitening and a maximum rate of change)
______ shades will whiten more easily than _____ shades.
red/yellow blue gray (SLOWWWWW changes)
Whitening treatment can last as long as _____ years depending on multiple factors.
1-3
What is the average treatment time?
2 weeks
What are the patient instructions for tray whitening?
- Brush teeth
- load a small amount of gel onto facial aspect of each tooth
- Wear tray according to determined time
- Remove tray, clean with brush and cool water
According to OSU Protocol, what should you do if a patient inquires about whitening?
Ask 5 listed questions
According to OSU Protocol, what are the contraindications for whitening?
- patients with extremely large pulps
- exposed root surfaces
- severe loss of enamel
- pregnancy
- Allergies to peroxide
According to OSU Protocol, what needs to be completed prior to whitening?
a complete prophylaxis
Before payment is made, the patient must _______.
read and sign the consent form
A payment for ______ is necessary before fabrication of the trays.
one arch
How long should you wait after whitening procedure before placing any anterior restorations?
2 weeks
What is the first appointment for?
taking impressions
What is the second appointment for?
fitting the trays and dispensing the whitening gel
What is the third appointment for?
2 weeks after second appt. assess the completion of whitening
Patients must sign the _____ and the _____.
consent form and progress notes
The consent form should be placed in the folder behind the _____ tab.
green
If a patient comes back for a fourth appointment and the saturation point has not yet been met, do they have to pay for additional syringes?
NO, no payment necessary…just obtain a faculty signature
Do patients pay for touch-up bleaching after appointment four?
YES, they will be given 3 more syringes after faculty receives the cashier’s receipt
