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Advanced Restorative > Teeth Whitening > Flashcards

Teeth Whitening Flashcards

1
Q

what are the causes of discoloration

A

extrinsic and intrinsic

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2
Q

what are extrinsic stains and what is it caused by and how is it removed

A
  • stains on the external surface of teeth
  • poor OH, eating habits, chromogenic microorganisms, tobacco
  • can be removed by prophylaxis
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3
Q

what are intrinsic stains, what are they caused by and what are they treated with

A
  • deeper internal stains or enamel defects
  • advancing age, metabolic drug staining, trauma, endo therapy
  • more complex to treat and usually requuires dental professional to treat
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4
Q

why do endo treatments cause intrinsic stains

A

tooth dehydration
effects of restorative materials

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5
Q

what is the most common form of tetracycline staining

A

long term use of minocycline

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6
Q

which types of tetracycline staining are harder to treat: dark blue-gray or yellow-orange

A

dark blue grey

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7
Q

what is the treatment for tetracycline staining

A

can require up to 6 months of consistent use of vital bleaching products

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8
Q

where should caries be treated before whitening

A

treat caries in the non esthetic zone prior to whitening and address failed restorations and/or areas of caries in the esthetic zone with temporary restorations

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9
Q

its possible to place esthetic restorations prior to whitening in a ____ shade

A

lighter

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10
Q

existing restorations in the esthetic zone will most likely need:

A

to be replaced

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11
Q

exposed root surfaces may experience ____ during teeth whitening

A

sensitivity

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12
Q

if restorations are inadequate patients may develop ______ during whitening

A

mild to moderately severe pain

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13
Q

when do you remove calculus and extrinsic stains

A

before whitening

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14
Q

if tissue is traumatized during calculus removal and extrinsic stain removal wait ______ before beginning bleaching treatment to minimize possible gingival sensitivity

A

one to two weeks

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15
Q

does whitening alter the shade of restorations

A

no

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16
Q

wait ______ following the bleaching procedure before matching and placing resin bonded restorations

A

two weeks

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17
Q

color stabilization requires_______ and residue peroxides may _____

A

time; interfere with bond strengths

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18
Q

teeth with large amalgam restorations may appear darker than other bleached teeth because:

A

the internal restoration becomes more visible through the bleached enamel

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19
Q

describe enamel in the tooth whitening mechanism

A

a semi-translucent, prismatic, primarily inorganic

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20
Q

describe dentin in tooth whitening mechanism

A

a yellow opaque, tubular, primarily organic

21
Q

what is the tooth whitening mechanism

A

hydrogen peroxide migrates through the enamel and breaks down organic pigment molecules in the enamel and dentin (primarily dentin)

22
Q

what is the tooth whitening mechanism in colgate optic white

A

electrochemical reaction to increase pH making the conducting gel more effective, faster, and less sensitive

23
Q

how do you use the colgate optic white professional in office at school

A
  • charge the light at least 4 hours or overnight
  • pt must pay in advance in order to get the kit from the dispensary to charge prior to the appt
  • take starting shade and confirm with pt
  • place cheek retractor and dry teeth with 2x2 gauze
  • click pen several times until you see a drop of serum, then paint a thin coat on each tooth. the serum does not have to be perfectly even but avoid the gingival tissue. if some gets on the tissue wipe away with gauze, cotton roll or swab
  • allow serum to dry 10-15 seconds, teeth will look shiny
  • remove cheek retractor and place LED device. it will beep once at 5 minutes then twice at 10 minutes and turn off
  • remove device, place cheek retractor and use ethanol pen to remove dried serum. apply 2-3 teeth at a time, then remove serum with gauze, cotton roll or swab
  • re apply whitening serum and repeat this process 2 more times for a total of 3 cycles
  • take a final shade and compare to starting shade
  • patient takes home kit but not the whitening serum- it is too strong for home use, refill pens are available for purchase and used with the LED device
24
Q

the colgate optic white at home kit is made of:

A

6% hydrogen peroxide serum

25
Q

what is the procedure for colgate optic white at home kit

A
  • similar pen with whitening serum that is a lower concentration for home use
  • patient dries teeth with tissue or gauze
  • paint serum on upper and lower teeth
  • insert LED device for 10 minutes
  • leave dry serum on teeth overnight
  • brush off dry serum in the morning
26
Q

what is the active ingredient in dentist supervised nightguard vital bleaching

A

10-22% carbamide peroxide or 3-6% hydrogen peroxide

27
Q

patients will notice whitening effects after ____ with a two week regimen in nightguard vital bleaching

A

4-5 days

28
Q

rebound of _____ shade should be expected in nightguard bleaching

A

half a shade

29
Q

bonding after nightguard vital bleaching should be delayed for _____ and why?

A

2 weeks; residual peroxide ions could interfere with bond strength and shade needs to stabilize to final shade

30
Q

what should you tell patients to do for nightguard vital bleaching sensitivity

A

potassium nitrate or stannous fluoride either as a toothpaste or a gel within the whitening trays

31
Q

describe carbamide peroxide

A
  • contains hydrogen peroxide and urea with the amount of hydrogen peroxide at a 3:1 ratio
  • 30% carbamide peroxide contains 10% hydrogen peroxide whereas a 10% carbamide peroxide would contain 3.33% hydrogen peroxide
32
Q

what ingredient is whitening the teeth

A

hydrogen peroxide

33
Q

what is the most important component in shade selection and why

A

value because it is the lightness to darkness of a hue

34
Q

what are the professional brands for use with custom trays

A
  • opalescence (ultradent) 10% and 22% carbamide peroxide
  • NiteWhite ACP (Discus Dental) 10% 16% and 22% carbamide peroxide
  • SDI Poladay 3% hydrogen peroxide, 6% hydrogen peroxide, PolaNight 10% carbamide peroxide 16% carbamide peroxide
35
Q

what are the over the counter whitening products

A
  • crest whitestrips
  • opalescence go
  • colgate optic white at home kit
  • go smile
36
Q

toothpaste alone is usually ____ for whitening

A

not effective

37
Q

what can discoloration treated by non vital bleaching be from

A
  • bleeding into dentin from trauma
  • residual pulp tissue left after RCT
  • staining from restorative materials
38
Q

what are the risks of teeth whitening

A
  • may not achieve full bleaching of the tooth results not guarunteed
  • existing composites may need to be repalced
  • chance of leakage of bleaching agents into root canal causing irritation/pain
39
Q

what are the benefits of tooth whitening

A
  • whiter/matching tooth
  • lower cost than crown or veneer
40
Q

what is the internal bleaching technique

A
  • make sure you have a successful RCT in place
  • make sure you have a substantial seal over GP
  • make sure access is thoroughly cleaned
  • crush sodium perborate granules and mix with sterile water or anesthetic solution to a stiff paste consistency and place in access
  • cover with cotton and substantial temporary restoration
  • schedule patient for 1-2 weeks repeat up to 2 times
41
Q

make sure of what in internal bleaching technqiue

A
  • all metallic materials are out of pulpal space
  • all pulp horns are adequately cleaned
  • all defective fillings are cleaned and replaced
  • this alone with a light shade of composite may help clear up a lot of the discoloration
42
Q

what is the most important part of internal bleaching technique

A
  • successful RCT
  • substantial seal of vitrebond over GP
43
Q

in the walking bleach technique you should see improvement after ___ applications

A

2

44
Q

what is the walking bleach technique

A
  • bleach lighter than desired
  • there will be some rebound
  • finish with lightest composite
45
Q

describe sodium perborate

A
  • recommended for use at UMKC
  • does not cause internal resorption so is safer
  • walking bleach
46
Q

descibr superoxyl - 35% hydrogen peroxide

A
  • not used at UMKC due to safety concerns
  • hazardous causing burns to skin, mucosa, and eyes and toxic to inhalation or ingestion
  • frequently causes resorption, especially when heated
47
Q

why is the vitrebond barrier important

A
  • to ensure bleaching agents do not leak through and destroy the RCT seal
48
Q

what would lack of a vitrebond seal cause and how

A

bleaching agents to leak through to the periapical tissues causing pain
- can occur due to percolation of nascent oxygen from bleaching agents through the GP

49
Q
A

Advanced Restorative (17 decks)

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