Teeth Whitening Flashcards
what are the causes of discoloration
extrinsic and intrinsic
what are extrinsic stains and what is it caused by and how is it removed
- stains on the external surface of teeth
- poor OH, eating habits, chromogenic microorganisms, tobacco
- can be removed by prophylaxis
what are intrinsic stains, what are they caused by and what are they treated with
- 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
why do endo treatments cause intrinsic stains
tooth dehydration
effects of restorative materials
what is the most common form of tetracycline staining
long term use of minocycline
which types of tetracycline staining are harder to treat: dark blue-gray or yellow-orange
dark blue grey
what is the treatment for tetracycline staining
can require up to 6 months of consistent use of vital bleaching products
where should caries be treated before whitening
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
its possible to place esthetic restorations prior to whitening in a ____ shade
lighter
existing restorations in the esthetic zone will most likely need:
to be replaced
exposed root surfaces may experience ____ during teeth whitening
sensitivity
if restorations are inadequate patients may develop ______ during whitening
mild to moderately severe pain
when do you remove calculus and extrinsic stains
before whitening
if tissue is traumatized during calculus removal and extrinsic stain removal wait ______ before beginning bleaching treatment to minimize possible gingival sensitivity
one to two weeks
does whitening alter the shade of restorations
no
wait ______ following the bleaching procedure before matching and placing resin bonded restorations
two weeks
color stabilization requires_______ and residue peroxides may _____
time; interfere with bond strengths
teeth with large amalgam restorations may appear darker than other bleached teeth because:
the internal restoration becomes more visible through the bleached enamel
describe enamel in the tooth whitening mechanism
a semi-translucent, prismatic, primarily inorganic
describe dentin in tooth whitening mechanism
a yellow opaque, tubular, primarily organic
what is the tooth whitening mechanism
hydrogen peroxide migrates through the enamel and breaks down organic pigment molecules in the enamel and dentin (primarily dentin)
what is the tooth whitening mechanism in colgate optic white
electrochemical reaction to increase pH making the conducting gel more effective, faster, and less sensitive
how do you use the colgate optic white professional in office at school
- 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
the colgate optic white at home kit is made of:
6% hydrogen peroxide serum
what is the procedure for colgate optic white at home kit
- 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
what is the active ingredient in dentist supervised nightguard vital bleaching
10-22% carbamide peroxide or 3-6% hydrogen peroxide
patients will notice whitening effects after ____ with a two week regimen in nightguard vital bleaching
4-5 days
rebound of _____ shade should be expected in nightguard bleaching
half a shade
bonding after nightguard vital bleaching should be delayed for _____ and why?
2 weeks; residual peroxide ions could interfere with bond strength and shade needs to stabilize to final shade
what should you tell patients to do for nightguard vital bleaching sensitivity
potassium nitrate or stannous fluoride either as a toothpaste or a gel within the whitening trays
what ingredient is whitening the teeth
hydrogen peroxide
what can discoloration treated by non vital bleaching be from
- bleeding into dentin from trauma
- residual pulp tissue left after RCT
- staining from restorative materials
what are the risks of teeth whitening
- 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
what are the benefits of tooth whitening
- whiter/matching tooth
- lower cost than crown or veneer
what is the internal bleaching technique
- 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
make sure of what in internal bleaching technqiue
- 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
what is the most important part of internal bleaching technique
- successful RCT
- substantial seal of vitrebond over GP
in the walking bleach technique you should see improvement after ___ applications
2
