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F - RESTORATIVE DENTISTRY > Tooth Whitening > Flashcards

Tooth Whitening Flashcards

1
Q

What regulation was implemented to aid with tooth whitening?

A

EU cosmetics regulation

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2
Q

What did the EU cosmetics regulation bring about?

A

Illegal to contain more than 6% hydrogen peroxide

Substances with 0.1-6% sodium peroxide should not be made directly available to consumer

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3
Q

What does GDC state about tooth whitening products?

A

Only sold to practitioners and first use can only be carried out by practitioners or under direct supervision

Not use over 6%

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4
Q

Causes of tooth discolouration?

A

Smoking

Red wine

Tea and coffee

Bacteria

Chlorhexadine

Iron supplement

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5
Q

Two types of tooth bleaching?

A

External vital bleaching
Internal non-vital bleaching

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6
Q

What is vital external bleaching?

A

Bleaching oxidises high molecular weight organic molecules within tooth substance

Causes ionic exchange leading to lighter colour

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7
Q

What active agent is used in vital external bleaching?

A

H2O2

Mixed with water producing free radical of HO2 which is oxidising agent

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8
Q

What ingredient is broken down to produce the H2O2?

A

Carbamide peroxide

Breaks down to form H2O2 and urea

10% carbamide gives 2.6% H2O2

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9
Q

What ingredient increases the viscosity of material in vital external bleaching?

A

Carbopol

Thickening agent to keep the material on the tooth or in the tray

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10
Q

Advantages of in office bleaching

A

Dentist controlled

Heat and light

Quicker results

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11
Q

Disadvantages of in office bleaching

A

Time for dentist

Uncomfortable

Results wear off quicker

Expensive

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12
Q

Technique of in office bleaching

A

Cleaning of teeth

Rubber dam or gingival mask

Apply bleaching gel and heat / light

Wash dry and repeat

30 mins - 1 hour

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13
Q

How is home vital bleaching done?

A

10-15% carbamide peroxide gel equating to 6% H2O2

Custom made tray and gels at home

Bleaches slowly over several weeks

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14
Q

How does dentist set up home bleaching?

A

Alginate impressions and then acrylic vacuum formed splint made that stops 1mm short of gingival margin and has buccal spacer

Full mouth cleaning in surgery and check trays

Give instructions

Load tray at home 1mm dot buccal on each tooth

Place tray in for 2 hours or overnight

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15
Q

When should one bleach

A

Age related bleaching

Mild fluorosis

Post smoking cessation - dont bleach a smoker

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16
Q

Possible issued with bleaching?

A

Sensitivity is large one
- normally resolves over 2-3 days
- pre-existing sensitivity or high bleach conc can increase risk

Possible irritation of the gingiva

Composite does not bleach but teeth do!

17
Q

Causes of non-vital tooth discolouration

A

Pulp canal obliteration

Pulp bleeding into dentine

Non vital tooth

18
Q

Indications for non vital internal bleaching?

A

Non vital tooth

Adequate RCT

19
Q

Contra indications for internal non vital bleaching

A

Heavily restored tooth

Amalgam staining in tooth

20
Q

Risks of internal bleaching?

A

External cervical resorption

Due to diffusion of H2O2 through dentine into periodontal tissues

21
Q

Technique for internal bleaching?

A

Record shade

Prophylaxis

Rubber dam

Remove filling from access cavity

Remove GP from pulp chamber and 1mm below ACJ

Place 1mm RMGIC over gp to seal canal

Remove dark dentine

Etch internal surface with phosphoric acid

Place 10\5 carbamide peroxide gel topped with cotton wool

Seal with GIC

Repeat weekly intervals until shade required or no change

Restore palatal cavity with white GP in pulp chamber and light shade composite

22
Q

What is micro abrasion?

A

Removes discolouration of enamel on outer layers only

Using 18% HCL and pumice

23
Q

What is resin infiltration?

A

Treats white spot lesions on teeth

Resin impregnates the porous enamel area and masks it to look like normal enamel

24
Q

What must be done prior to tooth whitening

A

Proper medical examination and history to ensure patient is ok for bleaching of teeth

25
Q

What are some medical contraindications

A

Glucose 6 phosphate dehydrogenase deficiency

Acatalasemia

Neither group can metabolise hydrogen peroxide

Aged under 18 - can only be used solely for preventing disease, not aesthetics

F - RESTORATIVE DENTISTRY (17 decks)

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