Treatment of Discolouration

Question 1

what are the treatment options for discolouration

Answer 1

enamel microabrasion
bleaching
resin infiltration
localised composite restoration
veneers

Question 2

what are the pre op records required for discoloured teeth

Answer 2

clinical photos
shade
sensibility testing
diagram of defect
radiographs if clinically indicated
patient assessment

Question 3

what is the technique for controlled hydrochloric acid pumice microabrasion

Answer 3

sodium bicarbonate
HCL pumice slurry in slow rotating rubber cup
wash direct into aspirator
10 x 5 secs completed on 6 anterior teeth
fluoride varnish application
polish with sandpaper disc
polish with toothpaste

Question 4

what are the function of sandpaper discs in microabrasion

Answer 4

changes the optical properties of the enamel so that areas of intrinsic discolouration become less perceptible

Question 5

how many microns of enamel are lost with HCL microabrasion

Answer 5

100

Question 6

what are the advantages of microabrasion

Answer 6

easily performed
conservative
inexpensive
teeth need minimal subsequent maintenance
fast acting
removes stains
effective
results are permanent
can use before or after bleaching

Question 7

what are the disadvantages of microabrasion

Answer 7

removes enamel
HCL acids are caustic
requires protective apparatus
prediction of treatment outcome difficult
must be done in dental surgery
cannot be delegated

Question 8

what are patient instructions after microabrasion

Answer 8

avoid highly coloured food and drinks for 24 hours

Question 9

when do you follow up with patient after microabrasion

Answer 9

4-6 weeks afterwards

Question 10

when is bleaching allowed in children as stated by the GDC

Answer 10

for treating or preventing disease

Question 11

what are the bleaching options

Answer 11

vital or non-vital

Question 12

what is the risk with in practice vital bleaching

Answer 12

greater soft tissue risk

Question 13

what are the instructions to patients for at home bleaching

Answer 13

brush teeth thoroughly
apply gel to tray
set over teeth and press down
remove excess
rinse gently
wear overnight
remove. brush and rinse

Question 14

how long is at home bleaching done

Answer 14

3-6 weeks

Question 15

what does 10% carbamide peroxide give

Answer 15

3% hydrogen peroxide and 7% urea

Question 16

what are the advantages of non-vital bleaching

Answer 16

simple
tooth conserving
original morphology
gingival tissues not irritated by restoration
adolescent gingiva level not a restorative consideration
no lab assistance for walking bleach

Question 17

how do you select a tooth for non-vital bleaching

Answer 17

adequate root filling with no disease
anterior teeth without large restorations
not amalgam intrinsic discolouration
not fluorosis or tetracycline discolouration

Question 18

what are the methods of non-vital bleaching

Answer 18

walking bleaching
inside out methods

Question 19

what is the walking bleaching technique

Answer 19

remove root filling below gingival margin
use small adult bur head
clean with ultrasonic tip
bleaching agent on cotton wool
cover with dry cotton wool
seal with GIC

Question 20

how often do you renew walking bleach

Answer 20

2 weeks with 6-10 changes in total

Question 21

what is the inside out bleaching technique

Answer 21

access cavity open
custom made mouthguard
patient applies bleach to back of tooth and tray
patient keeps cavity clean
worn all the time except eating and cleaning

Question 22

how do you restore the pulp chamber after bleaching

Answer 22

non-setting CaOH for 2 weeks
sela in GIC
white composite
composite resin

Question 23

what are the complications of non-vital bleaching

Answer 23

external cervical resorption
spillage of bleaching agents
failure to bleach
over bleach
brittleness of tooth crown

Question 24

how do you prevent external cervical resorption

Answer 24

layers of cement over GP
non-setting CaOH in tooth for 2 weeks before final restoration

Question 25

what are the short term effects of bleaching on soft tissues

Answer 25

minor ulceration/irritation
plaque reduction
aids wound healing

Question 26

what are the long term effects of bleaching on soft tissues

Answer 26

delayed wound healing
periodontal harm
mutagenic potential

Question 27

when is tooth mousse recommended

Answer 27

2 weeks after bleaching
4 weeks after microabrasion

Question 28

what is resin infiltration

Answer 28

infiltration of enamel lesions with low viscosity light curing resins

Question 29

what is a disadvantage of enamel reduction

Answer 29

overcontouring increases plaque retention and stagnation at gingival margin

Question 30

what is an advantage of enamel reduction

Answer 30

bond strength of composite resin to enamel is significantly increased after partial removal of buccal enamel