Treatment of discolouration Flashcards
Describe the HCL pumice technique for enamel microabrasion?
- PPE and patient protection
- Place petrolium jelly on gingivae and place dental dam
- Clean teeth
- Place sodium bicarbonate gaurd
- HCL pumice slurry is applied to tooth for 5 seconds by rotating rubber cup for a maximum of 10 times
- Apply fluoride varnish after cleaning the teeth
- Polish using sandpaper discs then toothpaste
4 pre-op records for discoloured teeth other than radiographs and clinical photos?
- Shade
- Sensibility testing to check for sensitivity
- Diagram of defect
- Patient assessment
Why do we use sandpaper discs at the end of enamel microabrasion?
- To change the optical properties of enamel so areas of intrinsic discolouration become less evident by removing the prismless layer of surface enamel
3 cases where you would use microbrasion for the treatment of discolouration?
- Decalcification due to orthodontics
- Fluorosis
- Trauma to primary incisors
How many microns are removed from HCL pumice microabrasion?
100
What concentration of HCL is used?
18%
4 advantages of microabrasion other than easily performed and conservative?
- Not expensive
- Minimal maintenance required
- Results are permanent
- Fast acting
4 disadvantages of microabrasion?
- Removes enamel
- Must be done chair side
- HCL components are causatic
- Required protective apparatus for patient, dentist and dental nurse
What would you warn the patient about after completing microabrasion ?
- To avoid highly coloured food and drinks for at least 24h
When would you review the patient after enamel microabrasion and what will you do at this appointment?
4-6 weeks
* Take post op photographs
When can you use 0.1% to 6% hydrogen peroxide on people who are under the age of 18 ? and when was this decision released?
For the purpose of treating or preventing disease
in 2014
What are the two types of bleaching?
Vital bleaching (external) and non-vital bleaching (internal)
What are the two options of vital bleaching?
- Chairside power bleaching
- Night gaurd vital bleaching
What is used in chairside vital bleaching?
- Hydrogen peroxide , using 15-38%
Two techniques used in internal non vital bleaching?
- Inside Outside
- Walking bleach technique
What is used in home vital bleaching?
10% Carbamide peroxide
Explain the process of Nightgaud vital bleaching?
- Cut windows in customised tray over teeth which are not included in the treatment
- Patient applies gel to tray after brushing teeth
- Wears the tray overnight for at least 2 hours
What is the time scale for vital home bleaching?
3-6 weeks
How does carbamide peroxide relate to hydrogen peroxide?
10% carbamide peroxide breaks down to 3% hydrogen peroxide and 7% Urea which breaks down to water ammonia and carbon dioxide
3 advantages of non vital bleaching?
- Simple
- Tooth conserving
- Gingival tissues not irritated by restoration
When selecting a tooth for non vital bleaching , what are 4 things you should take into consideration?
- Adequate root filling with signs of disease
- Anterior teeth without large restorations
- Not fluorosis or tetracycline discolouration
- Not amalgam discolouration
Describe the walking bleach technique?
- Root filling removed to below gingival margin
- Bleaching agent applied on cotton wool and placed in tooth
- Covered with dry cotton wool then sealed using GIC
When would you renew the bleach and how many changes ?
- Every two weeks , 6-10 times
When would you stop the process if there is no change?
After 3-4 renewals stop if there is no change
