Bleaching

BY:
✓ Abdullah Mohammad Al-khomsan
✓ Tariq Ali ALbakri
✓ Dhafer Ali S. Quayman
✓ Fayez Hamad Al-Aqil
Content:
o Introduction
o Definition of Dental Bleaching
o Types of Dental Bleaching Procedures
o The Procedures
o Common Reasons for Tooth Discoloration
o Benefits of Dental Bleaching
o Potential Risks and Side Effects
o Aftercare and Maintenance
o Conclusion
o References
 Introduction
• The lightening of the color of a tooth through the application of a chemical agent to oxidize the organic
pigmentation in the tooth is referred to as bleaching. In keeping with the overall conservative
philosophy of tooth restoration, consideration should be given first to bleaching anterior teeth when
intrinsic discolorations are encountered .

• The techniques may be classified as :

I. vital or non-vital teeth and
II. in the office or outside the office.

• non-vital teeth was first reported in 1848 and in-office bleaching of vital teeth was first reported in 1868
.

• A 3% ether and peroxide mouthwash used for bleaching in 1893 “dentist-prescribed as home-
applied” .

• Most bleaching techniques use some form or derivative of hydrogen peroxide in different
concentrations and application techniques. The mechanism of action of bleaching teeth with hydrogen
peroxide is considered to be oxidation of organic pigments .
Definition of Dental Bleaching
1 The Process

Dental bleaching is a cosmetic procedure that lightens the color of teeth and removes stains
through the application of bleaching agents.

2 Effective Treatment

It is one of the most popular and effective treatments to enhance the appearance of the smile by
achieving a brighter, whiter shade of teeth.
Types of Dental Bleaching Procedures
In-Office Bleaching
This professional treatment is performed at the dental
clinic using high-concentration bleaching agents.
At-Home Bleaching
Patient-performed treatment involving the use of
custom-fitted trays and lower-concentration bleaching
gels.
The Procedures Non vital Bleaching Procedures

In-Office Non vital Walking Bleach

Bleaching Technique Technique

In-Office Vital Dentist-Prescribed,

Bleaching Technique Home-Applied Technique

vital Bleaching Procedures

 The Procedures
‘’Non vital Bleaching Procedures ‘’

The primary indication for non vital bleaching is to lighten teeth that have undergone root canal therapy. Discoloration
may be a result of bleeding into dentin from trauma before root canal therapy, degradation of pulp tissue left in the
chamber after such therapy, or staining from restorative materials and cements placed in the tooth as a part of the root
canal treatment.

• In-Office Non vital Bleaching Technique :

➢ thermocatalytic technique consisting of the placement of 35% hydrogen peroxide liquid into the debrided pulp chamber and acceleration of the
oxidation process by placement of a heating instrument into the pulp chamber. The thermocatalytic technique is not recommended, however,
because of the potential for cervical resorption.

➢ A more current technique uses 30% to 35% hydrogen peroxide pastes or gels that require no heat. This technique is frequently the preferred in-
office technique for bleaching non-vital teeth .

• Walking Bleach Technique :

➢ Sodium perborate is used with this technique because it is deemed extremely safe and it should be changed weekly.

1. the dentist needs to evaluate the potential for occlusal contact on the area of the root canal access opening.
2. places a rubber dam to isolate the discolored tooth and removes all materials in the coronal portion of the tooth .
3. removes gutta-percha (1-2mm)
4. enlarges the endodontic access opening sufficiently to ensure complete debridement of the pulp chamber .
5. places an RMGI liner to seal the gutta-percha of the root canal .
The Procedures
‘’Non vital Bleaching Procedures ‘’

Indication for bleaching root canal– filled tooth. A, Before. B, After

intra coronal, non vital bleaching
 The Procedures
‘’ Vital Bleaching Procedures ‘’

• Different vital bleaching techniques are similar, with patient preference, cost, compliance, and difficulty in the removal of
certain discolorations .
• Indications for vital bleaching include teeth intrinsically discolored because of aging, trauma, or certain medications .
• Teeth exhibiting yellow or orange intrinsic discoloration seem to respond best to vital bleaching, whereas teeth exhibiting
bluish gray discolorations often are considerably more difficult to treat in this manner

• In-Office vital Bleaching Technique :

➢ In-office vital bleaching requires an excellent rubber dam technique and careful patient management.

Most consist of paste or gel compositions that most commonly contain 30% to 35% hydrogen peroxide, Other additives, such as metallic ion–
producing materials or alkalinizing agents [ Different in oxidation reaction ] .

➢ The patient is instructed to report any sensations of burning of the lips or gingiva that would indicate a leaking dam and the need to terminate
treatment.

• Dentist-Prescribed, Home-Applied Technique :

• The dentist-prescribed, home-applied technique (i.e., night- guard vital bleaching) is much less labor intensive and requires substantially less in-
office time. An impression of the arch to be treated is made and poured in cast stone.

• A 10% to 15% carbamide peroxide bleaching material generally is recommended for this bleaching technique.
Common Reasons for Tooth Discoloration
Discoloration
1 Extrinsic Factors

External stains caused by food, beverages, tobacco, or poor oral hygiene practices.

2 Intrinsic Factors

Internal discoloration due to aging, genetics, trauma, certain medications, or dental conditions.
dental conditions.

3 Environmental Factors

Discoloration caused by exposure to excessive fluoride or high levels of certain minerals during
tooth development.
Benefits of Dental Bleaching
1 Enhanced Aesthetics 2 Increased Confidence 3 Youthful Appearance

Removes stains and Achieving a whiter smile can Whiter teeth can give the
discoloration, resulting in a boost self-esteem and appearance of a more
brighter and more attractive improve social interactions. youthful and vibrant smile.
smile.
Potential Risks and Side Effects
Temporary Sensitivity Irritation of Gums Tooth Damage

Some individuals may Improper use of bleaching Overuse or misuse of bleaching

experience temporary tooth agents can cause gum agents without professional
sensitivity after bleaching, irritation, but this is generally guidance can potentially harm
which usually subsides within a rare when procedures are tooth enamel and tissues.
few days. performed by professionals.
Aftercare and Maintenance
1 Maintaining Oral Hygiene

Regular brushing, flossing, and dental check-ups help maintain the longevity of the bleaching
results.

2 Stain Minimization Strategies

Reducing consumption of dark-colored foods and beverages, limiting tobacco use, and practicing
good oral hygiene habits can prolong the effects of bleaching.

3 Professional Touch-ups

Periodic touch-up treatments by dental professionals can help maintain the desired shade of
whiteness.
Conclusion
Dental bleaching offers an effective solution to enhance smiles by removing stains
and achieving a whiter appearance. Consult with your dental professional to
determine the best bleaching approach for you.
References