Bleaching

Click to edit Master subtitle style

7/29/12

History ROMANS § Polished teeth using urea (carbamide) from Portugal MIDDLE AGES § Barbaric bleaching § Filed teeth with an iron grater Used Aqua fortis (contains nitric acid) § 7/29/12 .

WESTLAKE (1895) § Bleached teeth with high concentrations of hydrogen peroxide (H202) mixed with ether Treatment method was first published in the American Journal of Dental Science § ABBOT (1918) Used Superoxol (30% (H202) to bleach 7/29/12 teeth discolored by fluorosis § .

AMES (1937) § Bleached teeth with 30% hydrogen peroxide (H202) and ether along with a source heat Treatment lasted approximately 30 minutes and sessions were repeated up to 25 times. § ZACK AND COHEN (1965) 7/29/12 § First to conduct a scientific evaluation .

ARENS (1972) § Tried to bleach tetracycline discolorations with 35% Superoxol at 10°c below the pain threshold 7/29/12 .

History: Home Bleaching KLUSMIER (1895) § Orthodontist from Fort Smith. Arkansas Examined the effect of Gly-Oxid (Marion) used by his young patients for removable appliances Discovered teeth became brighter and lighter tetracycline stain disappeared § § WAGNER 7/29/12 .

MUNRO (1968) § Side effect of Carbamide peroxide in a splint: Teeth became whiter HAYWOOD (1988) § Adopted the concept HAYWOOD AND HEYMANN (1989) 7/29/12 § Developed a home bleaching technique .

HAYWOOD (1990) § Bleached teeth with high concentrations of hydrogen peroxide (H202) mixed with ether Treatment method was first published in the American Journal of Dental Science § ABBOT (1918) Used Superoxol (30% (H202) to bleach 7/29/12 teeth discolored by fluorosis § .

COMMERCIAL PRODUCTS INTRODUCED TO THE MARKET: § 1989White & Brite by Omni ü Based on Munro’s findings First commercial bleaching agent for vital teeth Contains 10% carbamide peroxide ü ü § 1991Opalescence by Den-Mat 1992Nite White by Discus Dental by Colgate § § 1994Platinum 7/29/12 .

7/29/12 .

Scientific Studies HAYWOOD (1990) § Studied on extracted teeth which were bleached for 5 weeks Scanning electron microscope showed no changes Bleaching materials used did not affect the topography of the enamel § § YARBOROUGH (1991) 7/29/12 § .

MURCHISON (1992) § Examined the effect of carbamide peroxide on enamel Conclusion: short term application did not cause any significant change to enamel § Generally. majority show that it is safe to bleach 7/29/12 teeth with 10% carbamide peroxide .

Cigarette smoke) Tendency to change oral flora If done over a long time.Side Effects of Bleaching Agent 1. CONTAINS PEROXIDES § Enhances effects of other chemicals (ex. POWER BLEACHING § Changes the hard structure of the hard tooth structures Resulted in Pulpitis (on animals) § 7/29/12 . C. Albicans can accumulate and hypertrophy the papilla § § 2.

ETCHED GINGIVA § § Unprotected gingiva Damage is temporary and disappears after a few days 7/29/12 .3. TEMPORARY HYPERSENSITIVITY § Disappears in almost every case when bleaching is interrupted Remineralize using toothpaste with fluoride § 4.

REDUCED 7/29/12 BONDING ABILITY .5. ROOT RESORPTION § § On non-vital teeth  prepared internally Possible CROWN FRACTURE 7. TOOTH HYPERSENSITIVITY § § Patients should not have their teeth bleached Higher risk for post-operative sensitivity 6.

red wine.8. fruit juices. NEED FOR SUPPLEMENTARY BLEACHING § Bleaching will decrease in time due and resulting to color changes (coffee. etc) Done approximately 1 year after 1st bleaching § 7/29/12 . soda.

Review of Bleaching Methods BLEACHING OF VITAL TEETH § Chemicals are placed on enamel Also called External Bleaching Can only change enamel discoloraiton § § BLEACHING OF NONVITAL TEETH §Chemicals §Also 7/29/12 placed in the pulp chamber called Internal Bleaching dentin is changed §Coronal .

3 bleaching treatments required § § § § 7/29/12 .IN – OFFICE BLEACHING § Power Bleaching  33% H2O2 with light and heat Stronger chemicals used Enamel damage could occur For patients who want to achieve results very quickly Mostly.

hypersensitivity Higher cost and longer treatment time (if patients prefer to have their bleaching by the Patients can bleach whenever they wish dentist) to Longer time ü ü ü ü ü No rubber dam required 7/29/12 ü .HOME BLEACHING Disadvantages Advantages ü Patients must collaborate actively Little time spent (dentist must have an assistant orno effect .Not worn.Too much. hygienist with necessary qualifications) Usually more affordable .