There are several causes and types of teeth discolorations and each of them need careful diagnosis and examination in order to select the proper treatment. Using home bleaching technique can be considered one of the minimal invasive approach for the treatment of teeth discolorations. The aim of this article is to show how to achieve success through the the bleaching to reestablish the natural appearance of discolored teeth and to improve our patients’ confident smile.
Fig.1
A 23-year-old male patient visited our dental clinic complaining about teeth discoloration, asking for a solution to have a brighter smile under one condition, no drilling
Fig.2
Pre-operative picture is very important to select the proper shade and to evaluate bleaching progress (the initial shade is A3.5 VITA classical).
Fig.3
Air-polishing by sodium carbonate powder with AquaCare device in order to remove all the stains from the enamel surface.
Fig.4
After polishing by AquaCare twin device (sodium carbonate powder) the teeth now is ready for bleaching.
Fig.5
The buccal surface of models teeth can be waxed-up to create a reservoir for the bleaching gel before tray fabrication, even when there is no difference in the rate of bleaching with or without reservoirs. There is no need to scallop the tray on each tooth. Only One or Two millimeters above the cervical area of each tooth.
Fig.6
One or two gel syringes should be delivered to the patient, so that the treatment can be done for a week. The patient should be instructed to report any abnormal change of the teeth and gingival tissue. The 16% carbide peroxide selected bleaching agent (White Dental Beauty) was to be used for 2-3 weeks from 2-4 hours a day, as long as no sensitivity is reported due to Novon technology. In case of sensitive teeth, 5% carbamide peroxide gel is recommended to be used.
Fig.7
After the custom tray fit was checked in terms of accuracy, tissue adaptation, and retention, the patient is instructed on how to insert the custom trays and how to apply the 16% carbamide peroxide gel (one drop per tooth).
Fig.8
After 14 days of bleaching with 16% carbamide peroxide (White Dental Beauty), we verified the color obtained with the same shade guide (the final shade is A1 VITA classical).
Fig.9
Patient smiling satisfied with the result. A few tips were given him to preserve the effects of the treatment longer.
Fig.10
Comparison between the initial and the final smile.
Fig.11
Before and after.
Conclusions
Bleaching is an everyday procedure which we propose to many of our patients. We usually suggest the home bleaching option, as it is the most cost-effective and safest way to whiten teeth without or with minimum side effects, minimizing sensitivity following an office bleaching.
Bibliography
1. Joiner A. The bleaching of teeth: a review of the literature, J Dent. 2006 Aug; 34(7):412-9.
2. Matis BA, Cochran MA, Eckert G. Review of the effectiveness of various tooth whitening systems. Oper Dent. 2009 Mar-Apr;34(2):230-5.
3. Akal N, Over H, Olmez A, Bodur H. Effects of carbamide peroxide containing bleaching agents on the morphology and subsurface hardness of enamel. J Clin Pediatr Dent. 2001 Summer; 25(4):293- 6.
