Dental bleaching and spot removal: goals and mistakes
Tooth bleaching and spot removal are frequent requests of our patients, or situations we bump into and want to solve for our patients’ aesthetic satisfaction. Moreover, bleaching procedures shouldn’t be considered as an isolated treatment, but as a minimally invasive part of a more extensive treatment plan.
Starting from whiter teeth facilitates all of our rehabilitation procedures whether they are very complex or simple cases.
As a protocol, we start treating the upper arch.
We started by temporarily covering the brown spots on teeth 22 and 23, and building new canine guides; it is better to do it in the beginning so you can adjust them during the following appointments and verify function.
In this phase there was actually a mistake; as many of you might have thought, having performed microabrasion, I should have filled the defect with some composite in addition to the ICON resin.
The defect on the surface of tooth 11.
Diagnosis is the key point to manage bleaching and resin infiltration.
The proper selection of the case and the patient always makes the difference: even though we can sometimes make up for mistakes thanks to our skills, it is always better avoiding problems than finding a solution!
Remember, bleach before you infiltrate, because afterwards, it’ll be too late. When you infiltrate, if you need to remove enamel even if just a little bit by sandblasting , remember to add composite to the resin.
Combining bleaching and resin infiltration is a great simple conservative, non-expensive and predictable solution for many cases of dyschromic anterior teeth.
Loguercio AD, Servat F, Stanislawczuk R, Mena-Serrano A, Rezende M, Prieto MV, Cereño V, Rojas MF, Ortega K, Fernandez E, Reis A. Effect of acidity of in-office bleaching gels on tooth sensitivity and whitenings: a two-center double-blind randomized clinical trial. Clin Oral Investig. 2017 Dec;21(9):2811-2818.
Attal JP, Atlan A, Denis M, Vennat E, Tirlet G. White spots on enamel: treatment protocol by superficial or deep infiltration (part 2). Int Orthod. 2014 Mar;12(1):1-31
Salat A. Post orthodontic white spots. Style Italiano.