Fig.1
A 35-year-old male patient presented to the dental clinic seeking a non-invasive solution for teeth discoloration. As part of the initial assessment, standardized intraoral photographs were captured using the Smile Lite MDP 2 (Smile Line, Switzerland) device to ensure optimal lighting and consistency. The primary photograph, taken with retractors and the teeth in occlusion, provided a clear and detailed view of the patient’s dental condition. These images play a crucial role in dental documentation, enabling accurate evaluation of the initial state, supporting diagnosis, and guiding the development of a personalized treatment plan. Follow-up photographs will be taken under identical conditions to assess the effectiveness of the treatment.

Fig.2
The image was captured using the Smile Lite MDP2 (Smile Line, Switzerland) at full power in combination with a Samsung S22 Ultra smartphone. To achieve soft, evenly diffused lighting, all six LEDs on each lateral panel and the eight LEDs on the central panel were activated and covered with the white diffuser.
Black pigmentation was clearly visible in this patient, who reported a history of smoking.

Fig.3
A polarized photograph was taken with the diffusers positioned over both the central and lateral LED panels to enhance visualization of the black stains.

Fig.4
The image was captured using the central LEDs of the Smile Lite MDP2 at maximum power, with the lateral LEDs deactivated, and a polarizing filter placed over the central light. This technique effectively eliminates surface glare, allowing for a more accurate assessment of tooth color, brightness, and surface characteristics such as incisal halos.
Polarized photography is a non-invasive, contactless method that enhances contrast and color saturation, making it particularly useful in clinical scenarios such as shade matching, white lesion detection, diagnosis, and monitoring of bleaching treatments. As described in Chapter 6 of Prof. Louis Hardan’s book, this technique is simple to perform, has a minimal learning curve, and significantly improves the clarity of intraoral images for diagnostic and documentation purposes.

Fig.5
The initial tooth shade was determined using the OptiShade colorimeter (Smile Line, Switzerland) and subsequently confirmed with a conventional shade guide, establishing a baseline shade of A3 prior to the whitening procedure. The shade guide plays a crucial role in patient communication, as it provides a visual reference that helps patients appreciate even subtle changes in tooth color throughout and after the treatment.

Fig.6
In this case, dental prophylaxis was performed prior to the bleaching procedure to remove the black stains present on the teeth. The method used involved the rubber cup technique with a pumice-water mixture applied to the tooth surfaces. This approach effectively eliminated surface stains and plaque, ensuring a clean enamel surface for more accurate shade assessment and enhancing the whitening treatment’s effectiveness.
The rubber cup technique was preferred over air polishing because it allows for controlled removal of stains with minimal abrasion, making it suitable for patients with sensitive teeth or when a gentle yet effective cleaning is required.

Fig.7
This image shows the tooth surfaces following the completion of dental prophylaxis using the rubber cup technique with a pumice-water mixture. The black stains have been effectively removed, revealing a cleaner and more uniform enamel surface in preparation for the bleaching procedure.

Fig.8
Intraoral close-up views before and after dental prophylaxis.

Fig.9
After stain removal, the tooth shade was reassessed using the same method, confirming that the shade remained consistent with the initial measurement—A3 on the VITA Classical shade guide.

Fig.10
A polarized photograph was taken to evaluate the tooth shade after dental prophylaxis, ensuring an accurate assessment by eliminating surface glare and enhancing color visualization.

Fig.11
The intraoral photograph, captured with the teeth in occlusion, clearly displays the desired level of whiteness achieved by the patient. This image provides a precise representation of the attained white shade.

Fig.12
The ultimate frontal view offers a comprehensive visual documentation of the patient’s whitening results.

Fig.13
Following the bleaching treatment, an intraoral photograph was captured using the Smile Lite MDP2 (Smile Line, Switzerland) to document the final aesthetic outcome. The patient expressed satisfaction with the whitening result and showed interest in maintaining the achieved shade over time.
The final tooth color was reassessed using the same VITA Classical shade guide, confirming a transformation from A3 to B1, which is considered a highly aesthetic and desirable outcome. This improvement is clearly visible in the post-treatment photograph, demonstrating the effectiveness of the bleaching procedure and proper case documentation.

Fig.14
The final outcome revealed a notable transformation in tooth shade, progressing to a vibrant B1, as confirmed by the shade guide. This remarkable improvement was visually documented through an intraoral photograph, showcasing a highly satisfactory and aesthetically pleasing result.

Fig.15
The final outcome was deemed satisfactory by both the patient and the dental practitioner, highlighting the success of the bleaching procedure.

Fig.16
The contrast between the “before” and “after” stages of bleaching can be profound, not only improving the aesthetic appearance of the teeth but also boosting patient confidence.

Fig.17
To help maintain the whitening results, professional dissolving whitening strips P3 (White Dental Beauty, UK) were introduced. These innovative strips contain a blend of three phosphates and offer a convenient, non-invasive approach to prolong the bleaching outcome. Application involves peeling the strip from one corner, placing it on the teeth starting from the buccal side, then folding it over the palatal surface in the maxilla or the lingual surface in the mandible. Once applied, the strip dissolves within approximately 15 minutes, depending on the level of moisture in the oral cavity, making it an effective and user-friendly solution for post-whitening maintenance. In this case, the patient applied two dissolving whitening strips daily for three days every two weeks, continuing this regimen until the third month, while dental prophylaxis was performed every three months to effectively maintain the whitening results.

Fig.18
Intraoral photographs before and after bleaching and maintenance, with teeth in occlusion. The daily clinical dental bleaching protocol is straightforward and follows the DBM approach: Document, Bleach, and Maintain.

Conclusions

Managing localized black stains through a conservative dental prophylaxis before bleaching is essential for optimizing whitening outcomes. Proper documentation with intraoral and polarized photographs allows accurate assessment and monitoring of tooth shade throughout the process. Performing thorough prophylaxis ensures the removal of surface stains, providing a clean enamel surface that enhances the effectiveness of the bleaching treatment. Finally, consistent maintenance, including the use of dissolving whitening strips and regular dental prophylaxis every three months, helps preserve the achieved results, ensuring long-term patient satisfaction. This structured approach balances effectiveness with minimal invasiveness, leading to predictable and aesthetically pleasing outcomes.

Bibliography

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