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Teeth whitening has become a popular cosmetic procedure to improve the appearance of smiles, with various methods available to brighten teeth. Among these, the bleaching of natural teeth using carbamide peroxide (CP) stands out as a widely used and effective approach. This procedure relies on the breakdown of CP into hydrogen peroxide, which penetrates the enamel and dentin, releasing oxygen molecules that break down stains. When administered properly, CP bleaching offers predictable and lasting results.
One of the common challenges in achieving a pleasing smile is the presence of canines that have a darker color compared to other teeth. This article explores the use of CP for whitening natural teeth, addressing the specific issue of canine discoloration, in a two-step protocol.
Fig.1
The patient’s primary concern was regarding the aesthetics of her smile. She expressed dissatisfaction with the appearance of her canines, specifically their dark color in contrast to her anterior teeth.
Fig.2
The patient presented with a significant difference in color between the canines and the four anterior teeth.
She desired an aesthetically pleasing, minimally invasive treatment option that would not require drilling of the teeth.
Fig.3
In comparison to a Vita shade guide, the patient’s canine was nearly similar to the 4.5 M2 color.
The decision was to create a two-step bleaching protocol that involves initially bleaching the canines only until their color almost matches that of the anterior teeth, followed by bleaching the entire teeth.
Home bleaching was performed using a custom tray and 10%CP gel (White Dental Beauty, UK), applied exclusively to the canines for a duration of one month.
The tray was worn throughout the night.
Fig.4
After four weeks of night bleaching, the color of the canines was clearly pleasant and deviating from the 4.5 M2 shade guide color.
At this moment, the second step started, the patient is kindly requested to bleach the entire teeth with the same product, overnight, and this for another month (10%CP gel (White Dental Beauty, UK)).
Fig.5
After a month of undergoing a night bleaching procedure, the patient was delighted with the noticeable improvement in the color of their teeth, which reached a shade of 0.5 M1.
She was particularly pleased with the reduction in the color difference between her canines and anterior teeth.
Fig.6
The difference is obvious when comparing the before and after treatment picture.
Conclusions
In conclusion, patients deserve intelligent, minimally invasive treatments with minimal risk to their teeth.
This two-step procedure is applicable in numerous bleaching cases due to the inherent color difference between canines and other teeth.
Additionally, employing low concentration of CP is gentle on the teeth and minimizes sensitivity.
Bibliography
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- Orilisi G, Tosco V, Monterubbianesi R, Notarstefano V, Özcan M, Putignano A, Orsini G. ATR-FTIR, EDS and SEM evaluations of enamel structure after treatment with hydrogen peroxide bleaching agents loaded with nano-hydroxyapatite particles. PeerJ. 2021 Jan 29;9:e10606.
- Rim Bourgi. Evolution of dental bleaching, from research to clinical evidence. Styleitaliano.org
- Sara Laface. When a tray solves it all: How to treat dyschromia with not-invasive dentistry. Styleitaliano.org
