‘Tooth whitening’, which is among the increasing aesthetic applications in recent years, helps the person to achieve an optimal aesthetic appearance.
Teeth whitening can be applied to a single tooth that has changed color for various reasons, or it can be applied to all teeth.
1-Office bleaching (application in the office)
2-Home bleaching (application at home)
It is done in the form.
1-Office bleaching: It is applied in practice conditions. Either by removing the discoloration on the enamel, which is called external whitening, or the bleaching process applied to the internal structures of devital (non-viable, canal treated) teeth, which is called internal bleaching, there are 2 types of application. has.
Superficial discolorations can be caused by food and beverages such as tea, coffee, cigarettes, wine, or by the use of some chlorine hexidine drugs. This type of discoloration can be removed by the dentist’s weighing and polishing processes. With this, the color of the tooth can be lightened.
Sometimes, systemic drugs taken in the early stages of tooth development may cause yellow-brown-green-gray discolorations due to damaged or missing mineralizations in the enamel and dentin tissue of the tooth. All of these are internal discolorations and cannot be removed by superficial cleaning. In such cases, bleaching applications alone will not give an aesthetically satisfactory result. In general, a prosthetic intervention (such as veneer crowns or laminate coatings) may be required.
There are also iatrogenic (dentist-induced) internal discolorations. For example, we can count the discoloration caused by pulp residues that were not cleaned well during root canal treatment, the use of silver cones, iodine-containing canal filling pastes, and silver fillings. In such discolorations, the bleaching process gives very positive results.
It would be more appropriate to whiten such discolorations in the office environment. The active ingredients of the bleaching agents that the dentist will apply in his office are agents such as carbamide peroxide 30%, or hydrogen peroxide (H2O2) 38%.
It is a self-applying whitening system, again under the control of a doctor, but at home. Although the active ingredient in the content of the whitening agents used here is the same as that used in the Office type, the concentrations are lower. The whitening agent is placed in the transparent plaques specially prepared for the teeth of the person, attached to the teeth, the excess is removed with a brush and left in the mouth for 3 to 8 hours as written in the product’s prospectus. It can be applied at night, as well as during the day.
Agents used in whitening and their side effects;
In whitening devital teeth, as a rule, bleaching agents such as sodium perborate or carbamide peroxide are placed in the pulp chamber of the tooth and waited for an average of 3 days. Carbamide peroxide-based oxygen bleaching agents or hydrogen peroxide (H2O2) are used in surface bleaching.
In vitro studies show that uncontrolled use of whitening agents can cause loss of tooth hard tissues and damage to tooth enamel. To prevent this situation, preferably after the whitening treatment is completed, the teeth should be fluoridated.
Side effects that may occur with whitening are as follows;
-oral mucosal irritations
-Increased incidence of tooth fractures
-The formation of postoperative sensitivity in the teeth
-Changes in composite fillings
-Change in dental hard tissue
The success and duration of whitening;
According to a study, there is no difference in whitening success between two one-hour applications and an eight-hour application overnight. This means that there is no difference in the result, whether it is whitening in the office or at home. In practice, doctor control is absolutely essential. The targeted whitening effect varies according to each patient and the bleaching agent selected for the patient.
Effect on restorations;
Bleaching agents have no effect on dentures, especially on porcelain restorations. Amalgam can remove mercury from fillings. Zincphosphate and glass ionomers can dissolve. Composite fillings can get a lighter color with bleaching, their hardness may change, their surfaces may become rough. As a result, cracks may occur in the composite. The color of the areas is generally lighter than the fillings and therefore the fillings stand out as darker. Because of this deteriorating aesthetic condition, restorations are indicated to be replaced.
AS A RESULT;
Traditional whitening agents must be applied under the control of a doctor. The whitening effects do not change for about 2 years, and it is possible to repeat the treatment. At the end of the treatment, the teeth should be polished very well by the dentist, possible roughnesses on the tooth surface should be removed and flour should be applied.