Dealing with Fluorosis

Dental Fluorosis manifests itself in a wide variety of discolorations, ranging from a chalk-white to a dark cocoa brown. The stains may also be in the superficial aspects of the enamel, or may range throughout the enamel structure. Proper treatment therefore can require utilization of several modifications of the basic tooth whitening procedure. On occasion, vital tooth whitening is not even necessary. If there is any reasonable chance that some of the discoloration is superficial, those areas...

Long Term Stability of Tooth Whitening

It is difficult to evaluate the long term stability of any procedure which is still new. The most that can be said about tooth whitening is that after the first two years there has been very little color relapse noted. This is particularly encouraging since a number of the technique innovations that have been recently instituted were not even available for those early cases. It is self-evident that certain deleterious habits such as smoking, drinking coffee or tea, and chewing tobacco may cause...

Speeding up the whitening process in selected areas

Most people who avail themselves of vital tooth whitening are seeking generally whiter teeth. There are times when we would like to selectively whiten only certain teeth or even certain portions of individual teeth. While it is true that the entire tooth is whitened even when only a portion of it is exposed to the whitening solution, the dentist can have an effect on the rate of whitening in specific areas. Using this tool, the dentist can therefore selectively whiten certain areas more or less...

Does tooth whitening work equally effectively on all teeth

Some types of disco orations are more easily removed than others. Perhaps the teeth which benefit most rapidly and profoundly are those which have darkened with age. Other situations, such as darkening from dental alloys, or dark tetracycline stains are slower to respond. In some cases, it is not possible to achieve a perfect result, although it is unusual to have no improvement at all. The chapter on discolorations should be a help in predicting the effectiveness of home tooth whitening...

External Marketing

External marketing is traditionally referred to as advertising. This is a form of patient education that may be accomplished through several venues, some of which may be restricted by the dictates of the local dental jurisdiction. No matter what type of advertising is selected, repetition of a simple message is absolutely vital to the success of any advertising campaign. Unless the dentist is willing to carry out a continuous organized program over a period of at least several months, he will...

Materials

There are a several somewhat similar materials which can be used for the home tooth whitening procedure. While they may superficially appear to be equivalent, the authors caution that differences do exist between the various products. Differences exist, for instance in pH, viscosity, concentration, and even composition. In addition, there are possible interactions between the whitening agent and the tray material itself. Doubtless, every material will have its proponents and detractors. In the...

References

Weitzman SA, Weitberg AB, Stossel TP, Schwartz J, Shklar G. Effects of hydrogen peroxide on oral carcinogenesis in hamsters. J Perio. November 1986 57 ll 685-688. 2. Goldstein RE. Dentists note concerns and advice about vital tooth bleaching - interview. Gen Dent. January February 1990 8-11. 3. Cobe HM. Investigations of a new ehemotherapeudc agent hi the presence of blood. Oral Surg. June 960 13 6 678-685. 4. Ambrose ER. Sound clinical procedures for amalgam restorations. JCDA. 1960 26...

Prophylaxis

Routine scaling and prophylaxis will eliminate plaque, calculus, and extrinsic staining. This step by itself may achieve a significant degree of tooth whitening, and provide enough positive reinforcement to the patient so that he will more readily undertake a whitening treatment. A standard prophylaxis employing a bristle brush and coarse prophylaxis paste will remove not only the debris, but approximately 10 microns of the outer layer of the enamel. A rubber cup removes a bit less. This can be...

Clinical Technique

Types Dental Stock Trays

The tooth whitening procedure actually begins with patient evaluation, since a thorough medical and dental history should be performed before initiating any therapy. In addition to the usual health history, however, information should be taken regarding the causes of the patient's present condition, as well as the patient's hopes and expectations of the treatment. Photographs should be taken prior to any treatment, including even a prophylaxis. This set of photographs should include at least...

Post Eruptively Caused Discolorations

Formation Secondary Dentin

Several non-pathologic conditions which are related to the process of aging work to gradually discolor the teeth over time. The natural process of gradual pulp withdrawal with the formation of secondary dentin causes the development of a yellowish-brown color.22 Treatment This is perhaps the strongest indication for tooth whitening. The results are the most rapid, and predictable. Standard vital tooth whitening should be used for these cases. Dental Metals. The most ubiquitous source of...

Intrinsic Discolorations Created During Odontogenesis

Hypocalcified Amelogenesis Imperfecta

Alkaptonuria is also known as phenylketonuria and ochronosis. It is a recessive genetic deficiency resulting in incomplete oxidation of tyrosine and phenylalanine, causing an increased level of homogentisic acid. This condition sometimes causes a dark brown pigmentation of Lhe permanent teeth.6 Treatment Tooth whitening can lessen or even eliminate the discolorations. In. severe cases the teeth may need additional esthetic procedures to achieve perfection. Amelogenesis Imperfecta....

Dangers in Current Techniques Supcroxol HeatLigh I Technique

Chemical Burns Dental Office

The prospect of a treatment posing danger to a patient or to the oral environment is of particular concern when embarking on an elective procedure. The corrosive nature of super-oxol and its potential deleterious effects on various tissues are a definite drawback to the superoxol heat light bleaching system. The tooth, which is more intimately and deliberately exposed to the bleaching agent than any other tissue, is the most at risk. The concerns about chemical and thermal intrusions on the...

Link J. Discolouration Of The Teeth In Alkaptonuria And Parkinsonism. Chron Omaha Dist Dent Soc 1973 36 136.

The nomenclature of the integuments of the enamel surface of teeth. Br Dent J. 1963 115 65. 2. Gatil KA. Histochemistry and scanning electron microscopy of tooth integurnental material in humans. Per-iodont 1975 46 415. 3. Vogel IV. Intrinsic and extrinsic discoloration of the dentition. J Oral Med. 1975 30 99-104. 4. Freedman GA, McLaughlin G. Color Atlas of Porcelain Laminate Veneers. St. Louis lshiyaku EuroAm erica 1990. 5. Eisenberg E, Beroick SM. Anomolies...

Idiopathic Pulpal Recession A

Discoloration Non Vital Teeth

Tooth may, on occasion, display idiopathic pulpal recession. Such teeth remain vital, but usually display a yellow to brown darkening. The appearance is often one of a non-vital tooth, but the tooth's actual condition can be differentiated on the basis of vitality testing. Such teeth will usually show greatly diminished pulp chamber size radio-graphically. Treatment Standard tooth whitening procedures should be instituted if the desired result is an overall whitening of all the teeth. This will...

The Safety of Tooth Whitening

One of the most important concerns for any new dental procedure is its safety. The dentist must have absolute confidence and security in the dental treatments being recommended to his patients. Safety is normally established in one of two ways the product can be tested on animals in order to predict its toxicity in humans, or in the case of a material that has previously been used for human treatment, Lhe record of the product can be examined for deleterious side effects. As may be expecLed,...

Historical Background

The desire for whiter teeth is not completely a recent phenomenon. In Biblical times it was considered that the person who whitens the teeth of his neighbor is better than the person who gives him milk to drink.1 Theophrastus of Ancient Greece wrote in the third century B.C. that it was considered a virtue to shave frequently and to have white teeth. If there was any attention paid to dental hygiene and appearance during the middle ages, there is no surviving documentation. Life spans were...