Tooth whitening

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Tooth whitening

What is it?

Tooth whitening is a painless procedure; in most of the cases, it gives back a brighter smile in few weeks without causing any damage to the dental tooth structure and surrounding soft tissue.

What’s behind your teeth dark shade?

Tooth staining may have a different origin. The assumption of colorants containing foods and beverages may be responsible for staining on the tooth surface; smoker’s teeth also presents yellow dark teeth from the accumulation of nicotine and other cigarettes products on the tooth. These stains are called extrinsic stains.

Sometimes teeth look dark but no external stain is visible on the tooth surface; it means that the reason of the discoloration is inside the tooth. These stains are called intrinsic stains. For example, old patients have usually darker teeth than young or adult patients; thinning of enamel (responsible for the white shade) due to wear is associated with thickening of dentin (responsible for the yellow shade) which is physiologically deposited inside the tooth during the entire life.

However, teeth may be dark since their eruption in the oral cavity. The administration of certain category of antibiotics (tetracycline) in-utero and in early childhoodmay result in yellow to brown-grey tooth discoloration. The most severe cases may exhibit a characteristic horizontal yellow to black banding.

Te excessive systemic fluoride during enamel matrix formation and calcification may also be responsible of chalky or opaque areas in the tooth associated with enamel surface pitting. Yellow-brown discoloration may result as consequence of staining around pitted areas.

Reddish to black staining may occur as a consequence of deposition of hemorrhagic by-products into the dentinal tubules after pulp trauma or necrosis; root canal is required first to extirpate the necrotic tissue (dead pulp). Yellow-brown discoloration may be common in previously devitalized teeth; medicaments and sealersutilized during the root canal therapy may be responsible for the staining.

Top ten list of stain-causing foods

  • Coffee or tea (hot or cold)
  • tobacco-cigarettes,
  • spit tobacco or cigars
  • red wine
  • grape juice
  • cola drinks
  • root beer soft drinks
  • berries or cherries
  • soy sauce
  • artificially colored foods
  • curried foods

Main factors responsible for intrinsic discoloration of teeth:

  • Medication (es. tetracycline , minocicline).
  • Fluorosis (endemic fluoride) – white spots.
  • Trauma / pulp necrosis (dead or devitalized teeth)
  • Age

What’s the better way to bleach your teeth?

Tooth whitening has become one of the most requested dental procedures for patients of all ages. Differing techniques are available to bleach the teeth; however, all of them are based on the use of bleaching gels containing differing concentrations of either hydrogen peroxide or carbammide peroxide.

Dr Deliperi technique is based on the application of the bleaching gel in a mouth guard which the patient wears at home each day. The patient may wear the mouth guard during the day or night according to Dr Deliperi recommendation.

This technique was first introduced in the USA almost 20 years ago; scientific reports agree to consider it as the safest and more predictable technique available for tooth whitening. Dr Deliperi gave his contribution in the development of the technique on both vital and non vital teeth; he published his findings on peer-reviewed journals (Deliperi S. et al 2004, 2005) . The material and technique adopted for non vital bleaching is very similar to the ones used for non vital tooth whitening. However, devital teeth staining differ from that of vital teeth and a modified bleaching technique is required. Results may be excellent for both vital and non vital teeth.

There has been considerable attention to so-called “laser” bleaching done in the dental office. Scientific reports showed that the light had little or no effect on the whitening of the teeth; conversely, the combination of peroxides and light may increase tooth sensitivity due to heat production. Results may not be faster as claimed by some manufactures.

In-office bleaching utilizes higher concentrations of peroxides and may be used as a jump-start for bleaching. A combination of in-office and at-home tooth whitening may dramatically speed-up the therapy. Dr Deliperi tested the efficacy of this combination and reported excellent whitening results with no sensitivity (Deliperi et al. 2004).

OF STAIN-CAUSING FOODS

lease, read Dr Deliperi manuscripts and a recent roundtable on tooth whitening Dr Deliperi co-authored

Special Notes

Tooth whitening is a very conservative procedure because it gives back brightness to the tooth without any damage to the tooth structure.

Tooth sensitivity may be the main concern of the tooth whitening therapy. The application of higher concentration of hydrogen peroxide along with the application of heat may increase tooth sensitivity. Dr Deliperi prescribes low concentration of bleaching material containing both fluoride and potassium nitrate. Fluoride is a re-mineralizing agent and potassium nitrate is a desensitizing agent. Dr Deliperi patients rarely experience tooth sensitivity.

The whitening procedure won’t change the color of tooth-colored fillings or crown and bridge works, so they may look darker after completing the procedure. Also, Dr Deliperi usually recommends whitening the teeth prior to the placement of any restorative works including fillings, crown on both natural and implant teeth. The shade of the new fillings or crowns is matched to the shade of bleached teeth and will look lighter and brighter.

The result of tooth whitening may last for many years depending on the assumption of stain-containing foods and beverages or other staining agent. Anyway, it is possible to retouch the color of the teeth with at-home follow-ups.

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