One study testing 16% and 35% CPS, however, reported significant changes in the enamel, including loss of the aprismatic layer, exposure and demineralization of enamel prisms, and pitting (Bitter 1995). Tooth color is primarily determined by the dentin and can be changed by whitening treatments. Activated charcoal is the new fad in the natural health market. 1991), and another study showed that surface hardness was unaffected by whitening (Nathoo et al. 1999; see Figures 3.8 and 3.9). • Not dehydrate the oral tissues or teeth. A study by Scherer et al. Significantly, in those studies that simulated the intraoral conditions as closely as possible, the risk of enamel microhardness decrease as a result of whitening treatments seems to have been reduced. If the patient cannot manage overnight use, then 2–3 hours is recommended in the evening. Each of your teeth is made up of an inner dentin layer and a hard outer enamel layer, which protects the teeth… Teeth whitening treatments with your dentist and over-the-counter products available today are easy to use and can have a noticeable effect on your smile. The combination of a hard toothbrush and an abrasive toothpaste has been recognized as creating further tooth wear problems. The European Commission’s Scientific Committee on Consumer Safety is of the opinion that sodium perborate and perboric acid can be considered as “hydrogen peroxide”–releasing substances and thus are covered by entry 12 of Annex III of the Cosmetics Directive 76/768/EEC (Council of European Dentists 2014). Recent studies have shown that surface effects may occur on existing restorative materials (such as composites, glass ionomers and, luting cements). Pulp penetration can occur within 5–15 minutes according to studies by Cooper et al. Chart patient's shade before and after tx 6. Table 3.7 Possible side effects of whitening agents, • Possible gingival irritation if the tray is overextended, • Possible opening of the black triangles and enlargement of black spaces, • Uneven, incomplete whitening, streaky appearance, • White spots or banding within the tooth may be more noticeable, • A demarcation line may be visible between the color on the incisal tip and the cervical neck, • Snow-capped appearance on the lower incisors as a result of slower whitening, • Flare-up of an existing quiescent apical area, • Irritation of the tongue from rough edges of the whitening tray, • Allergy, facial swelling or petechiae on face and neck. (1991) the patients who experienced transient tooth hypersensitivity after week 2 had overloaded their trays. The active ingredients in whitening strips vary, but many use … The only systemic effects that have been reported have been one case that produced a mild laxative effect, and mild gastric irritation reported by some patients who are using the treatment for whitening of tetracycline discoloration. • Discuss how a dental material is evaluated before it is marketed to the profession. The application technique relies on the mouthguard to keep the whitening agent in contact with the tooth so that the whitening product can penetrate through the enamel. This is because of the anatomy of the enamel and dentin microstructure. Sodium perborate has been banned in Europe for use in tooth whitening because it is considered to be fetotoxic and cytotoxic. At 7 years after treatment of the same patient pool, 35% were satisfied with the color of their teeth. In another clinical evaluation of two carbamide peroxide agents, both caused the teeth to lighten (Heymann et al. If you work with your dentist, they will take an impression of the teeth, and then your tray is made to fit your mouth. 1991). CPS is used in a variety of external-use OTC products such as ear drops and hair dyes. Each strip is worn for 30 minutes, removed, and discarded, and the procedure is performed twice a day for 14 days. There appears to be less penetration into the pulp from carbamide peroxide than from hydrogen peroxide. 1992). Restorations may need to be replaced after whitening owing to the color change in the tooth. The hydrogen peroxide must be in situ long enough and frequently enough to release the pigment molecules from the tooth by oxidation. As we continue to eat and drink acidic or dark-colored foods and beverages, our teeth can accumulate surface stains. With Philips Zoom, the No.1 patient-requested professional whitening brand in the U.S., you can customize a teeth-whitening treatment around each patient’s needs. Learn about the four different types of teeth whitening below. The application of fluoride improved remineralization of enamel. 5. However, whitening treatment at your dentist's office can have longer-lasting results. Keeping a healthy smile is of utmost importance, and maintaining good oral hygiene will keep your smile looking brighter longer. Carbamide peroxide also has an antibacterial effect (Gugan et al. At 3 years after treatment 62% were satisfied with their color. Caution should be taken to avoid addition of these chemicals to commercial preparations intended for tooth whitening. The H2O2 systems are aqueous gel based, whereas the CPS systems are anhydrous gel based. become green around the margins. A total of 55 studies were identified, with 166 hardness measurements conducted directly after whitening and 69 measurements performed after a post-treatment episode. The introduction of whitening toothpastes has been very rapid. There may be a decrease in the translucency of the tooth. 2008). In a study by McCracken and Haywood (1996), teeth exposed to CPS for 6 hours lost an average of 1.06 µg/mm2 of calcium. The hydrogen peroxide breaks down to water and oxygen and for brief periods forms the free radical HO2• perhydroxyl. 1991). Before we get into the details of tooth-whitening, let's take a minute to meet the enemy. The overzealous use of abrasive toothpaste will cause the removal of enamel as well as the stain. According to the American Academy of Cosmetic Dentistry, these include the following: Thankfully, teeth whitening products can lift surface stains, and teeth whitening treatments with your dentist can have a noticeable result in very little time. 1999). Whitening is often desirable when teeth become yellowed over time for a number of reasons, and can be achieved by changing the intrinsic or extrinsic color of the tooth enamel. After the first time period, a light radiation is directed toward the at least one tooth … Rather, these toothpastes target the surface of your teeth with a variety of substances, including abrasives and the chemical blue covarine. All trials were, however, short term, and most were judged to be at high risk of bias and were either sponsored or conducted by the manufacturers. Describe the properties of gold alloys and their application in the restoration of teeth. Yellow stains are the easiest to whiten. A brightness index derived from computer analysis of digitized images may be useful for monitoring effectiveness of whitening (Bentley et al. This results in the tooth appearing more yellow because the enamel layer is removed and the dentin-to-enamel ratio is changed (Haywood 1996). 1994). The success rate for home whitening using a viscous whitening material for 7–10 days is about 95% (Haywood et al. The bleaching products … Most of the teeth whitening products vary in the strength of the bleaching agent. CPS has been incorporated into a chewing gum with inhibition of plaque formation (Moss 1999). Studies by Torneck et al. 1997). However, not all combinations of amalgam and whitening agents result in higher mercury levels. 1991). Allergic symptoms have been reported, such as swelling of the lips (Goldstein and Garber 1995). • Pronounce, define, and spell the Key Terms. Longer treatment times may thus be advisable—that is, the agent needs to be active for extended periods of time; to get maximum use out of the whitening agent, it is preferable to sleep with the tray in position. Dentists should encourage their patients to stop smoking for general health improvement and to enroll in a smoking cessation program. A demarcation line may be detected on lower canines, also referred to as a “snow-capped appearance,” during the first few days of the treatment. 1992). We all have an individual, genetically defined tooth colour.Some people naturally have more yellowish, greyer or whiter teeth than others. Some amalgam restorations that are exposed to the tooth whitening materials may become green around the margins. Participants were instructed to wear the guard at night or during the day for 2–4 hours for 6 weeks of total treatment time. Once whitening has been terminated, a slight relapse in color occurs over the following 2 weeks. Resin tags in whitened enamel are less numerous, less defined, and shorter than those in unwhitened enamel (Titley et al. Composite temporary materials do not discolor ( Robinson et al one patient experienced allergies to tooth! Each strip is worn for 30 minutes, removed, and 3.5 ), to cleave the double.. To regain the bond strength of enamel as well as the stain Jefferson! 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