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Before
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After
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Before |
After |
| Aging |
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| Smoking |
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| Genetic |
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| Tetracycline |
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We use gentle chemical low
concentration hydrogen peroxide based bleaching agents under strict supervision. The bleaching treatment works in
most cases, but for the right candidate, the results obtainable are astonishing. This treatment has to be repeated
every 12 to 24 months to maintain the enhancements.
THE
PROCEDURE IS VERY SAFE
For
some patients the best option is to provide
Porcelain veneers or laminates. This can
lead to a beautiful bright white smile that will last up to 15
years
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Supervised
Bleaching of Teeth
Patients are very
interested in Tooth Bleaching. This is because appearance is important
to them and they realize that the mouth and their smile is the focus of
considerable attention, as we go through our daily routines. If we feel
good about our appearance we feel good about ourselves. These good
feelings in turn result in better relationships with those around us.
Bleaching procedures are
not new in dentistry. Many techniques have been developed by dentists to
lighten the shade of a patient's teeth. In the past, treatments were
done in the dentist's office. Most methods involved isolating the teeth
and sealing them off from the remainder of the patients mouth. This was
necessary because strong hydrogen peroxide solutions, heat, and light
were used to bleach the teeth. The large amount of time involved made
the procedures costly. The results were generally good but one major
problem existed. The teeth would return to their former shade in 3 to 6
months. The process would have to be repeated again, with another charge
incurred. Needless to say few people had their teeth bleached.
Current techniques are
usually done by the patient at home. Much milder methods are used which
are much gentler and easier to control. Instead of attempting to bleach
the teeth in one session at the dentist's office, the process takes 2-3
weeks and is done at home with supervision and instructions provided by
the dentist. This technique utilizes a vacuum formed plastic device,
called a tray, that holds the bleach in contact with the teeth. The
bleach is still basically hydrogen peroxide based. Usually the chemical
used is carbamide peroxide which breaks down to hydrogen peroxide after
it is applied to the tray and teeth. The results are quite similar to
the former in-office treatments but the advantage is that, periodically,
every 3-4 weeks, the teeth can be retreated, at home, by the patient,
with no additional cost or bother to the patient. This periodic
re-treatment maintains the desired colour and shade.
Bleaching can remove many
stains that are in the outer layers of your teeth. Teeth tend to change
shades, usually yellow, with age. These changes can be reversed. Stains
in the gray family (such as tetracycline) can be more stubborn, if not
impossible, to bleach. Usually, we cannot predict the effectiveness of
bleaching for each individual patient. Bleaching must be tried first to
see what degree of bleaching is obtainable. Bleaching will not change
the color of existing dental restorations. If restorations are planned
for the anterior part of the mouth it is advisable to accomplish the
bleaching first, then match the new restorations to the now bleached
teeth.
So,
What do you need to do next if you want to have your teeth bleached and
whitened?
First of all, your
dentist should examine all of your teeth and determine the health of
your mouth. After treatment plans are made and you are ready to go ahead
with bleaching, the dentist will need to take moulds or impressions, of
your teeth. These moulds are used to make the custom vacuum formed trays
to hold the bleaching agent against your teeth. After the trays are made
they will be tried in and adjusted. You will be given instructions for
wearing the trays and how to apply the bleach. Usually, you will be
returning to the dentist office for a visit to review your progress and
determine the response of the teeth to bleaching and any side effects.
There are a few side
effects that you need to be aware of. At our practice, we have a printed
sheet of the side effects that you may experience. As with any procedure
we can have problems which vary with each patient. The most common side
effect is sensitivity of the teeth and gums. This can be controlled by
fluoride mouth rinses, and the use of Sensodyne (TM) or another
desensitizing toothpastes Usually, by cutting down the time of bleaching
this problem can be controlled. Many times breaking up the amount of
time bleaching is done into smaller, longer spaced segments, will
alleviate the sensitivity problem.
Another problem is sometimes the wearing of the tray makes the teeth
tender to biting pressure. This can happen when the original impression
was distorted in some manner. This results in an inaccurate model. When
the tray is vacuum formed to fit the model the inaccuracy is reproduced
and when the trays are placed in the mouth they act like weak
orthodontic appliances which result in sore teeth. The trays will
probably have to be remade.
Other effects of
bleaching are really not known facts. We have used hydrogen peroxide for
years as a mouth rinse and we have seen no apparent problems with its
use. In all honesty, we can't say for sure that its use will not cause
harm to the teeth or gums that become apparent years from now. All we
can say is that we suspect no long term problems will exist.
What, if any, are the
contra-indications for tooth bleaching? And which people should not have
any bleaching process carried out? As of this writing we would not
recommend bleaching for smokers. Smokers should stop smoking before
having their teeth bleached. The smoking not only defeats the effect of
bleaching but some authors are concerned about the mixture of hydrogen
peroxide with smoking having a potentiating effect on tissue damage
already known to be caused by smoking. As far as we are aware, pregnancy
and other diseases are not a contra-indication.
So I have now decided to
have my teeth bleached, I have my trays so what next? Brush your teeth
before putting in your bleaching trays. Apply a small amount ofthe
peroxide based gel provided into the tray and insert into your mouth.
Don't try and eat or drink while the trays are in your mouth. After
about one hour of wear replenish the bleach in the trays and replace
them in your mouth. We recommend that our patients wear the trays about
3 hours per day for 2-3 weeks. The hours do not have to be continuous.
After removing the tray and discontinuing bleaching rinse your mouth.
Avoid citrus fruits and other acidic foods while in the process of
bleaching. They may contribute to sensitivity, and there is concern that
the fruit acids may cause damage to the outer tooth surfaces.
After the first 3-4 weeks
your teeth are probably bleached as much as possible. The time it takes
for you to attain the colour and shade that you want, is very variable.
The longer you wear the tray and the bleaching gel, the quicker the
effects will be. But you have to balance this with the degree of
sensitivity you may have. From here on, you may have to renew the
bleaching every 6 to 8 weeks or so by wearing the tray with bleach for
2-3 hours. Above all enjoy your bright smile!
For a permanent change,
you should consider the placement of Veneers, and you can access this
information from our Patient Information
pages.
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