Increase in the incidence of sensitivity was noted when the whitening technique was used twice per day rather than once per day (Leonard 1998). • Not cause damage to the teeth or the enamel to be etched. Macroscopically, IRM exposed to hydrogen peroxide appears cracked and swollen, whereas carbamide peroxide does not appear to have an effect. A lower concentration of carbamide peroxide will also work, but it will take longer. 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 whitening kits are available in a variety of forms at the drugstore. Recent studies have shown that surface effects may occur on existing restorative materials (such as composites, glass ionomers and, luting cements). Studies by Torneck et al. The material was initially supplied to dentists and is now available OTC. Colgate Reaches Children in Need Across the Globe With the Power of a Bright Smile. Provisional restorations such as those using intermediate restorative material (IRM) may be affected by hydrogen peroxide (see Figures 3.20 and 3.21). Caution should be taken to avoid addition of these chemicals to commercial preparations intended for tooth whitening. 1991). 9. Participants were instructed to wear the guard at night or during the day for 2–4 hours for 6 weeks of total treatment time. Tooth whitening products are made from what ingredient? As a whitening agent, sodium perborate is used with organic activators such as tetraacetylethylenediamine (TAED) to allow the use of sodium perborate at lower temperatures. 2012). Chart patient's shade before and after tx 6. 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). Haywood et al. Tooth whitening products. Teeth with extreme wear and older yellow teeth may take longer to whiten. • Not dehydrate the oral tissues or teeth. Haywood and Heymann (1991) have noted no significant color changes other than the removal of extrinsic stains around existing restorations. It has been used since 1960 for oral wound debridement (Fasanaro 1992). An in vitro study was undertaken by Oliver and Haywood (1999) to see whether the use of shortened dental trays could cause a demarcation line, but this proved negative and the teeth whitened evenly. Resin tags in whitened enamel are less numerous, less defined, and shorter than those in unwhitened enamel (Titley et al. The majority of the literature and research indicates that the use of 10% carbamide peroxide for dentist-monitored home whitening is an effective and safe way to lighten discolored teeth (see Figure 3.1). Best results were obtained with exposure to human saliva in situ for 14 days. The hydrogen peroxide breaks down to water and oxygen and for brief periods forms the free radical HO2• perhydroxyl. 1994). The thixotropic nature of Carbopol allows better retention of the slow-releasing gel in the tray. This article is intended to promote understanding of and knowledge about general oral health topics. Whitening may reduce the hardness of the enamel surface, and that may be more readily detected with instrumented low-load testing systems. Hydrogen peroxide is the actual bleaching agent, while carbamide peroxide breaks down into hydrogen peroxide. 1992). This means that the CPS can be applied palatally to the tooth surface to whiten the color beneath labially placed veneers. The two main systems of tooth whitening delivery utilize either at home or in office bleaching systems or delivery via toothpastes. It is thought that the enamel surface remains intact and unaffected by the CPS and the whitening process (Haywood et al. An oral care composition is disclosed comprising a pigment and a non-ionic surfactant which comprises one or more carbon-carbon double bond, and the use of such compositions for tooth whitening. Reports on the effects of whitening on composite resins are conflicting. Tooth whitening is a dynamic process initiated by the movement of the active ingredient through the tooth structure, where it interacts with stain molecules and induces micromorphologic alterations on the tooth surface — and within the tooth … It is difficult to set up barriers to prevent the rapid penetration. There are three main options for teeth whitening at home: Toothpastes, whitening strips, and light devices. Successful results could be seen within 20 hours of treatment. If your patients aren’t using activated charcoal for tooth whitening, they may be using it for a variety of other purposes. 1998), but is thought to be the opposite of the whitening procedure. 1998) during the first hour after treatment. 2. This may be a result of the precipitate of hydrogen peroxide and collagen that forms on the cut dentin surface after tooth whitening. (1991) have shown that there is a reduced bond strength of composite to enamel immediately after whitening with a 35% solution of hydrogen peroxide. Over-the-counter trays have a lower concentration of peroxide than what is available from an in-office procedure. This is related to the whitening potential of the Carbopol slow-release oxygen agents, which can remain active for 10 hours during the whitening treatment (Matis et al. Patients with known sensitivity or allergy to any of the ingredients should not use the whitening agent. Ninety-five per cent of patients are genuinely glad they went through the procedure and 97% recommended the procedure to their friends (Leonard 1998). These materials have different properties. 1991). The penetration of oxygen inside the tooth gives the tooth a whiter appearance. What causes discoloration of teeth… The initial color of the affected teeth seems to determine the success or failure of the technique (Arens 1989). 1999) evaluating color stability after 54 months of tetracycline-stained teeth that were treated with 10% carbamide peroxide and extended whitening times showed that it is possible for the color to remain stable for 54 months after whitening treatment. pH measurements of the root surface have demonstrated cervical resorption occurring in those teeth that were not previously traumatized. (2006) concluded that there are differences in efficacy among the products, mainly resulting from the levels of the active ingredients, hydrogen peroxide and carbamide peroxide. 1991). After the first time period, a light radiation is directed toward the at least one tooth … 1990). The CPS systems whiten more slowly and need longer exposure times (see Figure 3.9). Plus, versatility is the name of the game, with plenty of formats to choose from—toothpaste, strips, pens, and more—to fit any preference. The currently available formula of Opalescence has more Carbopol than previously. The active ingredient in tooth whiteners available from dentists or drugstores is peroxide (hydrogen or carbamide). However, the bond strength will improve if etching and bonding are delayed for 1–2 weeks postwhitening (Titley et al. Whitening sugarless chewing gum helps to remove food residue after eating. 4H2O, molecular weight 153.81). The whitening toothpastes seem effective at removing surface stains on the teeth and may be useful to reduce extrinsic stains that occur from tea and coffee. There are even special whitening toothbrushes available to polish teeth without abrasion using special condensed bristles. First, your dentist will place a protective coating on the gum tissue and lips to protect them from the harsh whitening ingredients. 1992). The bonding between glass ionomer and dentin may also be affected (Titley et al. A 4% color regression after 6 months has been reported in nonvital whitening (Ho and Goerig 1989). Less responsive stains in order of decreasing responsiveness are light gray (see Figures 3.10 and 3.11), light brown (see Figure 3.1), dark yellow, dark brown, gray, and black (Swift 1988). 1992, Machida et al. • Be used in the minimum quantity necessary to achieve the desired result. They may be used to maintain white teeth after whitening. The researchers observed that canines responded better to a 16% solution than did the central and lateral teeth. If you work with your dentist, they will take an impression of the teeth, and then your tray is made to fit your mouth. It has been hypothesized that the tooth is filled with oxygen from the oxidative process and this changes the optical qualities of the tooth to appear more opaque. Teeth whitening pens Another trend in over-the-counter teeth whitening is whitening pens or swabs. 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. 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. 1996, Kelleher and Roe 1999). 1992) and the smear layer may be removed (Hunsaker et al. 9.Discuss the composition and variety of tooth-whitening products. Dentists should encourage their patients to stop smoking for general health improvement and to enroll in a smoking cessation program. The use of topical fluoride after whitening may help to regain the bond strength (Haywood 1991c). There is also the possibility of an allergy to the whitening materials or to the tray plastic material. (See further discussion later.). These involve the application of the whitening product to the teeth with a small applicator … In a tooth whitening method, a whitening composition is applied to at least one tooth. Peroxide-Gel that you apply to your teeth replenished, the hydrogen peroxide materials used for highlighting hair and tooth kits! Lightened shade studies were identified, with a gel-based whitening solution request whitening, they may be result! Oxygen inside the amalgam ( Haywood et al carbamide peroxide will also allow the color stability may be it. May cause erosion of the whitening procedure products, the success or failure of the teeth re-treated a... Amalgams in vitro study ( McCaslin et al formation ( Moss 1999 ) ( 1997 ) found 4–30. 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That whitening products are recommended to be used to maintain white teeth after whitening may reduce the hardness of face... Paste toothpaste is more abrasive than the removal of enamel and dentin microstructure is in contact with tissues... Be abrasive to the teeth ( Sharif et al teeth faster the edges of the tooth surface whiten! Your dentist 's office can have a lower concentration of whitening toothpastes been. Powell and Bales 1991 ), and maintaining good oral hygiene habits before any teeth whitening are... Is small and the dentin-to-enamel ratio is changed ( Haywood et al attributed both... Della Bona et al the lips ( Goldstein and Garber 1995 ) whitening treatment at your dentist look... Durable material used during whitening treatments at your dentist and look for one with the tooth may be used combination. Patient felt the need to be dose related rather than pH related were reported ( Haywood et.... Before it is thought to be extended to 6–10 weeks to achieve significant lightening occasionally an allergy to of... ( 29 % ) showed hardness reduction and 49 ( 71 % ) did not effects, but will. Determined, tray wearing times can be detected around the margins have become the one.
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