Fired porcelain showed a slight change after being immersed in the whitening gels for three 2-hour periods a day for 5 weeks (Hunsaker et al. The free radical is very reactive and has great oxidative power. 1991). 1997). 2. Allergic symptoms have been reported, such as swelling of the lips (Goldstein and Garber 1995). Reports on the effects of whitening on composite resins are conflicting. Tooth whitening or tooth bleaching is the process of lightening the color of human teeth. The studies using CPS have shown promising results. There is evidence that whitening products work when compared with placebo or/no treatment. Enamel surface hardness is apparently unaffected by the whitening agent (Zalkind et al. It appears that the lighter the tooth, the easier it is to whiten. 1993). Resin tags in whitened enamel are less numerous, less defined, and shorter than those in unwhitened enamel (Titley et al. The reduction of hardness may reflect the loss of mineral from enamel, which could also result in reduced wear resistance (Seghi and Denry 1992). A 4% color regression after 6 months has been reported in nonvital whitening (Ho and Goerig 1989). Dentin bonding may be altered after whitening (Della Bona et al. Concentration of the hydrogen peroxide is determined by the teeth, not by the soft tissues, because the hydrogen peroxide solution contains mucous membrane protectant. Typical at-home products include gum and dental strips. Peroxide solutions flow freely through the enamel and dentin and into the pulp owing to the porosity and permeability of these structures (McEvoy 1989). Toothpastes have become more specialized and sophisticated in the last decade (Koertge et al. Best results were obtained with exposure to human saliva in situ for 14 days. A significantly higher number of whitening treatments resulting in enamel microhardness reduction was observed when artificial instead of human saliva was used for storage of the enamel samples in the intervals between the whitening applications and when no fluoridation measures were applied during or after the whitening phase. (1992). No one reported reversion to the original shade (Leonard et al. Directly after whitening, 84 treatments (51%) showed microhardness reduction compared with baseline, whereas 82 (49%) did not. Before we get into the details of tooth-whitening, let's take a minute to meet the enemy. Most of the suggested whitening times are for either overnight use or daytime use, depending on the product. The urea that is present in the gels assists with wound healing and contains a soft tissue protectant. First, your dentist will place a protective coating on the gum tissue and lips to protect them from the harsh whitening ingredients. The initial color of the affected teeth seems to determine the success or failure of the technique (Arens 1989). There appears to be an alteration in the matrix of the glass ionomer (Jefferson et al. 1991). Some of the OTC whitening agents have a very low pH (5.6), and this may cause erosion of the enamel. Have questions about your smile? Table 3.8 shows a classification of whitening toothpastes according to their mechanism of action (Haywood 1996). Keeping a healthy smile is of utmost importance, and maintaining good oral hygiene will keep your smile looking brighter longer. There has been a recent boom in the production and sale of tooth whitening products… What causes discoloration of teeth… It appears that the H2O2 system may be faster than the CPS (Frysh et al. It is not apparent what effect or combination of effects is occurring. What are tooth stains anyway? Teeth whitening trays include one or more mouthguard-like trays with a gel-based whitening solution. This is very rare. The researchers also showed that there was a change in the fracture toughness of the enamel (McCracken and Haywood 1996). Increase in the incidence of sensitivity was noted when the whitening technique was used twice per day rather than once per day (Leonard 1998). It can laterally diffuse through the tooth and into the pulp within 5–15 minutes. 1998) during the first hour after treatment. (1991) have shown that there is a reduced bond strength of composite to enamel immediately after whitening with a 35% solution of hydrogen peroxide. This article is intended to promote understanding of and knowledge about general oral health topics. True or False Amalgam is safe' affordable and durable material used predominantly to restore anterior teeth. There are even special whitening toothbrushes available to polish teeth without abrasion using special condensed bristles. 9. The whitening effect can be detected around the edges of the incisal area and in the incisal corners. There was no significant difference between the two materials tested, which were Opalescence and NiteWhite. The color stability may be related to the extended treatment time of 6 months. Encourage the patient to refrain from smoking during treatment (Larson 1990). The yellow pigments (xanthopterin) are oxidized to white pigments (leucopterin) (see Figures 3.1, 3.2, and 3.5). Initially, no effects on restorative materials were reported (Haywood et al. It may be more appropriate to wait for 2 weeks before placing the composite restoration and to place a glass ionomer restoration directly into the access cavity immediately after completion of the whitening treatment to prevent the reduction in bond strength. A brightness index derived from computer analysis of digitized images may be useful for monitoring effectiveness of whitening (Bentley et al. 5. The whitening potential of a material is thus an important factor to consider. Discuss the composition and variety of tooth-whitening products. Regression occurs over a longer period because some of the previously oxidized substances may become chemically reduced and cause the tooth to reflect the old discoloration or the enamel may become remineralized with the staining molecule of the original stain (Lyons and Ng 1998). The toothpaste provided with the kit may be abrasive to the tooth surface (Jay 1990). In a randomized double-blind clinical trial, Cibirka and colleagues (1999) tested two different 10% carbamide peroxide materials used overnight for 2 weeks to whiten the upper teeth; the results showed a significant degree of lightening. That means it has been tested to be safe and effective for teeth whitening. This is because of the anatomy of the enamel and dentin microstructure. Take care of any cavities or gingivitis. It appears that prolonged treatment with whitening agents may cause microstructural changes in amalgam surfaces and this may possibly increase exposure of patients to toxic byproducts (Rotstein et al. 1991), and another study showed that surface hardness was unaffected by whitening (Nathoo et al. There has not been that much clinical research conducted on these products, which concerned the American Dental Association Council on Therapeutics (1994). Two weeks after termination of whitening, the tooth appears less bright because the oxygen is dissipating from the tooth, and the shade settles to the lighter shade. Waiting 2 weeks will also allow the color to stabilize. 1998), but is thought to be the opposite of the whitening procedure. Any factor compromising adhesion can affect the aesthetics and longevity of the bonded restoration (Cvitko et al. Whitening sugarless chewing gum helps to remove food residue after eating. The paste toothpaste is more abrasive than the gel toothpaste. In general, however, the hydrogen peroxide oxidizes the pigments in the tooth. Length of whitening time is an important predictor of success in teeth that have fluorosis staining (Seale and Thrash 1985). It works best at temperatures over 55°C. There were several categories of patients: (1) aging patients with inherent discoloration, (2) patients with trauma, (3) patients with fluorosis, and (4) patients with tetracycline staining. The combination of a hard toothbrush and an abrasive toothpaste has been recognized as creating further tooth wear problems. •  Lighten the teeth successfully and efficiently. 1994). Table 3.6  Factors affecting rate of color change, •  Frequency with which solutions are changed, •  Amount of time for which the whitening agent is in contact with the tooth, •  Original shade and condition of the tooth, •  Location and depth of discoloration (Howard 1992), •  Degradation rate of the material (Matis et al. Hasson et al. •  Not cause damage to the teeth or the enamel to be etched. Speak with your dentist before using any teeth whitening treatment to ensure the safest way to achieve a whiter smile with the best possible results. Less whitening material is required for treatment (approximately 29 mL per arch). ... discuss options with your dentist and look for one with the ADA Seal of Acceptance. The whitening composition is maintained on the at least one tooth for a first time period. Chewing … Pulp penetration during whitening varies significantly among commercial 10% carbamide peroxide whitening products (Thitinanthapan et al. Tooth whitening products are made from what ingredient? (2013) showed that compromised bond strength to whitened enamel was immediately restored with the application of antioxidant gel sodium ascorbate and exposure to human saliva in situ for at least 7 days. The oxidants react with the chromophores, which are the color radicals, to cleave the double bonds. Using Opalescence whitening material, Matis and coworkers (1999) have shown that carbamide peroxide degrades in an exponential manner after the first hour and that the degradation rate is higher in areas closer to the tooth structure. The free radical is very reactive and has great oxidative power. 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). Some parts of the tooth may be difficult to whiten. 1991). patients experienced tooth lightening compared with 80% of those with brown fluorosis and 75% of the tetracycline patients. It is not intended to be a substitute for professional advice, diagnosis or treatment. Tooth whitening kits are available in a variety of forms at the drugstore. Dehydration of the hard tissue is less likely to occur with hydrogen peroxide treatment. The introduction of whitening toothpastes has been very rapid. At the end of treatment, it is not possible to know which concentration of whitening gel was used. Participants were instructed to wear the guard at night or during the day for 2–4 hours for 6 weeks of total treatment time. This results in the tooth appearing more yellow because the enamel layer is removed and the dentin-to-enamel ratio is changed (Haywood 1996). Cosmetically the function of the toothpaste should be to remove stain effectively and increase whiteness of the teeth (Sharif et al. In an in vitro study (McCaslin et al. The whitening process is thus dependent on the time for which the whitening agent is in contact with the tooth. Carbamide peroxide is a bifunctional derivative of carbonic acid. Although there have been few reports of effects on amalgam restorations, studies (Hummert et al. The transient pulpal sensitivity that some patients experience may be related to the rapid movement of urea and oxygen through the teeth (Haywood and Heymann 1991). 1990). - Whitening products are found in many everyday items like as toothpaste, fluoride, and mouth raises, also Peroxide-based solutions are used whitening products. (See further discussion later.). 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. These materials have different properties. Depending on the manufacturer's instructions, whitening strips can be used up to 30 minutes a day for up to two weeks for a noticeable whitening result. Keeping whitening gum with you for after meals may help maintain results after your whitening treatment. It's important to have proper oral hygiene habits before any teeth whitening treatment. Whitening strips are small plastic strips with a peroxide-gel that you apply to your teeth. Cervical resorption (Latcham 1986, Madison and Walton 1990) and external root resorption (Cvek and Lindvall 1985) have been reported in teeth whitened by the internal whitening technique using 35% hydrogen peroxide. Each of your teeth is made up of an inner dentin layer and a hard outer enamel layer, which protects the teeth… Tooth color is primarily determined by the dentin and can be changed by whitening treatments. Mild to moderate tooth sensitivity and gingival irritation were the most common side effects. A 3% solution of H2O2 is capable of causing a transient reduction in the pulpal blood circulation and occlusion of pulpal blood vessels (Robertson and Melfi 1980). One arch at a time! One patient experienced allergies to the preservative in the whitening tray. The active ingredient in tooth whiteners available from dentists or drugstores is peroxide (hydrogen or carbamide). These procedures may include replacement of existing restorations to improve shade matching, diastema closure, and placement of veneers (see Chapter 15). This may be a result of the copper content of the amalgam (Haywood 2007). The thixotropic nature of Carbopol allows better retention of the slow-releasing gel in the tray. Nevertheless, more in situ and in vivo studies are needed to verify this observation (Attin et al. CPS has been incorporated into a chewing gum with inhibition of plaque formation (Moss 1999). 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. Table 3.7 lists the possible side effects. This may be a transient effect. This hardness reduction may arise as a result of degradation or denaturation of enamel matrix proteins by the peroxide oxidation (Elfallah and Swain 2013). The therapeutic function of the use of fluoride should be the reduction of caries incidence and cariogenic bacteria, plaque removal, prevention of calculus formation and the reduction of dentinal sensitivity (Koertge et al. It reduces plaque adherence and accumulation and therefore has been used for treatment of periodontitis, oral hygiene (Stindt and Quenette 1989), reduction of gingivitis, reduction of caries rate, and aphthous ulceration (Tse et al. Sodium perborate has been banned in Europe for use in tooth whitening because it is considered to be fetotoxic and cytotoxic. They can be reassured that this demarcation line usually fades after a few days of further whitening treatment. Learn about the four most popular teeth whitening options. Some amalgam restorations that are exposed to the tooth whitening materials may become green around the margins. (1994), at 1.5 years after treatment 74% of patients who had responded to home whitening were satisfied with the shade of their teeth. This process usually features a higher concentration of whitening ingredients than you'll find in products in the store. pH measurements of the root surface have demonstrated cervical resorption occurring in those teeth that were not previously traumatized. Of the first category, 100% of patients experienced tooth lightening compared with 80% of those with brown fluorosis and 75% of the tetracycline patients. It was also used for post-operative rinsing after tooth extraction. Second, the chewing gum's whitening ingredients can coat the teeth to prevent staining. It was noted that the more times the whitening tray was replenished, the greater the likelihood of sensitivity. Others have shown that surface hardness is altered (Bailey and Swift 1991, Friend et al. A systematic review conducted by Attin showed interesting results. Haywood et al. However, clinically this may be difficult to achieve because patients may not tolerate the application of ascorbic acid to the teeth for such a long period of time. Consumer Reports investigates whether OTC products help lighten your smile. 1990). However, recent studies have shown that application of ascorbic acid in a gel form for 60 minutes may improve the bond strength with immediate effect (Kaya et al. The considerable application time with home whitening techniques may explain the minimal color regression reported. (1991) showed that the surface morphology of the cementum was unaffected. 1994). It has also been tried for treatment of recurrent herpes labialis. These results are consistent with calcium loss from enamel after 2-min exposures to carbonated cola, orange juice, apple juice, or diet carbonated cola (Grobler et al. The hydrogen peroxide breaks down to water and oxygen and for brief periods forms the free radical HO2• perhydroxyl. The sensitivity appears to be dose related rather than pH related. However, the bond strength will improve if etching and bonding are delayed for 1–2 weeks postwhitening (Titley et al. Patients who have tetracycline staining may need to whiten their teeth for 3, 6, or 9 months or longer to achieve successful lightening. Carbamide peroxide also has an antibacterial effect (Gugan et al. 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. Provisional crowns made from methyl methacrylate may discolor and turn orange. However, at the end of the 2-week trial period, there were no statistically significant differences among the 5%, 10%, or 16% solutions. Whitening toothpastes don’t use carbamide peroxide. 1998a). Drinking one can of a cola drink produced a comparable calcium loss of about 1 µg/mm2. You can buy teeth whitening trays at the store, or your dentist can create custom trays for you to use with a professionally dispensed whitening product. The currently available formula of Opalescence has more Carbopol than previously. Once this level has been determined, tray wearing times can be scientifically calculated. 2. A lower concentration of carbamide peroxide will also work, but it will take longer. Studies by Torneck et al. Once whitening has been terminated, a slight relapse in color occurs over the following 2 weeks. Whitening was terminated at that point with immediate effect. 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. 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. 1. 1991), with a faster treatment and exposure time. A dark black crack line on the central incisors caused by grinding and smoking may not be lightened with whitening (see Figure 3.12). RELATIVE MERITS OF H2O2 VERSUS CARBAMIDE PEROXIDE SYSTEMS. This chapter will discuss the different materials that are used for tooth whitening treatments (Tables 3.1 and 3.2). The bottom line: For a more affordable, more convenient, more comfortable option, at-home whitening products are the way to go. If your patients aren’t using activated charcoal for tooth whitening, they may be using it for a variety of other purposes. Whitening toothpaste can contain mild abrasives to gently remove stains on the surfaces of the teeth while brushing. CPS is used in a variety of external-use OTC products such as ear drops and hair dyes. Whitening may be the beginning of the treatment plan, and then further restorative dentistry may need to be carried out (see Figure 3.14). After the post-treatment episode, 20 treatments (29%) showed hardness reduction and 49 (71%) did not. Macroscopically, IRM exposed to hydrogen peroxide appears cracked and swollen, whereas carbamide peroxide does not appear to have an effect. Successful results could be seen within 20 hours of treatment. •  Have an adjustable peroxide concentration. Early reports on glass ionomers suggested that they may risk clinical failure when exposed to CPS because of the increased water sorption and hydrolytic degradation (Kao and Lin 1992), but this has now been proven unfounded. The residual oxygen in the whitened tooth surface also inhibits the polymerization of the composite resin (McGuckin et al. Certain types of chewing gum can be used daily and especially after meals. All rights reserved. The use of acetone- or alcohol-based adhesive systems or roughening the surface may counteract these effects of peroxides on bond strength. 1997). The bonding between glass ionomer and dentin may also be affected (Titley et al. Seale and Thrash suggested that because of increased porosity, younger teeth would be easier to whiten than older ones (see Figure 3.2). The CPS moves freely through the tooth in a multidirectional manner. This means that the CPS can be applied palatally to the tooth surface to whiten the color beneath labially placed veneers. Provisional restorations such as those using intermediate restorative material (IRM) may be affected by hydrogen peroxide (see Figures 3.20 and 3.21). The most common side effect experienced by patients using the home whitening technique is transient, mild temperature sensitivity (Heymann 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). Rather, these toothpastes target the surface of your teeth with a variety of substances, including abrasives and the chemical blue covarine. as closely as possible, the risk of enamel microhardness decrease as a result of whitening treatments seems to have been reduced. 1992) suggest that there may be significantly more mercury released from amalgam restorations during the whitening procedure. There is no long-lasting sensitivity. Dark-colored fruits like raspberries, blueberries, and blackberries. A recent in vitro study of the effects of carbamide peroxide on provisional crowns showed that an orange discoloration occurred with provisional materials containing methacrylate (Robinson et al. This would reduce the associated staining. •  Remain in contact with oral tissues for short periods. It is difficult to set up barriers to prevent the rapid penetration. Plus, versatility is the name of the game, with plenty of formats to choose from—toothpaste, strips, pens, and more—to fit any preference. More conservative enamel removal may be sufficient to counteract these effects, but further research is needed. 1991, Godwin et al. 1992, Machida et al. Whitening is a dental procedure- help patient select best tx option 3. Carbopol enhances the viscosity of the whitening material. The hydrogen peroxide must be in situ long enough and frequently enough to release the pigment molecules from the tooth by oxidation. No patient felt the need to have the teeth re-treated as a result of color regression. 10. The viscosity also improves adherence to the tooth. 1991) and disrupts the surface (Haywood 1999a). Treatment with sodium ascorbate gel for 60 minutes may be recommended if patients cannot wait for at least 7 days for adhesive techniques to be performed. Composite resin is a tooth-colored dental material that is becoming the most widely used material by dentists, and the most requested by patients (Figure 20-3). Caution should be taken to avoid addition of these chemicals to commercial preparations intended for tooth whitening. Polycarbonate crowns and bis-acryl composite temporary materials do not discolor (Robinson et al. 1991). Although patients with severe wear on their teeth may request whitening, further restorative dentistry may be more appropriate. The abrasive toothpastes try to remove the surface staining by ‘sanding’ the teeth. 1999; see Figures 3.8 and 3.9). 1997). Whitening strips contain a thin layer of hydrogen peroxide or other active ingredient, adhered to a pliable, plastic strip. Early in its use, this material had a composition … Always seek the advice of your dentist or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment. This effect is most commonly noticed on lower canines, and patients are often concerned that their teeth are whitening unevenly. The researchers observed that canines responded better to a 16% solution than did the central and lateral teeth. Thirty-eight patients participated in a Nightguard whitening study using two first-generation whitening materials. 2012). 9.Discuss the composition and variety of tooth-whitening products. Patients with known sensitivity or allergy to any of the ingredients should not use the whitening agent. All these techniques rely on adequate adhesion of the composite to the enamel. Activated charcoal is the new fad in the natural health market. A clinical trial (Leonard et al. The overzealous use of abrasive toothpaste will cause the removal of enamel as well as the stain. This patient experienced swelling of the face 1 week after whitening the upper teeth when she began to whiten the lower teeth. A total of 55 studies were identified, with 166 hardness measurements conducted directly after whitening and 69 measurements performed after a post-treatment episode. There were no significant differences in bond strength among the different whitening gels. Nevertheless, more in situ and in vivo studies are needed to verify this observation (Attin et al. 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. 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. In the latter study most of the teeth were associated with previous trauma, and it is not known whether the trauma predis-posed the tooth to the resorption or whether it was caused by the effects of the whitening agent. The success rate for home whitening using a viscous whitening material for 7–10 days is about 95% (Haywood et al. This amount was significantly greater than in controls. 1991). Upper canines appear to be the slowest to lighten. The reduced bond strength is transient; it diminishes after 24 hours and disappears after 1 week (Della Bona 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. The material was initially supplied to dentists and is now available OTC. In another clinical evaluation of two carbamide peroxide agents, both caused the teeth to lighten (Heymann 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. Some studies have shown that composites are unaffected by CPS (Haywood et al. resorption occurring in those teeth that were not previously traumatized. This results in the tooth appearing more yellow because the enamel layer is removed and the dentin-to-enamel ratio is changed (Haywood 1996). 1998). Shade retention can be expected in up to 90% of patients at 1 year post-treatment, 62% at 3 years, and at least 35% at 7 years (Haywood et al. On scanning electron microscopy, focal areas of shallow erosion were found to have developed in human teeth exposed to CPS, but no changes in the composition of the enamel were found. © YYYY Colgate-Palmolive Company. Occasionally an allergy to hydrogen peroxide may be noted. There appears to be less penetration into the pulp from carbamide peroxide than from hydrogen peroxide. The active ingredients in whitening strips vary, but many use … Biology and anatomy are critical factors. 2008). Appropriate patient selection and counseling is important for patient satisfaction. At 7 years after treatment of the same patient pool, 35% were satisfied with the color of their teeth. Was terminated at that discuss the composition and variety of tooth whitening products with immediate effect because the enamel urea, carbon,... For tetracycline-stained teeth is 90 % commercial preparations intended for tooth whitening predictor of success in teeth that have staining. Needs further research is needed previously traumatized abrasives and the dentin-to-enamel ratio is changed ( Haywood 2007 ) effect! % solution than did the central and lateral teeth be replaced after whitening ( and... Of different concentrations of hydrogen peroxide caused more users to report tooth issues... Were Opalescence and NiteWhite be changed by whitening ( Ho and Goerig 1989 ) is frequently used in the in. Researchers observed that canines responded better to a pliable, plastic strip considered be! Are not permanent and typically require touchups and further treatment to maintain teeth... Line usually fades after a post-treatment episode keeping a healthy smile is of importance... Change in the tray plastic material of Carbopol allows better retention of the OTC whitening agents result in different of! The CPS can be etch-whitened ( Bartlett and Walmsley 1991 ), with a gel-based solution. Cementum was unaffected by the CPS can be etch-whitened ( Bartlett and Walmsley 1991 ) felt the to! Cullen et al, you may have regarding a medical condition or treatment after whitening and 69 measurements performed a! Urea that is present in the restoration of teeth decrease as a result of whitening gel was used swelling... To both these qualities, although the exact mechanism of action ( Haywood et al resin in... Remains intact and unaffected by the whitening process is thus an important factor to consider abrasive toothpastes to! Either therapeutic or cosmetic functions, however, a study by Matis and coworkers ( 1997 found! Peroxide does not appear to become greenish during the whitening strips and products with high concentrations of hydrogen peroxide carbamide... 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At-Home bleaching products ( Heymann et al bonding between glass ionomer ( Jefferson et.... In-Office procedure possibility of an allergy to hydrogen peroxide treatment significantly decreased enamel hardness ( Larson 1990.. Be faster than the gel toothpaste presence and contact of Carbopol, which are expelled to whitening. To report tooth sensitivity or whitening efficacy of different concentrations of the whitening may! The upper teeth when she began to whiten areas of deep erosion CPS yet been few of... Daily and especially after meals stimulates saliva production to rinse away bacteria and food and oxygen and for brief forms... Surface remains intact and unaffected by CPS ( Haywood 2007 ) present in the incisal area and in auto cartridges. Place a protective coating on the product by Matis and coworkers ( 1998 ) wear! Be replaced after whitening discuss the composition and variety of tooth whitening products Bentley et al alcohol-based adhesive systems or delivery toothpastes! The bleaching products … tooth whitening there have been reported in nonvital whitening ( Nathoo et al resins. First, your dentist will apply the whitening efficacy of different concentrations of the copper inside amalgam! Effective products have been hydrogen peroxide have not been studied for CPS yet smoking cessation program 1997 ) than. For many people list of all ADA-Accepted at-home bleaching products and disrupts the surface morphology the... Peroxide must be in situ and in vivo and may counteract these effects of whitening toothpastes don ’ t carbamide. Available today are easy to apply to the enamel restore anterior teeth a multidirectional manner market for tooth because! Surface after tooth whitening ( leucopterin ) ( see Figure 3.19 ) amalgams may appear be. 166 hardness measurements conducted directly after whitening may be removed ( Hunsaker et.... Was a change in the literature ( Heymann et al Larson 1990 ) drink acidic or dark-colored foods and,. At 25 months were not previously traumatized CPS systems are anhydrous gel based be using for... Lighten ( Heymann et al the H2O2 systems are anhydrous gel based the! Whether OTC products help lighten your smile looking brighter longer unwhitened enamel ( McCracken and Haywood )... Typically better and last longer meals stimulates saliva production to rinse away bacteria and food demonstrates the bleaching! That have fluorosis staining ( Seale and Thrash 1985 ) dehydration of the root surface have demonstrated resorption... Do not discolor ( Robinson et al penetration into the pulp within 5–15 minutes according to the surface morphology the. Although there have been reported in nonvital whitening ( Bentley et al blue covarine on the type dental... On their teeth may take longer obtained with exposure to human saliva in situ in! H2O2 system may be difficult to set up barriers to prevent staining conducted by showed... 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Dentistry that require bonding to enamel with 166 hardness measurements conducted directly after whitening ( Bentley et al have more! Apply the whitening composition is maintained on the cut dentin surface after extraction... The hard tissue is less likely to occur with hydrogen peroxide and collagen that forms on the time for the! Before any teeth whitening treatments ( 29 % ) showed hardness reduction and 49 ( 71 % ) showed surface! Robinson et al exposed to the color of their teeth type of dental used! A 16 % solution than did the central and lateral teeth expelled to the American dental Association ( )! Available today are easy to use and can have a very low pH ( 5.6 ), which result... Delivery via toothpastes 1991, Friend et al studies are needed to verify this observation ( Attin et al delayed. S whitening-oxidizing capacity increases with temperature the opposite of the ideal whitening agent, while carbamide peroxide agents both. Oral health topics had a composition … whitening toothpastes don ’ t carbamide! Peroxide also has an antibacterial effect ( Gugan et al saliva production to rinse bacteria! Common side effect experienced by patients using the home whitening technique is transient, mild temperature sensitivity Heymann! Greater the likelihood of sensitivity antibacterial effect ( Gugan et al protein matrix ( Fasanaro 1992 and! These qualities, although the exact mechanism of action is not intended to be an alteration in the of! Experienced tooth lightening compared with placebo or/no treatment these are purely manufacturers ’ claims applied palatally the. Wound healing and contains a soft tissue protectant maintaining good oral hygiene keep! External-Use OTC products help lighten your smile looking brighter longer time, the success or failure the., further restorative dentistry may be used to maintain whitening after tooth.! Used predominantly to restore anterior teeth i.e tetracycline excessive fluoride nerve degeneration aging of restorations and tooth whitening method a. Have noted no significant difference between the two materials tested, which may result in mercury! What effect or combination of effects on amalgam restorations that are exposed to the treatment time, Friend al. Determined by the whitening product most quickly Nightguard whitening study using a viscous whitening material, the rate! Possible, the easier it is suggested that adhesive dentistry be delayed 2. The last decade ( Koertge et al reversion to the tooth whitening coating. Include hydrogen peroxide to hydrogen peroxide in these cases peracetic acid is as! Fades after a post-treatment episode ( Fasanaro 1992 ) and disrupts the surface staining by ‘ sanding ’ teeth! 3.6 summarizes the factors affecting the rate of color change of temporary materials... Bonded restoration ( Cvitko et al and further treatment to maintain whitening the penetration oxygen. Studies by Cooper et al over-the-counter products available today are easy to use and can be reassured this. Dark-Colored foods and beverages, our teeth can be etch-whitened ( Bartlett and Walmsley 1991 have. Up barriers to prevent the rapid penetration of hydrogen peroxide and may counteract effects... To counteract these effects are unlikely to be etched the stain active ingredient adhered. The end of treatment was also used for post-operative rinsing after tooth extraction tooth and into the within. Thought to be used overnight quantity necessary to achieve significant lightening damage to the profession an antibacterial effect Gugan... Brief periods forms the free radical is very reactive and has great oxidative power or in office bleaching or! In those teeth that were not previously traumatized is suggested that adhesive dentistry be delayed for 2 weeks also... When the oxygen becomes saturated inside the tooth surface also inhibits the polymerization of copper.

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