Bleaching And Whitening Agents

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• Aaradhya Dental Care

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Bleaching And Whitening Agents
Dental bleaching also known as tooth whitening,
is a common procedure in general dentistry but
especially in the field of cosmetic dentistry. A
child's deciduous teeth are generally whiter than
the adult teeth. As a person ages the adult teeth
often become darker due to changes in the mineral
structure of the tooth, as the enamel becomes
less porous. Teeth can also become stained by
bacterial pigments, foodstuffs and tobacco.
Certain antibiotic medications (like
tetracycline) can also lead to teeth stains or a
reduction in the brilliance of the enamel.
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There are two methods to whiten teeth-bleaching
gel and laser bleaching. Traditionally, at-home
whitening is done with bleaching gel which is
applied to the teeth using thin guard trays.
Oxidizing agents such as hydrogen peroxide or
carbamide are utilised to lighten the shade of
the tooth. The oxidizing agents oxidize the
porosities in the rod-like crystal structure of
interprismatic stain deposits over a period of
time, the dentin lying underneath the enamel is
also bleached. Laser bleaching utilizes light
energy to accelerate the process of bleaching in
a dental clinic. The effects of bleaching can
last for several months, but may vary depending
on the lifestyle of the patient. Factors which
will decrease whitening include smoking and the
ingestion of dark coloured liquids like coffee,
tea and red wine.

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Internal staining of dentin can discolour the
teeth from inside out. Internal bleaching can
remedy this. If heavy staining or tetracycline
damage is present on a patient's teeth and
whitening is ineffective, there are other methods
of whitening teeth. Bonding, when a thin coating
of composite material is applied to the front of
a person's teeth and then cured with a blue
light. This can be performed to mask the
staining. A veneer can also mask tooth
discolouration.
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The mechanism of bleaching involves free radicals
and breakdown of pigment whereas whitening is
accomplished by abrasive action as in
dentrifices. Tooth bleaching agents may be used
for external or internal bleaching performed in
the clinic by a dentist or at home by a patient.
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Internal bleaching
Internal bleaching procedures are performed on
devitalized teeth that have undergone endodontic
therapy but are discoloured due to internal
staining of the tooth structure by blood and
other fluids. Unlike external bleaching which
brightens teeth from the outside in, internal
bleaching brightens teeth from the inside out.
Bleaching the tooth internally involves drilling
a hole into the pulp chamber, cleaning, sealing
and filling the root canal with a rubber- like
substance, and placing a peroxide gel into the
pulp chamber so that the gel can work directly
inside the tooth on the dentin layer. Internal
bleaching is always performed in the dental
clinic. Seldom produces reliable results when
used to eliminate intrinsic stains in dentin.
There are two common approaches to internal
bleaching

• Office bleach The agent here is a mixture of 30
  to 35 hydrogen peroxide and sodium perborate
  which is heated to accelerate the process of
  bleaching.

• Walking bleach A mixture of hydrogen peroxide
  and sodium perborate are sealed to the tooth for
  2-3 days .

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Mechanism of action Sodium perborate powder
decomposes into sodium metaborate and hydrogen
peroxide thus releasing nascent oxygen. The
sodium perborate powder that is mixed with
hydrogen peroxide also releases nascent oxygen.
This combination is thought to be synergistic and
very effective in bleaching.
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Extrinsic bleaching
Is indicated for teeth that are discoloured from
ageing, fluorosis or tetracycline staining. It
can be applied by the dentist or by the patient.
Dentist applied bleaching can be divided into

• Power bleach with high concentrations of hydrogen
  peroxide which are premixed gels or liquid bleach
  with powder system that are mixed chairside.
  These products are caustic and thus should be
  cautiously used .
• Assisted bleaching with high concentrations of
  carbamide peroxide.

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Whitening Agents
Various chemical and physical agents can be used
to whiten teeth. Toothpaste typically has small
particles of silica, aluminum oxide, calcium
carbonate or calcium phosphate to grind off
stains formed by coloured molecules that have
lodged onto the teeth from food. Unlike bleaches,
whitening toothpaste does not alter the intrinsic
colour of teeth. Bleaching solutions contain
peroxide which bleaches the tooth enamel to
change its colour. Off-the-shelf products
typically rely on a carbamide peroxide solution
varying in concentration from 10 to 22.
Bleaching solutions may be applied directly to
the teeth, embedded in a plastic strip that is
placed on the teeth or use a gel held in place by
a mouthguard. Because the concentration is less
to avoid toxicity, whitening often takes several
weeks.
Whitening treatments used by dentists are much
more concentrated, containing substances with
more than 30 hydrogen peroxide and require
protection of the soft tissues. Source
- https//www.ida.org.in/Membership/Details/Bleac
hingAndWhiteningAgents
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