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Editorial

Dr. Parvez A. Khan

Authors : Dr. Parvez A. Khan
 

In Office Bleaching

VITA classical A1-D4 shade guide arranged according to chroma; A: red-brown, B: red-yellow, C: grey, D: red-grey

Before the treatment, the dentist may examine the patient: taking a health and dental history, observe hard and soft tissues, placement and conditions of restorations. These shades determine the effectiveness of the whitening procedure, which may vary from two to seven shades. The effects of bleaching can last for several months, but may vary depending on the lifestyle of the patient.

In-office bleaching procedures, a light cured protective layer is used to protect the gingiva to reduce the risk of chemical burns. The bleaching agent used is hydrogen peroxide or carbamide peroxide, which breaks down in the mouth to form hydrogen peroxide itself. The bleaching gel contains between 10% and 44% carbamide peroxide, which is roughly equivalent to a 3% to 16% hydrogen peroxide concentration.

Bleaching is least effective when the original tooth color is grayish and may require custom bleaching trays. Bleaching is most effective with yellow discolored teeth.

Light-accelerated bleaching

Power or light-accelerated bleaching, sometimes colloquially referred to as laser bleaching uses light energy which is intended to accelerate the process of bleaching in a dental office. Different types of energy can be used in this procedure, with the most common being halogen LED or Plasma arc. Use of light during bleaching increases the risk of tooth sensitivity and may not be any more effective than bleaching without light when high concentrations of hydrogen peroxide are used.

The ideal source of energy should be high energy to excite the peroxide molecules without overheating the pulp of the tooth. Lights are typically within the blue light spectrum as this has been found to contain the most effective wavelengths for initiating the hydrogen peroxide reaction. A power bleaching treatment typically involves isolation of soft tissue with a resin-based, light-curable barrier, application of a professional dental-grade hydrogen peroxide whitening gel (25-38% hydrogen peroxide), and exposure to the light source for 6–15 minutes. Most power teeth whitening treatments can be done in approximately 30 minutes to one hour, in a single visit to a dental professional.

Editor

Dr. Parvez A. Khan
Dr. Parvez A. Khan