Teeth Whitening – Bleaching
It is an aesthetic dental treatment method that is applied to remove discolorations caused by various factors on the teeth and to make the natural color of the teeth a few shades whiter. Discoloration can be observed in teeth congenitally and / or for various reasons over time. The teeth whitening process can be performed by applying various materials for the removal of these coloration and whiter teeth. Teeth whitening is a frequently preferred method in Aesthetic Dentistry thanks to its application without any shaving and fast results.
The colorations occurring on the teeth can be external or internal. External discolorations may develop due to some foods and beverages (tea, coffee, wine, etc.), use of tobacco products, metallic restorations, and poor oral hygiene. Internal discoloration may develop due to the fluorine rate taken in the development stage of the teeth, some drugs (tetracycline and minocycline group antibiotics) used in the development stage of the teeth, genetic diseases including tooth enamel and dentin (amelogenesis imperfecta, hyperbilirubinaemia etc.) and traumas.
General oral examination should be performed prior to whitening. If there are exposed dentin or root surfaces, they should be closed, active caries should be treated, and the tooth surface should be cleaned and the roughness on the teeth should be removed. However, since the dental restorations such as fillings, crowns, veneers on the teeth will not be affected after the bleaching process, the color difference will occur. In accordance with the result obtained, these restorations will need to be changed.
Different techniques and whitening methods can be used for whitening depending on the person’s time, the intensity of coloration and the vitality of the tooth. There are 3 types of whitening methods:
Office Bleaching: It is applied in a clinical setting under the control of a dentist. Depending on the colouring rate of the teeth, 1-4 sessions can be applied and the sessions take 30-40 minutes. However, in order to avoid post-operative sensitivities and pulpal damage, 2-3 days waiting periods between sessions are recommended. 35-40% concentration of hydrogen peroxide is used in the process. In order to prevent hydrogen peroxide from causing damage to soft tissues, first the insulation of soft tissues is provided and then the whitening gel is applied. Activation of gel is achieved with appropriate light source (halogen, laser, led).
Home Bleaching: It is known as home bleaching but it should be applied under the supervision of a dentist. Special plaques are prepared for you by your doctor with holes on the teeth, the appropriate dose and frequency of application are determined. With prepared plaques, you can easily apply the whitening gel on your teeth at home. At 15-20% concentration, carbamide peroxide is used, and the side effect of carbamide peroxide in soft tissues is much lower. However, since its concentration is lower, it will take longer to reach the desired level of whiteness.
Home bleaching and office bleaching can be used in a combined way. After the bleaching process applied in the clinic, a low concentration of home type whitening application provides a kind of reinforcement and increases the permanence of the result obtained.
Devital Bleaching: It is also known as Walking-bleaching and is a method applied to teeth that have lost vitality. Sodium perborate is used. Pulpal necrosis caused by trauma or bruises, root canal treatment material left in the pulp chamber and old amalgam restorations cause discolorations affecting the enamel and dentin layers of the teeth. After the root canal treatment is applied, sodium perborate is placed in the cavity and the top is temporarily closed. It is checked at intervals of 2-3 days and after reaching the desired whiteness, permanent restoration is completed.
Whitening can be applied to almost everyone. However, it is not applied to very intense tetracycline colorations, cases of fluorosis with defects in enamel and genetic diseases, presence of active caries in the mouth and exposed dentin surfaces. Absolute contraindication for pregnancy and breastfeeding is not specified.
The permanence of the result obtained after whitening is 6-12 months. However, this period varies according to the person’s oral hygiene, habits, tobacco use and applied method.