Bleaching by specialists in esthetic dental medicine.

Tooth discoloration can result when stain-producing foods, luxury consumption goods and substances, such as alcoholic beverages, tee, tobacco smoke, coffee, juices, etc., permeate the tooth. In addition, internal factors such as the effects of medication or malnutrition, can also potentially cause tooth discoloration.

In general, preparations containing hydrogen peroxide are used for dental bleaching. These substances can permeate the tooth and break down oxygen radicals, which are able to alter the chemical composition of the pigmentation in the tooth so that it appears colorless.

With this method – after an impression of the teeth is taken and a model is made – a customized plastic splint that covers the teeth is made for the patient. This splint is then filled by placing a small drop of bleaching gel containing peroxide (10 to 20 percent).

Depending on the individual initial condition, the patient wears this splint between 30 minutes to several hours every day for up to 14 consecutive days. Home bleaching is especially recommended for full arch bleaching. If the tooth structure remains unchanged, the splint can be used for years to come to refresh the treatment.

With this method, a higher concentration of bleaching gel is used. Therefore, the treatment takes place in the dental practice. As preparation, a protective elastic-like cover called a “coffer dam” or a free-flowing material called a “gingival protector” is used for the gums.

Afterwards, the dentist applies the bleaching agent directly to the teeth, which then takes effect. Sometimes, the effectiveness of some gels is intensified by means of light activation with bleaching lamps. After 15 to 45 minutes, the gel is removed. If the effect is not sufficient, the bleaching treatment can be repeated. In general, one to three visits are necessary after the initial treatment in order to achieve a lasting result (one year or longer).

Power bleaching is usually chosen when individual, especially vital teeth, are to be bleached or if the wish for brighter-looking teeth needs to happen quickly.

For all commercially available methods the following applies: Brightening the teeth does not last forever, but often for many years. The durability of the result is essentially dependent on the quality and quantity of oral hygiene, the individual habits of consumption - especially of coffee, tobacco and tea - as well as a regularly performed PZR.

As soon as the brightened teeth darken in the whole or partially noticeably, the bleaching must be repeated.

Even during the treatment, a sensitivity reaction to the bleaching agent may occur. Freshly treated teeth can be sensitive to sweet, acid or temperature, which may be painful in some cases. These symptoms, however, are usually only temporary and sound a few days after the treatment.

During the whitening treatment the color pigments in the tooth melt are changed by a chemical oxidation, which causes the brightening. Over the last 25 years, a large number of studies have been published which have shown the harmlessness of lightening treatments. As long as the treatment is carried out professionally, brightened teeth will not become rougher, more brittle or more caries-prone. In the case of lightening preparations containing fluoride and potassium nitrate, even a caries-protecting effect was found.

Through the whitening process, minerals can be removed from the teeth, which can lead to demineralization as well as to the temporary removal of the protective layer of the tooth. Consequences may be increased white spots or completely covering the tooth, but which normally disappear again in the days after the treatment. Remineralisation is often supported by special gels.

By the "walking bleach technique", the tooth structure can be weakened, resulting in brittleness of the tooth and root resorption, and if the bleaching agent reaches mucous membranes, there is a risk of skin irritation "Home-bleaching" on when patients fill their rail with bleaching gel. It is estimated that 25% of the whitening gel is swallowed during tooth whitening, which can cause mucous membrane irritation in the mouth, throat and stomach. When the dosage is correct, the bleaching bars seal off very well. In the context of the "in-office bleaching", the ingestion can be prevented preventively by continuous aspiration of the saliva.

The color of tooth fillings as well as veneers of tooth crowns and bridges are not altered by a tooth whitening. Therefore, it may be necessary to renew these in the visible area after the tooth whitening. A professional tooth whitening before the new integration of dentures brings the same problem.

In these cases as well, the patient must be informed that in the future teeth whitening must be carried out from time to time in order to avoid color differences.