There are different ways of whitening teeth ranging from different budgets to qualities depending on the materials and technique to be used, which consists for cosmetic dentistry, in eliminating dental stains and making the dentition acquire a whiter and brighter tone in shades that go five to seven different shades of whiteness. This dental procedure is one of the most requested in recent years. Bleaches contain an active ingredient, usually carbamide peroxide or hydrogen peroxide in concentrations of 10-22%, which help to remove superficial or deep stains.
It is especially important that dentists are trained in the handling of whitening agents, following an adequate protocol for diagnosis, planning of the procedure, and maintenance of results. For this reason, it is vital that the professional fully understand both the indications and contraindications of teeth whitening techniques in order to be able to transmit them to patients.
On the other hand, the population must conceive this treatment as a medical process that has to be carried out under the supervision of a dentist, and only carried out in the dental clinic.
Causes of teeth darkening
Seguir una inadecuada higiene oral y el consumo de ciertos productos pueden provocar alteraciones en la tinción dental. Existen distintos tipos de manchas dentales que podemos clasificar como manchas intrínsecas o endógenas y manchas extrínsecas o exógenas.
Among the intrinsic or endogenous stains are those that affect the teeth in their formation phase, before they erupt in the oral cavity, caused by the consumption of certain drugs such as tetracyclines, by enamel hypoplasia, vitamin deficiency or fluorosis. Also classified in this group are those spots that appear after tooth eruption, caused by bumps, fractures or due to the passage of time due to aging of the dentition, which acquires a darker hue.
Extrinsic or exogenous stains are produced by the contact of the teeth with pigmenting agents, present in certain foods, beverages such as wine, tea and coffee, and other products, such as tobacco. These stains can also occur after prolonged use of certain oral mouthwashes and Chlorhexidine-based toothpastes.
Types of teeth whitening
Whitening in vital teeth
This type of whitening can be of two different types:
Teeth whitening performed in the dental office. It is carried out in the dental clinic by applying a 35% hydrogen peroxide-based whitening agent, which can be activated by a light source. It is necessary to previously carry out adequate prophylaxis and check that the oral cavity is healthy. After this step, the area to be treated is isolated, so as to avoid contact of the bleaching agent with the periodontal tissues and subsequently the bleaching agent is added. It is essential to follow the instructions of the manufacturer of the bleaching system for the results to be satisfactory.
Outpatient whitening with the supervision of a dentist. In this type of whitening, the concentration of carbamine peroxide is 10%. This method is performed at the patient's home, under the instructions of the dentist. In the same way as in the previous whitening, it is necessary to carry out a prophylaxis and an oral revision before the treatment. A splint is made to measure for the patient in which the bleaching agent will be applied, in order to avoid any possible contact with the periodontal tissues.
Whitening in non-vital teeth
The reason for discoloration in non-vital teeth is usually due to the presence of blood or bacterial products within the canals (pulp necrosis). This type of whitening is performed in the dental office and consists of the elimination of all bleaching agents and existing necrotic tissue from the pulp chamber in endodontic teeth.
Risks of teeth whitening
However, in addition to knowing what tooth whitening is, we must know that this treatment is not without risks. Teeth whitening is a treatment that, despite generally obtaining satisfactory results, carries a series of risks. It is the dentist's obligation to inform about them so that they are considered prior to performing tooth whitening.
Possible risks of teeth whitening include cervical resorption, gingival sensitivity, and post-operative tooth sensitivity.
To potentially reduce adverse effects, it is necessary to comply with the necessary biological safety measures, using the appropriate concentrations according to each technique and following the appropriate exposure times.