Bleaching is a simple and effective way to whiten teeth. During the process, oxygen-releasing chemicals are applied to the teeth; these chemicals react with discolorations and oxidize them out. Today’s bleaching materials also contain chemicals to reduce tooth sensitivity, the most common side effect.

Today’s dental practices use several different bleaching techniques, including:

    • In-office bleaching: In-office bleaching techniques like Bright Smile and Zoom offer fast, convenient results to whiten outer surfaces of the teeth. Here’s how the process works: first, your dentist will first isolate the teeth to be treated using a liquid rubber material that hardens to protect your gums. Your tongue and lips will also be protected with special props and a “sun block” cream. The bleaching gel will then be applied, allowed to remain on your teeth for around 20 minutes and rinsed off. Generally, there will be 3 of these 20-minute applications.Careful, controlled bleaching won’t harm your teeth, but it may make them temporarily more sensitive. If you feel any discomfort, your dentist can simply stop the process by removing the gel.

The advantage of in-office bleaching is that it can be completed in one 90-minute visit. Claustrophobic patients and patients who have trouble sitting for long periods of time may have difficulty, however.

  • Home bleaching: There are many bleaching systems that can be used at home. Some can be purchased at pharmacies, while others are done under professional supervision. In the case of dentist supervised home bleaching, an impression will be taken of your teeth and a soft appliance called a bleaching tray—which looks like a thin mouth guard—will be fabricated. At home, you will line this appliance with a bleaching gel and wear it for 30-60 minutes each day for about two weeks.Compared with in-office bleaching, the process is rather slow. But the final results are comparable, and the bleaching can also be continued for a longer period of time to achieve additional whitening. In addition, should you wish to repeat the process later, you can use the same bleaching trays and simply purchase bleaching gel from your dentist at a fraction of the original cost.More and more dentists are now using both office and supervised home methods, for more dramatic results than either accomplishes by itself.
  • Walking bleach technique: If a tooth is discolored due to a damaged nerve or a root canal treatment, it may also be bleached from within. During root canal therapy, for example, your dentist will apply a mild bleach as part of the standard procedure to clean and sterilize the pulp and canal of your tooth, which often oxidizes and removes any stains in the surrounding dentin.If stains persists or appear after root canal treatment, walking bleach can be applied. During this procedure, your dentist will reopen the pulp chamber and partly empty it of the root canal filling material. He or she will then insert a bleaching gel and seal it under a temporary filling. After a few days during which you “walk around” while the bleach diffuses into the dentin and oxidizes the stain, the temporary filling and bleach will be replaced by a permanent one.

The results of bleaching vary widely. Some stains, such as the mottling caused by fluorosis, usually come out without difficulty— often with a single treatment. Mild tetracycline stains and the natural darkening of teeth in later years can also be reduced with considerable success. Severe tetracycline stains, however, may resist even repeated treatments. Teeth that are stained gray, even when bleached lighter, tend to remain gray.

Some discolorations cannot be corrected by bleaching. For example, teeth with dead-white “headlights” can’t be bleached to match the areas of deficient calcium. Bleaching is also ineffective on the stains caused by diffused amalgam/silver fillings, unless the fillings themselves are removed and replaced.

Bleaching may not be permanent. Dentin stains, such as those caused by tetracycline, are especially likely to return. Later “touch-ups” may be desirable. Sometimes bleaching is undertaken as a first step in trying to remove discoloration. If it doesn’t produce satisfactory results, more elaborate methods, such as bonding or dental veneers, may be required.

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