Benefits / Advantages of Bleaching
Tooth bleaching has achieved wide spread acceptance with the patient as well as with the dental profession due to clear cut advantages over other treatment options. These include:
Clearly perceptible results can be seen in 2-3 sittings.
Results can be seen without any damage to teeth with very limited incidence of side effects.
The time taken for this procedure is very short.
Risks / Side effects associated with Tooth Bleaching
Increased sensitivity: Bleaching generally leads to tooth sensitivity, that is, pain on taking hot or cold food. This is more pronounced in individuals with thin enamel.
Soft tissue irritation: The bleaching agents are acidic in nature and when in contact with the soft tissue for a long time can cause soft tissue irritation.
When is Tooth Bleaching advised?
It is important that the bleaching only be done after the cause and extent of discolouration have been carefully evaluated. Effective treatment planning ensures that we get predictable results. The best prognosis can be seen in patients with discolouration due to:
Factors such as food, smoking, aging or poor oral hygiene
Mild tetracycline staining
When is Bleaching not advised?
When the extent of discolouration is too severe for bleaching to be effective, it is best to go for other treatment options that would give more reliable results.
Patients with caries, gum problems, damaged teeth or restorations, exposed roots, incomplete dental workand/orincreased sensitivity must also get these problems treated first before bleaching is undertaken as the procedure can further complicate these problem.
Pregnant and nursing mothers must also avoid bleaching.
Children under the age of 16 should avoid tooth bleaching as their pulp chambers are large and there is a chance of dental hypersensitivity.
Bleaching should be avoided in patients undergoing orthodontic treatment. It may be considered after the treatment is completed.
Precautions to take after Bleaching
As the process of bleaching opens up the pores of our teeth, it is best to avoid food and beverages that stain your teeth for duration of 48 hrs.
Sensitivity is a common complaint after bleaching and it is best to use fluoride mouth rinses for at least 2-3 weeks after bleaching.
In case pain and sensitivity persist, it is best to go back to your dentist.
Alternatives to Bleaching
When the degree of discolouration is very extensive and the dentist feels good results cannot be achieved with bleaching alone other treatment options such as porcelain or composit laminates or full coverage crowns may be tried. In case of tobacco stains, the dentist may also try air abrasion.
References:1. Tooth Whitening/Bleaching: Treatment Considerations for Dentists and Their Patients ADA Council on Scientific Affairs September 2009.
2. J.E. Dhal; Tooth Bleaching-a Critical Review of the Biological Aspects;Critical Reviews in Oral Biology & Medicine, July 2003; vol. 14, 4: pp. 292-304.
3. Howard E. Strassler, Vital Tooth Bleaching: An Update ;University of Maryland Dental School
4. A Watts & M Addy Tooth discolouration and staining: Tooth discolouration and staining: a review of the literature; British Dental Journal 190, 309 - 316 (2001).
5. C J Tredwin, S Naik, N J Lewis & C Scully: Hydrogen peroxide tooth-whitening (bleaching) products: Review of adverse effects and safety issues: British Dental Journal 200, 371 - 376 (2006).
6. Baratieri, Luiz Narciso; Ritter, Andrι Vicente; Monteiro Jr., Sylvio; Caldeira de Andrada, Mauro Amaral; Cardoso Vieira, Luiz Clσvis: Nonvital tooth bleaching: Guidelines for the clinician: Quintessence International. Sep1995, Vol. 26 Issue 9, p597-608. 12p.