What is teeth bleaching ?

There are a lot of stains on the teeth which discolour the teeth and which cannot be removed with normal brushing and scaling. For example, extrinsic stains caused by tobacco chewing, smoking ,foods such as coffee,tea,wine.Frequent use of mouthwash as well as normal ageing causes stains on the outer side of the teeth.

Some times, Intrinsic stains are caused due to fluorosis,medications such as tetracyclines which are commonly given during pregnancy.These stains can be of varying colours such as yellow,brown and black.

All of these can be lightened with the help of bleaching.

 

What is the mechanism of bleaching?

Bleaching is basically a chemical process by which organic material is converted to chemical intermediates lighter than organic substance .This process results in direct oxidation of stains and there-fore their removal. The chemical agents in the form of foam or  liquid or gel or paste base have varying concentrations of hydrogen peroxide,carbamide peroxide.

 

Carbamide peroxide when comes in contact with water breaks into urea and 3.5% hydrogen peroxide . Urea reacts with enzyme urease present in saliva which inturn converts into ammonia and carbon dioxide.This results in cleansing of the tooth surface. Hydrogen peroxide gives unpaired electrons  (free radicals) and acts as mechanical cleanser . These chemicals when applied on the teeth cause the whitening of the teeth. 

 

What is the procedure for  bleaching?

There are in-office and at-home bleaching options available.

 The process of  In office bleaching is:

• Shade of the teeth are recorded 

• Gingiva(gums) are protected by the gingival dam .

• Bleaching agent is applied on the teeth.

• The bleaching agent is activated by light

• This activated bleaching agent is kept on teeth for 15-20 minutes.

• During this time the patient shall be monitored for any discomfort or sensitivity.

• Bleaching agent and gingival dam is removed.

• Post-bleaching shade will be recorded

• If required a second appointment shall be given after a week

• You’ll be advised not to eat/drink food of intense pigmentation(coffee,tea,wine)

 

What is at-home bleaching?

 

An impression of your teeth is made and a customised tray is made with a gap of 1-2 mm between the outer side of teeth and tray .

The bleaching agent is applied using the tray for a prescribed duration of time.The concentration used in the home method is less and hence this tray needs to be refilled and worn multiple times to obtain the desired effects.

 

What are the side effects of bleaching?

The most common side effect is sensitivity . But, careful patient selection and right concentration of agents can minimise the side effects. Desensitising agents will be prescribed to reduce the chances of sensitivity

There are no long term detrimental effects on the teeth or the surrounding tissues with bleaching.

 

What is the difference between in-office and at-home bleaching techniques?

Concentration of hydrogen peroxide and carbamide peroxide is lower in at-home bleaching.

Method of delivery is also different. While a tray is used for at-home bleaching ,the bleaching agent is directly applied during in-office bleaching. Hence the effect is faster and better with In-Office bleaching. 

 

What is the cost of bleaching in  Bangalore?

Bleaching of teeth starts from 10000 for both the arches.

 

What are the contra-indications for bleaching?

Patients with existing restorations/crowns. These would have been made according to the existing shade. Restorations and crowns do not get bleached and hence there might be a requirement to change them after bleaching to match with new whiter shade.

Cases like the above mentioned ones can be treated with using composites resins or the veneering technique.

It is advised to avoid bleaching during pregnancy.

 

What are the problems with over the counter products available for bleaching?

• The procedure is unregulated and unsupervised.

• Gums might get damaged due to an ill-fitting tray.

• Lack of reservoir so limited whitening.

• Low ph can etch enamel.

• Repeated use can cause loss of tooth structure.