As with any treatment, it is necessary to make an accurate assessment of the patient first because unfortunately not all are good candidates for teeth whitening. In this evaluation, the dentist must examine several aspects that are indicated below:
IMPORTANT ASPECTS TO TAKE INTO ACCOUNT:
When the collars of the teeth are discovered it is imperative to seal them, and for this there are several methods that your dentist must know. The exposed collars provide direct entry of chemicals into the pulp or nerve of the tooth as well as making them susceptible to changes in temperature. This is why patients experience pain when they eat cold foods. A neck can be exposed without being visible, it is here that the diagnosis of your dentist becomes more important.
Badly adapted seals:
As with exposed collars, they also provide an entryway for chemists to the tooth pulp.
Existence of crowns or resins in the anterior teeth:
When the patient has crowns or resins on the teeth to be bleached, the treatment is contraindicated because they can not be colored. It is of vital importance that the dentist evaluates in what cases the color can be unified by changing crowns and resins after obtaining the desired color.
In these patients treatment is totally contraindicated, since there are no studies that demonstrate the safety of the material in this state.
In these patients the treatment is contraindicated. Smokers must avoid smoking at all costs during treatment, that the teeth are more susceptible to acquire spots and as long as they continue to avoid, the result will be predictable.
In case of presenting a patient to perform the treatment, even after knowing the inconveniences, it will be necessary that he signs a document called “informed consent”, where he accepts the consequences.
TYPES OF WHITENING SYSTEMS
There are several types of whitening systems, and they depend basically on the chemical to be used and its concentration. Not all are equally safe, but unfortunately the rise of dental cosmetics has impaired the good judgment of a large number of dentists who in their desire to earn money, use indiscriminately any system that is released to the market as new even when there are not enough studies serious that guarantee their long-term security.
All the current whitening systems work with hydrogen peroxide or carbamide peroxide, the latter being the best to choose since it is much less aggressive with the teeth and gums.
In most cases, some dentists take advantage of patients’ ignorance on the subject to offer treatments that promise whiter teeth regardless of the consequences. Thus, they offer “laser whitening” , as the one that produces the best results. They have turned this type of bleaching into a panacea, without really being it. The results are the same with all systems, only that some are much faster, but not by the laser, but by the concentration of the chemical to be used. Of course, when it comes to charging, the cost of whitening with “laser” will be well justified.
A conventional treatment with the safest chemical and in the safest concentration (10% carbamide peroxide)It lasts approximately 10 days, and the patient does it at home comfortably at night. This type of treatment may cost 1/2 of what is charged for the previous one, so if you are not a television model or a super busy public figure who does not have time for anything, it is well worth it to opt for the conventional whitening.
The disadvantage of this, in addition to the number of applications, is that being more exposed to the material, can produce more sensitivity, and this is a disadvantage in those with a history of sensitive teeth. There are also patients who need to see immediate changes to motivate themselves. In these cases, it is advisable to use a rapid whitening in the office preferably with the zoom whitening treatment System, which is described below.
In order for a laser device to actually increase the effectiveness of the whitening it must raise the temperature of the material on the tooth to approximately 60 ° C, which is unacceptable from the biological point of view. No teeth can be subjected to these temperatures, and in fact these devices do not. In comparison, it is the laser that produces the most heat, which is why it is the least recommended.
So what is the advantage of this treatment Vs. The conventional? Only the reduction in the time of application and the immediate results thanks to the increase in the concentration of the bleaching material helped sometimes by the rapid activation of this with the light emitted by the apparatus.
A conventional whitening is done with carbamide peroxide in concentrations of 10% to 16% . This material reacts chemically by converting to 5% hydrogen peroxide and approximately 8% . It is made with daily applications of 6 minimum hours (it is advised all night), for 10 to 14 days. It is not necessary to protect the gums.
The laser bleaching , is made with hydrogen peroxide in concentrations of 30% to 40% , with applications of approximately 20 minutes. It is necessary to protect the gums to avoid burns. It is usually enough with 1 or 2 sessions. There is heat emission.
The plasma arc whitening is done with hydrogen peroxide of 25% to 35%, and in some systems with 35% carbamide peroxide. It is necessary to protect the gums to avoid burns. 2 applications are usually sufficient. There is heat emission .
The whitening with ultraviolet light of high intensity , is carried out with 25% hydrogen peroxide. It also requires the isolation of soft tissues, the use of special filters so that UV rays do not affect the skin and lenses to protect the eyes. The emission of heat is minimal, faint. This system, well managed, would be the most recommended among the options for whitening in the office because there is little or no heat emission to the teeth and because the concentration of the whitening gel is the lowest among the rest of the systems. It is commercially known as ZOOM! And the Discus Dental home produces it .
From the above it is summarized that these bleaching uses hydrogen peroxide in concentrations up to 8 times more than with the conventional system.
There are long-term studies of pathologies related to these high concentrations, when the necessary protection measures are not taken in cases of neck exposure, so that the only justification exists to opt for a treatment that costs 2 times more obtaining the same results would be that you want to see immediate changes or have sensitive teeth, in which case conventional whitening is not recommended.
This tooth whitening can be done day or night, as the patient deems appropriate. At the first appointment, samples of the teeth are taken to obtain an exact replica that will serve to make the latex plates as sleeves, where the bleaching agent is deposited.
Using the bleach kit for the day, the patient will place the plates 1/2 hour in the morning and 1/2 hour in the afternoon. With the night kit the plates will be used at least 6 hours (all night). The duration of the treatment depends on each patient, not all cases are the same, for example, the yellow teeth are easier to whiten than the gray ones, and the young teeth whiten faster.
Then, the patient continues visiting the dentist every 2 days to monitor the evolution of the treatment. There is a belief that the whiter teeth are better, but when the patient bleaches too much the teeth do not look natural, that is why the controls are very important. The degree of bleaching that is going to arrive should be discussed with the dentist, because this is who really knows the natural colors.
The saturation pointThe color in a tooth marks the difference between a natural result and one that is not. Once past this point, the tooth acquires a matt appearance, which has no reversion. The teeth take on that “chalk” appearance , which is not natural at all.
Unfortunately, the concepts of “aesthetics” have been distorted a little helped by the bad publicity of the media that promote these treatments taking as models the celebrity models that expose their teethultra whites thinking that beauty is measured by the intensity of color away from the natural and physiological.
When a good diagnosis has been made, teeth whitening can be done without any problem and has extraordinary results, many people today enjoy the benefits of white teeth, bright and natural.
Consult your dentist for your questions, or you can Consult the Contusalud Specialist and we will gladly answer you about this or another topic of your interest.