Teeth Bleaching

costs of teeth bleaching

noreply@blogger.com (Unknown) — Thu, 16 Feb 2012 05:11:00 +0000

The standard fee for teeth whitening and teeth bleaching procedures is about $500 in most cases. Costs can vary depending upon the area of the country you live in and the type of whitening treatment you undergo. Laser teeth whitening is typically over $1000. for example. In-home tray bleaching can cost between $50. and $100. dollars for a total teeth whitening system. Store-bought whitening strips can cost as little as $25.

for a total treatment whitening system. Teeth whitening stores, stands and kiosks typically cost between $50. and $150. dollars per treatmentGenerally speaking, the price of teeth whitening increases with the number of in-office treatments required by the patient. Dental insurance does not typically cover the cost of the teeth whitening procedure

Teeth Whitening Procedure

noreply@blogger.com (Unknown) — Thu, 16 Feb 2012 05:06:00 +0000

Tooth whitening (or bleaching) is a simple, non-invasive dental treatment used to change the color of natural tooth enamel and is an ideal way to enhance the beauty of your smile. Because having whiter teeth has now become the number one aesthetic concern of most patients, there are a number of ways to whiten teeth.

Cosmetic teeth whitening training video

Factors affecting teeth bleaching part 2

noreply@blogger.com (Unknown) — Fri, 03 Feb 2012 21:23:00 +0000

Heat and light
The rate of chemical reactions can be increased by increasing the temperature, where a 10 8C rise can double the rate of reaction. The use of high-intensity light, for raising the temperature of the hydrogen peroxide and accelerating the rate of chemical bleaching of teeth was reported in 1918 by Abbot. Other approaches for heating the peroxide have historically been described to accelerate tooth bleaching, such as heated dental instruments. However, excessive heating
can cause irreversible damage to the dental pulp.

Contemporary approaches and literature has focussed on accelerating peroxide bleaching with simultaneous illumination of the anterior teeth with various sources having a range of wavelengths and spectral power, for examples, halogen curing lights, plasma arc lamps, lasers and light-emitting diodes. For some light sources, significant increases in pulpal temperatures have been measured using in vitro models during tooth bleaching. The light source can activate peroxide to accelerate the chemical redox reactions of the bleaching process. In addition, it has been speculated that the light source can energise the tooth stain to aid the overall acceleration of the bleaching process.

Some products that are used in light activated bleaching procedures contain ingredients that claim to aid the energy transfer from the light to the peroxide gel and are often coloured materials, for examples, carotene and manganese sulphate. Case studies have demonstrated the efficacy of light activated peroxide tooth bleaching systems. However, the literature evidence from in vitro and clinical studies for the actual effect of light on tooth bleaching versus a suitable non-light control is limited and controversial. An in vitro study using naturally coloured extracted human teeth showed that the application of various light sources significantly improved the whitening efficacy of some bleach materials, but not for others.Other in vitro studies have clearly shown significant tooth whitening benefits for peroxide plus light versus suitable control conditions.

However, these studies artificially stained the tooth specimens with, for examples, black tea, coffee, tobacco and red wine, i.e. ingredients commonly found to promote extrinsic stains. These chromophores are likely to be different to that which may be found naturally inside the tooth. Tavares et al. conducted a tooth whitening clinical study to compare 15% hydrogen peroxide gel illuminated with a gas plasma light source versus 15% peroxide alone versus placebo gel plus light, all treatments lasting 1 h. The change in Vita shade from baseline for peroxide plus light, peroxide alone and placebo plus light were 8.35, 5.88 and 4.93, respectively, with peroxide plus light being significantly different to the other two groups. In contrast, Hein et al. demonstrated no additional effect of any of the three light sources tested over the bleaching gel alone for three commercial products in a split mouth clinical design. Thus, further work is clearly required in order to unequivocally demonstrate the additional efficacy benefit of light activated tooth whitening systems versus their non-light activated controls.

Other factors
The type of intrinsic stain and the initial tooth colour can play a significant part in the ultimate outcome of tooth bleaching. Mild to moderate tetracycline staining tends to respond to extended bleaching regimes of 2–6 months. However, It is documented that severe tetracycline staining is more difficult to bleach with the darker the teeth at baseline, the longer it can take to lighten them. In addition, it is reported that when the tetracycline discolouration is located in the neck of the tooth, the prognosis for bleaching is the poorest; when it is dark gray or blue, the prognosis also is poor. For non-tetracycline stained teeth, a meta analysis of placebo controlled, patient applied tooth whitening clinical studies using 10% carbamide peroxide found that 93% of people who used the peroxide product and 20% who used the placebo exhibited a change of two shade guide units.

In addition, 20% of subjects who used the peroxide product achieved a mean change of five shade guide units. Ishikawa-Nagai et al. evaluated the tooth colour change of 80 subjects after using 10% carbamide peroxide in a gum shield over 14 days and found a strong correlation between total colour change and b* values, demonstrating that bleaching works efficiently for teeth with a yellow hue. Further, an analysis of the clinical results with over 600 subjects undergoing tooth bleaching, indicate that the yellower the teeth at baseline, the greater the magnitude of the whitening response. This analysis demonstrated a significant relationship between subject age and the magnitude of whitening response, with younger subjects experiencing greater tooth whitening. Further, there was a relationship between subject age and the initial colour and the magnitude of whitening response.

Older subjects with less yellow initial tooth colour exhibited the smallest mean colour change post bleaching, whereas younger subjects with more yellow initial tooth colour exhibited the greatest mean colour change post bleaching. In addition, neither gender nor coffee/tea consumption had any significant affect on the tooth whitening response. The presence on the tooth surface of pellicle and plaque has the theoretical potential to reduce the activity of peroxide by acting as a substrate for peroxide bleaching and/or degrading peroxide. Wattanapayungkul et al. has shown that the rate of peroxide degradation did not increase with the presence of pellicle on tooth surfaces in vivo over 1 h indicating that pellicle does not have a significant effect on the stability of peroxide. In addition, a clinical study by Gerlach et al.comparing the effect of immediate prebrushing with a toothpaste versus no prebrushing prior to tooth bleaching with 6.5% hydrogen peroxide over a 14-day period, suggested that toothbrushing immediately before bleaching has only a modest positive impact on overall efficacy. Thus, the modifying role of pellicle on peroxide delivery and whitening efficacyappears to be overall small.

Factors affecting teeth bleaching part 1

noreply@blogger.com (Unknown) — Fri, 03 Feb 2012 21:07:00 +0000

1. Type of bleach
The majority of contemporary tooth whitening studies involve the use of either hydrogen peroxide or carbamide peroxide. This latter material is an adduct of urea and hydrogen peroxide which on contact with water breaks down to urea and hydrogen peroxide. For example, a 10% (w/w) carbamide peroxide gel would yield a maximum of 3.6% (w/w) hydrogen
peroxide. In general, the efficacy of hydrogen peroxide containing products are approximately the same when compared with carbamide peroxide containing products with equivalent or similar hydrogen peroxide content and delivered using similar format and formulations, either tested in vitro or in vivo.

For example, Nathoo et al. demonstrated in a clinical study that a once a day application of either a 25% carbamide peroxide gel or a 8.7% hydrogen peroxide gel both gave a statistically significant tooth shade lightening after 2 weeks use compared to baseline, but found no statistically significant differences between products. An alternative source of hydrogen peroxide is sodium percarbonate and this has been used in a silicone polymer containing product that is painted onto the teeth forming a durable film for overnight bleaching procedures. The peroxide is slowly released for up to 4 h73 and gave significant tooth colour improvement after 2 weeks versus baseline. However, the relative clinical or in vitro efficacy of sodium percarbonate versus hydrogen peroxide tested in the same product format and conditions has not been reported.

A tooth bleaching system based on sodium chlorite applied to the tooth surface and activated under acidic conditions has been described in the literature, however, no efficacy data has been reported to date. Similarly, other potential vital tooth bleaching systems have been outlined in the literature with limited supporting evidence for their efficacy. These include sodium perborate, peroxymonosulphate, peroxide plus metal catalysts and oxireductase enzymes. The long-term acceptability and relative efficacy of these alternative tooth bleaching systems requires significant further research.

2. Concentration and time
Two of the key factors in determining overall tooth whitening efficacy from peroxide containing products are the concentration of the peroxide and duration of application. For example, Sulieman et al. compared the in vitro tooth bleaching efficacy of gels containing 5–35% hydrogen peroxide and found that the higher the concentration, the lower the number of gel applications required to produce uniform bleaching. Similar results were found by Leonard et al. who compared the in vitro tooth bleaching efficacy of 5%, 10% and 16% carbamide peroxide gels and found the whitening was initially faster for the 16% and 10% than the 5% concentration. However, the efficacy of the 5% approached the higher concentrations when the treatment time was extended.

In a clinical study using custom made bleaching trays, Kihn et al. showed that a 15% carbamide peroxide gel gave significantly more tooth whitening than a 10% carbamide gel after 2 weeks use. This result was confirmed in another clinical study
reported by Matis et al.84 However, in this latter study, by extending treatment time to 6 weeks, the differences in tooth lightness were no longer of statistical significance. The initial faster rate of bleaching for higher concentrations of carbamide peroxide has also been observed when bleaching tetracycline stained teeth in vivo over a 6 months period. In this case, the most rapid whitening occurred in the first month with 20% carbamide peroxide compared to 15% and
10% carbamide peroxide. In addition, clinical studies with hydrogen peroxide strip based products have shown similar concentration and time effects for tooth whitening efficacy.

Mechanism of tooth bleaching

noreply@blogger.com (Unknown) — Fri, 03 Feb 2012 20:53:00 +0000

Bleaching is a decolourisation or whitening process that can occur in solution or on a surface. The colour producing materials in solution or on a surface are typically organic compounds that possess extended conjugated chains of alternating single or double bonds and often include heteroatoms, carbonyl, and phenyl rings in the conjugated system and are often referred to as a chromophore.

Bleaching and decolourisation of the chromophore can occur by destroying one or more of the double bonds in the conjugated chain, by cleaving the conjugated chain, or by oxidation of other chemical moieties in the conjugated chain. Hydrogen peroxide oxidises a wide variety of organic and inorganic compounds. The mechanisms of these reactions are varied and dependent on the substrate, the reaction environment, and catalysis. In general, the mechanism of bleaching by hydrogen peroxide is not well understood and it can form a number of different active oxygen species depending on reaction conditions, including temperature, pH, light and presence of transition metals. Under alkaline conditions, hydrogen peroxide bleaching generally proceeds via the perhydroxyl anion (HO2* ). Other conditions can give rise to free radical formation, for example, by homolytic cleavage of either an O–H bond or the O–O bond in hydrogen peroxide to give H* + *OOH and 2*OH (hydroxyl radical), respectively. Under photochemically initiated reactions using light or lasers, the formation of hydroxyl radicals from hydrogen peroxide has been shown to increase.

The mechanism by which teeth are whitened by oxidising materials such as hydrogen peroxide and carbamide peroxide are currently not fully understood. Considering the available literature, evidence points towards the initial diffusion of peroxide into and through the enamel to reach the enamel dentine junction and dentine regions. Indeed, in vitro experiments by a number of authors have demonstrated the penetration of low levels of peroxide into the pulp chambers of extracted teeth after exposure times of 15– 30 min from a range of peroxide products and solutions. The levels of peroxide measured in these experiments is considerably much lower than that needed to produce pulpal enzyme inactivation. As peroxide diffuses into the tooth, it can react with organic coloured materials found within the tooth structures leading to a reduction in colour.

This is particularly evident within dentine as demonstrated by McCaslin et al. who showed, using hemi-sectioned human teeth mounted on glass slides, that following external bleaching with carbamide peroxide, colour changes occurred throughout the dentine. Indeed, the treatment of dentine specimens with 10% carbamide peroxide, 5.3% and 6% hydrogen peroxide has been shown to give a significant reduction in yellowness and an increase in whiteness. In addition, Sulieman et al. showed using sectioned extracted teeth stained internally with black tea chromophores that significant bleaching occurred within the
dentine, particularly on the buccal surface where a 35% hydrogen peroxide gel had been applied. For tetracycline stained teeth, the colour is derived from photo-oxidation of tetracycline molecules bound within the tooth structures.

In some cases, it is possible to bleach these teeth to give significant and long lasting tooth whitening. The mechanism by which peroxide affects the tetracycline stain is considered to be by chemical degradation of the unsaturated quinone type structures found in tetracycline leading to less coloured molecules.However, in contrast there appears to be a paucity of information available in the literature regarding the nature and chemical composition of the coloured materials naturally found within the dental hard tissues and the mechanistic effects of peroxide on these structures. Thus, this is clearly an area that requires further research if the chemical mechanistic aspects of tooth bleaching are to be significantly resolved.

Tooth Bleaching Risks

noreply@blogger.com (Unknown) — Fri, 27 Jan 2012 09:54:00 +0000

Tooth bleaching in modern aesthetic dental medicine, The bleaching effect is caused by active oxygen. There are no changes to the tooth enamel and nothing is removed, sanded down or etched. Possible Side Effects:
One of the most common side-effects is a temporary hypersensitivity of the teeth when in contact with hot or cold stimulation; this can also apply to the necks of the teeth. To reduce the severity of such temporary side-effects a special, desensibilizing tooth paste with natrium fluoride should be applied . If the bleaching agent comes into contact with the gums an irritation may develop, however this will only last a few days
If the patient decided to use a home-bleaching kit then smoking should be avoided. This is because the peroxide in the bleaching agent can increase the carcinogenic affects of nicotine. The peroxide can also have a temporary effect on the health of the oral flora. Regular dental care and oral hygiene is very important.

.Bleaching of “dead teeth” can cause a weakening of the inner structure and lead to breakage which may require a crown . If the patient suffers from any allergy to peroxide or peroxide-related agents, acryl resins or latex or high-grade light sensibility the dentist should be informed before treatment begins.

Information for Allergy Sufferers:
The applied resins have been specially developed for use in dental medicine and are insoluble in the environment in which they are applied and therefore suitable for allergy sufferers. However, before treatment, patients with a synthetic material allergy should consult a specialist. Please inform your dentist of any allergies to peroxide, peroxide-related substances, acryl resin or latex or high-grade light sensitivity. Your teeth are as individual as your personality and the results can differ from patient to patient. The results are dependent on your natural tooth coloration and the outcome may differ to your desired results.

Advantages Of In-Office Teeth bleaching

noreply@blogger.com (Unknown) — Thu, 26 Jan 2012 15:52:00 +0000

There are many different options available for you to choose from today when it comes to using teeth whitening gel. There are in-office types of procedures as well as out of the office or at home kits and systems. They both offer some advantages that you can consider when deciding which is the best method and system for you. There are some significant advantages to the in-office or in the dental office methods of teeth whitening that should be considered.

First of all, there is no other method of whitening procedures that produce faster results for you when you want to bleach your teeth. The in-office methods are also the safest ways of using teeth whitening gel, especially since everything is supervised and monitored by the dental office staff who can make sure everything is going well. They are also the ones who administer the bleach and put it on your teeth, which should produce better coverage and therefore better results. In the past, the drawbacks of using the teeth whitening were that some people experienced gum and tooth sensitivity after using the bleaching methods. Today, the whitening methods have been greatly improved and this problem has become not much of a problem for most people anymore. The sensitivity has become more controllable today due to the fact that the gels are improved and much thicker. This helps the peroxide bleaching agents not to soak into the teeth as much as the previous gels. There are also desensitizers such as potassium nitrate that can help with the sensitivity. Fluoride helps with this as well.

There are many stains and discolorations that can be removed or lessened by the teeth whitening gel. Organic stains or discoloration caused by aging can be greatly reduced or eliminated. Over time, teeth tend to darken with a yellowish, brown or grey color. This can be caused by heredity and/or eating habits. Yellow colored teeth tend to whiten most easily. Consuming certain foods such as red wine, soda pops, and even dark colored fruits and vegetables can also cause discoloration of your teeth and cause them to look dingy and not white and bright. People who use tobacco may get some of the worst stains on their teeth. All of these discolorations may be able to be removed or significantly lessened by using the teeth whitening methods in the office.
Consulting with your dentist and his staff can help you determine if using whitening gel is a good option that you may want to consider to brighten your teeth.

Peter Morgan is a health writer on subjects regarding teeth whitening kits, teeth whitening gel as well as the latest technology and information on the latest teeth whitening methods.

Article Source: http://EzineArticles.com/6838630

How To Use Teeth bleaching Kits Effectively

noreply@blogger.com (Unknown) — Thu, 26 Jan 2012 15:42:00 +0000

There are many different teeth whitening products that are currently available over the counter. This means that they can be used by anyone at any time. There are a number of compelling advantages to using teeth whitening kits. They are very convenient and portable, meaning that they can be used on the go, in the office, on vacations or trips, as well as in the comfort and privacy of your own home. They are designed to be very affordable, but they are also extremely effective, often yielding striking results within only a few treatments.
Because these kits are made by various different companies and are designed to fit many different lifestyles, they can range significantly in cost and in the way that they are used. As you follow a few simple steps for effectively using your teeth whitening products, you will find that they are effective and that you are successful as you whiten your teeth.
When you first purchase teeth whitening kits, it is a good idea to thoroughly read the instructions and warnings that are found inside of the package. Although many bleaching products are considered to be extremely safe, it is also important that you know the risks and the recommended procedures for using them. By doing this, you can make sure that you are following the right steps and that you will achieve optimum results.
As with any new task, it is advisable that you make a plan for when you will use your teeth whitening products. Think about the time of day that is best for you, the location, and other factors. If you think you might have a hard time remembering to use your kit, make sure that you place it somewhere that you will surely see it. You may even want to leave a note or some sort of reminder on your bathroom mirror or even set up an alarm on your phone. By taking steps to ensure that you will remember to use your teeth whitening kits every day, you are more likely to be able to implement them into your regimen without any difficulty.
Be flexible. Often, people have schedule changes and other various reasons that they may not be able to follow their planned routine. Look for ways that you can continue to use your whitening kit, even if you take a last minute trip or have other scheduling conflicts. They are designed to be portable and very easy to use. Many kits only require a five minute time commitment so that you can continue your day with very little interruption.

Peter Morgan is a health writer on subjects regarding teeth whitening kits, teeth whitening gel as well as the latest technology and information on the latest teeth whitening methods.

Article Source: http://EzineArticles.com/6838640

teeth bleaching with Hydrogen peroxide

noreply@blogger.com (Unknown) — Thu, 26 Jan 2012 15:39:00 +0000

Hydrogen peroxide is produced by the combination of oxygen and hydrogen, and has been routinely and safely used in the process of teeth bleaching for years. In typical hydrogen peroxide teeth bleaching solutions, you'll find a strength of 3% to 10% with varying degrees of effectiveness. One thing to consider is that you may experience sensitivity when using hydrogen peroxide to whiten your teeth, particularly in your gum area. However, the discomfort is usually minimal and can be equated to a burning sensation that typically does not last once the peroxide solution is removed or rinsed from the teeth.

Hydrogen peroxide is a weak acid with oxidizing properties which act like a bleaching agent when used in teeth whitening solutions. It's also often found in tooth pastes, disinfectants, and mouth washes. Hydrogen peroxide teeth bleaching can be completed in a number of different ways. There are many commercially available solutions on the market that offer hydrogen peroxide as a bleaching agent, and you can also easily create your own remedy using hydrogen peroxide for at home teeth whitening. This article will give you some tips and suggestions on the various methods you can use, and finding the best hydrogen peroxide teeth whitening method for you.
To create your own at home teeth whitening solution, a popular method is to combine baking soda (which you can find at any grocery store), with hydrogen peroxide to form a thick paste like consistency. You can also add some mint flavored toothpaste which will make the solution more pleasant to brush with, as well as a little table salt for extra exfoliation. It is very important that this mixture is not ingested, but should be used in place of regular toothpaste once or twice a week. For added whitening benefits, you can also rinse your mouth after brushing with a 3% hydrogen peroxide solution.

Another option is to choose an over the counter, home tooth whitening solution that uses carbamide peroxide and/or hydrogen peroxide in its formulation. These products (including teeth whitening trays, gels and strips) are generally more pleasant to use and may provide faster and longer lasting effects. Although whitening toothpastes do not have the strength or intensity of teeth bleaching products, these can be used in conjunction with other products enhance the effects of home tooth whitening in between treatments.

It's important to note that hydrogen peroxide teeth whitening is considered to be safe and effective by the American Dental Association. However, be sure to read all safety labels and do not ingest or swallow your tooth whitening products. Also take note of any tooth or gum sensitivity that you may experience, and notify your dentist if this sensitivity persists for a prolonged period of time.
A more sophisticated and longer lasting alternative to hydrogen peroxide teeth bleaching would be in-office dental treatments, which employ the use of higher concentrated bleaching agents. There's also the new and more sophisticated laser teeth whitening procedures. Of course, dental office treatments will be much more expensive than using at home teeth whitening methods, but they may be the ideal option for you if you're looking for very rapid results.

Safety Concerns with Tooth Bleaching Materials

noreply@blogger.com (Unknown) — Tue, 24 Jan 2012 22:04:00 +0000

Concerns regarding the safety of all bleaching treatments and products have long existed, but were heightened since the introduction of at-home bleaching.5-8 Discussions in this section focus on peroxides and their use as active ingredients in tooth bleaching materials. Important concerns related to patient examination and diagnoses are addressed elsewhere in this report. A variety of peroxide compounds, including carbamide peroxide, hydrogen peroxide, sodium perborate and calcium peroxide, have been used as active ingredients for bleaching materials; however, essentially all extracoronal bleaching materials currently available for whitening of vital teeth in the United States contain carbamide peroxide and/or hydrogen peroxide.

Recently, products containing chlorine dioxide were introduced in the United Kingdom, but there is no evidence that tooth bleaching products using chlorine dioxide as the active ingredient are safer than peroxide-based materials. In fact, safety concerns have been documented with chlorine dioxide and its use for tooth bleaching treatment due to the low pH of the material and resultant tooth etching.
Most OTC bleaching products are hydrogen peroxide-based, although some contain carbamide peroxide. Carbamide peroxide decomposes to release hydrogen peroxide in an aqueous medium: ten percent carbamide peroxide yields roughly 3.5% hydrogen peroxide. In-office bleaching materials contain high hydrogen peroxide concentrations (typically 15-38%), while the hydrogen peroxide content in at-home bleaching products usually ranges from 3% to 10%; however, there have been home-use products containing up to 15% hydrogen peroxide. Safety issues have been raised regarding the effects of bleaching on the tooth structure, pulp tissues, and the mucosal tissues of the mouth, as well as systemic ingestion. Regarding mucosal tissues, safety concerns relate to the potential toxicological effects of free radicals produced by the peroxides used in bleaching products. Free radicals are known to be capable of reacting with proteins, lipids and nucleic acids, causing cellular damage. Because of the potential of hydrogen peroxide to interact with DNA, concerns with carcinogenicity and co-carcinogenicity of hydrogen peroxide have been raised, although these concerns so far have not been substantiated through research. However, studies have shown that hydrogen peroxide is an irritant and also cytotoxic. It is known that at concentrations of 10% hydrogen peroxide or higher, © 2009 American Dental Association. All rights reserved. the chemical is potentially corrosive to mucous membranes or skin, and can cause a burning sensation and tissue damage. The amount of products applied during office bleaching treatment and other formulation variables can change the potential to cause damage.

However, severe mucosal damage can occur if gingival protection is inadequate with high strength tooth whitening products. Clinical studies have also observed a higher prevalence of gingival irritation in patients using bleaching materials with higher peroxide concentrations. Data accumulated over the last 20 years, including some long-term clinical study follow up indicate no significant, long-term oral or systemic health risks associated with professional at-home tooth bleaching materials containing 10% carbamide peroxide (3.5% hydrogen peroxide). However, these data were collected from studies which include examinations by dental professionals, and there is no safety evidence on bleaching materials that do not involve such examinations by dental professionals, regardless of hydrogen peroxide concentration or application venue. Additionally, consumers are not generally aware of how to report adverse events through FDA’s Medwatch system. If a licensed dental professional is not consulted when patients use OTC bleaching products, adverse effects due to product abuse may go unreported.
Regarding hard tissues, transient mild to moderate tooth sensitivity can occur in up to two-thirds of users during early stages of bleaching treatment.18 Sensitivity is generally related to the peroxide concentration of the material and the contact time; it is most likely the result of the easy passage of the peroxide through intact enamel and dentin to the pulp during a five- to 15-minute exposure interval. However, there have been no reported long-term adverse pulpal sequellae when proper techniques are employed. The incidence and severity of tooth sensitivity may depend on the quality of the bleaching material, the techniques used, and an individual’s response to the bleaching treatment methods and materials. To date, there is little published evidence documenting adverse effects of dentist-monitored, at-home whiteners on enamel, but two clinical cases of significant enamel damage have been reported, apparently associated with the use of OTC whitening products. This damage may be related to the low pH of the products and/or overuse.

In vitro To address the safety of bleaching materials, the ADA convened a panel of experts in 1993. The ADA subsequently published its first set of guidelines for evaluating peroxide-containing tooth whiteners. These guidelines have been revised periodically.
In March 2005, the European Scientific Committee on Consumer Products (SCCP) concluded the following: ―The proper use of tooth whitening products containing >0.1 to 6.0% hydrogen peroxide (or equivalent for hydrogen peroxide-releasing substances) is considered safe after consultation with and approval of the consumer's dentist. The © 2009 American Dental Association. All rights reserved. SCCP, in January 2008, again recommended that up to 6% hydrogen peroxide is a safe limit to use for at-home tooth bleaching; however, it did not recommend use of such products without dental consultation. In summary, available data indicate that extracoronal bleaching treatment in the dental office or at home may cause short-term tooth sensitivity and/or gingival irritation. More severe mucosal damage is possible with high hydrogen peroxide concentrations. While available evidence supports the safety of using bleaching materials of 10% carbamide peroxide (3.5% hydrogen peroxide) by dental professionals, there are concerns with the use of at-home bleaching materials with high hydrogen peroxide concentrations. Studies designed specifically to assess the long-term safety of high hydrogen peroxide concentration in at-home bleaching materials are needed, especially for repeated use of these products. There appears to be insufficient evidence to support unsupervised use of peroxide-based bleaching materials.
Similar to other dental and medical interventions, questions have been raised about the safety of tooth whitening treatments during pregnancy. In the absence of such evidence, clinicians may consider recommending that tooth whitening be deferred during pregnancy.

The safety of tooth bleaching for children and adolescents is also a consideration. More research is needed to establish appropriate use and limitations for these patients. However, bleaching is a conservative approach compared with restorative options when tooth discoloration causes significant concern. If possible, delaying treatment until after permanent teeth have erupted is recommended, as is use of a custom-fabricated bleaching tray to limit the amount of bleaching gel. Close professional and parental/guardian supervision are needed to maximize benefits and minimize adverse effects and overuse. studies suggest that dental restorative materials may be affected by tooth bleaching agents. These findings relate to possible physical and/or chemical changes in the materials, such as increased surface roughness, crack development, marginal breakdown, release of metallic ions, and decreases in tooth-to-restoration bond strength. Such findings have not appeared in clinical reports or studies.

Factors affecting tooth whitening

noreply@blogger.com (Unknown) — Tue, 24 Jan 2012 21:46:00 +0000

Type of bleach

The majority of contemporary tooth whitening studies involve the use of either hydrogen peroxide or carbamide peroxide. This latter material is an adduct of urea and hydrogen peroxide which on contact with water breaks down to urea and hydrogen peroxide. For example, a 10% (w/w) carbamide peroxide gel would yield a maximum of 3.6% (w/w) hydrogen peroxide. In general, the efficacy of hydrogen peroxide containing products are approximately the same when compared with carbamide peroxide containing products with equivalent or similar hydrogen peroxide content and delivered using similar format and formulations, either tested in vitro or in vivo.
For example, Nathoo et al. demonstrated in a clinical study that a once a day application of either a 25% carbamide peroxide gel or a 8.7% hydrogen peroxide gel both gave a statistically significant tooth shade lightening after 2 weeks use compared to baseline, but found no statistically significant differences between products. An alternative source of hydrogen peroxide is sodium percarbonate and this has been used in a silicone polymer

containing product that is painted onto the teeth forming a durable film for overnight bleaching procedures. The peroxide is slowly released for up to 4 h and gave significant tooth colour improvement after 2 weeks versus baseline. However, the relative clinical or in vitro efficacy of sodium percarbonate versus hydrogen peroxide tested in the same product format and conditions has not been reported. A tooth bleaching system based on sodium chlorite

applied to the tooth surface and activated under acidic conditions has been described in the literature, however, no efficacy data has been reported to date. Similarly, other potential vital tooth bleaching systems have been outlined in the literature with limited supporting evidence for their efficacy. These include sodium perborate, peroxymonosulphate, peroxide plus metal catalysts and oxireductase enzymes. The long-term acceptability and relative efficacy of these alternative tooth bleaching systems requires significant further research.

Concentration and time

Two of the key factors in determining overall tooth whitening efficacy from peroxide containing products are the concentration of the peroxide and duration of application. For example, Sulieman et al. compared the in vitro tooth bleaching efficacy of gels containing 5–35% hydrogen peroxide and found that the higher the concentration, the lower the number of gel applications required to produce uniform bleaching. Similar results were found by Leonard et al. who compared the in vitro tooth bleaching efficacy of 5%, 10% and 16% carbamide peroxide gels and found the whitening was initially faster for the 16% and 10% than the 5% concentration. However, the efficacy of the 5% approached the higher concentrations when the treatment time was extended. In a clinical study using custom made bleaching trays, Kihn et al.

showed that a 15% carbamide peroxide gel gave significantly more tooth whitening than a 10% carbamide gel after 2 weeks use. This result was confirmed in another clinical study

reported by Matis et al. However, in this latter study, by extending treatment time to 6 weeks, the differences in tooth lightness were no longer of statistical significance. The initial faster rate of bleaching for higher concentrations of carbamide peroxide has also been observed when bleaching tetracycline stained teeth in vivo over a 6 months period.85systems. Typically, an image of the anterior teeth is captured under controlled lighting conditions by a digital camera together with suitable calibration tiles or standards and then subsequently analysed via computer software to determine the colour of the individual teeth, often expressing them in terms of CIE Lab values. For example, after 14 days use of a 10% carbamide peroxide tray-based system, the mean change from baseline in L* and b* were 2.07 and 1.67,

respectively.

Heat and light

The rate of chemical reactions can be increased by increasing the temperature, where a 8C rise can double the rate of reaction. The use of high-intensity light, for raising the temperature of the hydrogen peroxide and accelerating the rate of chemical bleaching of teeth was reported in 1918 by Abbot.Other approaches for heating the peroxide have historically been described to accelerate tooth bleaching, such as heated dental instruments.However, excessive heating

can cause irreversible damage to the dental pulp.Contemporary approaches and literature has focussed on accelerating peroxide bleaching with simultaneous illumination of the anterior teeth with various sources having a range of wavelengths and spectral power, for examples, halogen curing lights, plasma arc lamps, lasers and light-emitting diodes. For some light sources, significant increases in pulpal temperatures have been measured using in vitro models during tooth bleaching.The light source can activate peroxide to accelerate the chemical redox reactions of the bleaching process. In addition, it has been speculated that

the light source can energise the tooth stain to aid the overall acceleration of the bleaching process. Some products that are used in light activated bleaching procedures contain

ingredients that claim to aid the energy transfer from the light to the peroxide gel and are often coloured materials, for examples, carotene and manganese sulphate. Case studies have demonstrated the efficacy of light activated peroxide tooth bleaching systems. However, the literature evidence from in vitro and clinical studies for the actual effect of light on tooth bleaching versus a suitable non-light control is limited and controversial. An in vitro study using naturally coloured extracted human teeth showed that the application of various light sources significantly improved the whitening efficacy of some bleach materials, but not for others. Other in vitro studies have clearly shown significant tooth whitening benefits for peroxide plus light versus suitable control conditions However, these studies artificially stained the tooth specimens with, for examples, black tea, coffee, tobacco and red wine, i.e. ingredients commonly found to promote extrinsic stains. These chromophores are likely to be different to that which may be found naturally inside the tooth. Tavares et al. conducted a tooth whitening clinical study to compare 15% hydrogen peroxide gel illuminated with a gas plasma light source versus 15% peroxide alone versus placebo gel plus light, all treatments lasting 1 h. The change in Vita shade from baseline for peroxide plus light, peroxide alone and placebo plus light were 8.35, 5.88 and 4.93, respectively, with peroxide plus light being significantly different to the other two groups. In contrast, Hein et al.demonstrated no additional effect of any of the three light sources tested over the bleaching gel alone for three commercial products in asplit mouth clinical design. Thus, further work is clearly required in order to unequivocally demonstrate the additional efficacy benefit of light activated tooth whitening systems

versus their non-light activated controls.

Various teeth bleaching products

noreply@blogger.com (Unknown) — Tue, 24 Jan 2012 21:33:00 +0000

The increase in the number of over-the-counter products that claim to have "tooth bleaching" properties, and the emergence of new treatment methods directly available to the public, give rise to a number of questions.

COSMETIC PRODUCTS

cosmetic product’ shall mean any substance or preparation intended to be placed in contact with the various external parts of the human body (epidermis, hair system, nails, lips and external genital organs) or with the teeth and the mucous membranes of the oral cavity with a view exclusively or mainly to cleaning them, perfuming them, changing their appearance and/or correcting body odours and/or protecting them or keeping them in good condition.

This definition, given in the European Council Cosmetics Directive 76/768/EEC, equates with the claims of a range of tooth bleaching products. The Directive defines the composition, labelling and packaging regulations applicable to cosmetics, and very clearly distinguishes cosmetics from medical devices.

Annex III of the Directive provides the “list of substances that cosmetic products, It is these rules that the United Kingdom puts forward to forbid the importation, selling or distribution on its market of any products that contain or may release, must not contain except subject to the restrictions and conditions laid down” for each category of product. The list includes "hydrogen peroxide, and other compounds or mixtures that release hydrogen peroxide, including carbamide peroxide and zinc peroxide”. The maximum hydrogen peroxide concentration currently authorised for cosmetics is "0.1% of H_{2O2, present or released"}. There are no requirements for specific conditions for use or particular warnings to be printed on the label. more than 0.1% hydrogen peroxide, which the UK refuses to recognise as medical devices. However, the local authorities (Department of Trade and Industry, Department of Health) seek amendments to Directive 76/768/EEC so that British practitioners may meet their patients' demands (Morris, 2003).

Cosmetic products

As for the few products that do contain a bleaching agent, the limited active compound concentrations imposed by law make their therapeutic efficacy questionable. It is impossible from the documentation provided to have a clear view on this matter, as there are always many significant biases (patient selection criteria, absence of test group, objectivity of measures...).
that claim to have tooth-whitening properties, including certain toothpastes (Table 5), rarely contain hydrogen peroxide or one of its precursors, or even for that matter any other kind of bleaching agent. Their main whitening effect results from the action of the abrasive elements they contain, which remove superficial extrinsic stains. Some manufacturers take the precaution of reassuring their customers on the safety of their products and insist on their low abrasiveness. Unfortunately, this point is difficult to prove from the various documents available, as the abrasive power of the products in question is rarely indicated. "New generation" toothpastes do however seem to contain cleaning agents that do not increase their abrasiveness. Nevertheless, in view of the lack of information available, it is advisable to use these toothpastes in alternation with less abrasive ones, as the regular use of a highly abrasive toothpaste may cause a roughening of the tooth surface that will encourage the deposition of new pigments (Clergeau-Guérithault et al., 2002).

Get the Facts on Teeth bleaching

noreply@blogger.com (Unknown) — Mon, 23 Jan 2012 05:05:00 +0000

We all want a whiter smile, and today, it can be accomplished safely, quickly, and effectively. While tooth whitening is the quickest and most cost-effective way of improving a healthy smile, there are so many options available for getting teeth their whitest, that it can be confusing to choose the best method.

The Basics
The most important and first step in any whitening procedure is to seek the advice of an oral health care professional for a thorough examination, assessment, and recommendation. A visit with your dental hygienist will result in the whitest teeth possible by making sure your teeth and mouth are healthy and that any oral health problems are addressed before you begin a whitening program.Additionally, surface stains and deposits that have collected on the teeth will be removed allowing for the best possible whitening. Finally, your dental hygienist will advise you of strategies that will help you maintain your new whiter smile once you have it. Basic tooth whitening involves two different types of whitening techniques: peroxide-based whitening and non-peroxidebased surface stain removal. Peroxide-based whitening products work deep within the tooth to remove discoloration resulting from years of accumulated stain and aging. In addition, peroxidebased products will slightly lighten hardto- reach surface stains.When the peroxide agent contacts the teeth it breaks down, and the resulting oxidation action “dissolves” internal and surface stains and makes the teeth appear whiter and brighter.

Professional Treatment Options
There are two types of professional whitening procedures your oral health professional can recommend—in-office treatments and professional whitening products for use at home. Professionally applied inoffice procedures give you immediately visible results with few negative side effects. With this type of treatment, the whitening agent is applied carefully to your teeth by the oral health professional and may be enhanced with a light or laser source.With
this type of procedure, your smile can be whitened up to five shades or more in as little
as one hour. Professionally dispensed options for home use also include specially designed
trays that are custom-fitted to your mouth and are worn for a certain amount of time during the day or overnight. These will whiten your teeth up to six shades or more over time in as few as two weeks. Either method—in-office procedures, or a professional product used at home—can
provide optimal whitening. The oral health care professional’s recommendation about which method is right for you will depend on your personal needs, such as time, cost, and the type of fillings or dental work, including tooth colored fillings or crowns you have. Those with tooth colored dental work in the front of the mouth need professional advice prior to whitening since
only natural teeth respond to whitening agents. Your dental hygienist will discuss options to provide uniform whitening for the best possible result.

Over-the-Counter Options
There are a variety of over-the-counter (OTC) peroxide-based products available and you may be tempted to use them to speed up the process. However, many of these product especially those advertised on television or over the Internet—are not safe, reliable, or effective. Some products may be runny or acidic and may be swallowed easily, or may damage your tooth enamel. Others use unproven means to deliver the whitening substance with uncomfortable, universal “boil-and-bite” mouth trays. Many of these products have not undergone the vigorous testing of professionally dispensed products. Other OTC peroxide-based products, such as whitening strips and paint-on solutions are safe for maintaining professionally delivered results or if you want to see if whitening is right for you; however, these products will not achieve the dramatic improvement available with professional options and should not be used if you have
tooth colored fillings that can be seen when you smile. In addition to procedures and products
designed specifically to whiten teeth, manufacturers have responded to the almost universal desire to have a whiter smile by including whitening agents in everyday products like toothpaste, floss, toothbrushes, and chewing gum. These may be useful for maintaining professionally whitened teeth and work by removing slight surface stains through physical-mechanical action, not unlike cleaning any surface with a cleaning agent. However, the shade improvement will be far less dramatic than with peroxidebased, professionally administered and supervised services.

A Final Word
Tooth whitening will continue to provide an excellent safe and cost-effective way to improve your smile. Your oral health care professional is pivotal in determining which teeth will whiten and the best product for your individual needs. Most important to having an attractive and healthy smile: See your dental hygienist on a regular basis to maintain your newly whitened smile and to maximize your oral health. Your dental hygienist will advise you on the best way to maintain your oral health as part of your total health, enhance your teeth cosmetically, keep your breath fresh, and assure a lifelong healthy smile.

teeth bleaching

noreply@blogger.com (Unknown) — Sun, 22 Jan 2012 23:00:00 +0000

Dental bleaching, also known as tooth whitening, is a common procedure in general dentistry but most especially in the field of cosmetic dentistry. A child's deciduous teeth are generally whiter than the adult teeth that follow. As a person ages the adult teeth often become darker due to changes in the mineral structure of the tooth, as the enamel becomes less porous. Teeth can also become stained by bacterial pigments, foodstuffs and tobacco. Certain antibiotic medications (like tetracycline) can also cause teeth stains or a reduction in the brilliance of the enamel.

There are many methods to whiten teeth:bleaching strips, bleaching pen, bleaching gel, laser bleaching, and natural bleaching. Dentures can also be whitened using denture cleaners Traditionally, at-home whitening involves applying bleaching gel to the teeth using thin guard trays. At-home whitening can also be done by applying small strips that go over the front teeth. Oxidizing agents such as carbamide peroxide are used to lighten the shade of the tooth. The oxidizing agent penetrates the porosities in the rod-like crystal structure of enamel and oxidizes interprismatic stain deposits; over a period of time, the dentin layer, lying underneath the enamel, is also bleached. Power bleaching uses light energy to accelerate the process of bleaching in a dental office. The effects of bleaching can last for several months, but may vary depending on the lifestyle of the patient. Factors that decrease whitening include smoking and the ingestion of dark colored liquids like coffee, tea and red wine.

Internal staining of dentine can discolor the teeth from inside out. Internal bleaching can remedy this. If heavy staining or tetracycline damage is present on a patient's teeth, and whitening is ineffective, there are other methods of whitening teeth. Bonding, when a thin coating of composite material is applied to the front of a person's teeth and then cured with a blue light can be performed to mask the staining. A veneer can also mask tooth discoloration.

What is teeth bleaching ?

noreply@blogger.com (Unknown) — Sun, 22 Jan 2012 22:51:00 +0000

Teeth whitening is a highly effective way of lightening the natural colour of your teeth without removing any of the tooth surface.
Why whiten my teeth?
White teeth look great- attractive, youthful and clean. Few people have naturally white teeth, and teeth can become darker with age. Smoking and drinks such as tea, coffee and red wine will also progressively darken the teeth.
What does teeth whitening involve?
Teeth whitening is a bleaching process that lightens discoloration and removes stains from within the enamel of the teeth. During your consultation the procedure will be discussed with you to determine if tooth whitening is suitable in your case. Teeth whitening does not affect the colour of artificial teeth, crowns, veneers or fillings.
An impression of your teeth is taken with a dental compound. This is used to make thin, clear trays, which fit snugly over your teeth. You are given syringes of gel that contain a 15% carbamide peroxide bleaching agent. You simply place some of the gel in the tray and fit it over your teeth for a few hours daily for one to three weeks. You need to wear the tray for at least three hours each day- or overnight if you prefer. We will see you again to review progress after two weeks.
Is the process safe?
Yes. Research and clinical studies indicate that whitening teeth with carbamide peroxide and/or hydrogen peroxide under the supervision of a dentist is safe for teeth and gums.
How much does it cost?
Teeth whitening at Studental costs £198. This includes: impressions, upper and lower whitening trays, storage case, six syringes of whitening gel (usually enough for about three weeks of whitening if necessary), a follow-up appointment and advice.
How long will my teeth stay whiter?
The effects of whitening normally last for many years, although this will vary from person to person. Inevitably with time the teeth will start to darken again due to drinks and food (and more rapidly if you are a smoker). Most people like to maintain their whitening effect by using the gel for one or two nights every three to six months. Additional syringes of gel can be purchased for £15 each.
Is teeth whitening OK for everyone?
Teeth whitening can only lighten the existing colour of your natural teeth. It will not work on any types of ‘false’ teeth such as crowns, veneers or dentures. These may need replacing if they are stained or are the wrong colour. If you have white fillings, these will not change and may also need to be replaced to match your whitened teeth.
What if I am pregnant?
To date, there has been no testing done on the effects of teeth whitening while pregnant or breast-feeding. To be cautious we recommend that you do not have your teeth whitened during pregnancy.
Are there any side effects?
Most people find that their teeth become sensitive to cold during the treatment. This lessens after a few days, but you may find you need to have a break from whitening for a day or so or use a toothpaste such as “Sensodyne” to reduce the effect. If you have natural white flecks in your enamel these will become more apparent during treatment but will fade following treatment.