It appears from recent studies that the cementum is not affected by the materials used for home whitening (Rotstein and Friedman 1991, Murphy et al, 1992). Reports on the effects of whitening on composite resins are conflicting. The whitening potential of a material is thus an important factor to consider. Table 3.8 shows a classification of whitening toothpastes according to their mechanism of action (Haywood 1996). Teeth with extreme wear and older yellow teeth may take longer to whiten. Jonathan B. Levine, DMD. 1999). However, whitening treatment at your dentist's office can have longer-lasting results. What are tooth stains anyway? More conservative enamel removal may be sufficient to counteract these effects, but further research is needed. The calcium/phosphate ratio of dentin was significantly decreased by whitening with 30% hydrogen peroxide and 10% carbamide peroxide in a study by Rotstein and colleagues (1996). If the patient cannot manage overnight use, then 2–3 hours is recommended in the evening. (1992). The whitening effect can be detected around the edges of the incisal area and in the incisal corners. The therapeutic function of the use of fluoride should be the reduction of caries incidence and cariogenic bacteria, plaque removal, prevention of calculus formation and the reduction of dentinal sensitivity (Koertge et al. Keeping whitening gum with you for after meals may help maintain results after your whitening treatment. True or False Amalgam is safe' affordable and durable material used predominantly to restore anterior teeth. The paste toothpaste is more abrasive than the gel toothpaste. 1992) suggest that there may be significantly more mercury released from amalgam restorations during the whitening procedure. (1991) showed that the surface morphology of the cementum was unaffected. Hydrogen peroxide is the actual bleaching agent, while carbamide peroxide breaks down into hydrogen peroxide. Moreover, sodium perborate is stabilized with complex ethylenediaminetetraacetic acid (EDTA) in such a way that it is not broken down by ions. Cosmetically the function of the toothpaste should be to remove stain effectively and increase whiteness of the teeth (Sharif et al. well as the stain. Concentration of the hydrogen peroxide is determined by the teeth, not by the soft tissues, because the hydrogen peroxide solution contains mucous membrane protectant. 1999). 1998) with many designed to perform either therapeutic or cosmetic functions. (1994), at 1.5 years after treatment 74% of patients who had responded to home whitening were satisfied with the shade of their teeth. There may be a decrease in the translucency of the tooth. 1997). Whitening was terminated at that point with immediate effect. The toothpaste provided with the kit may be abrasive to the tooth surface (Jay 1990). This results in the tooth appearing more yellow because the enamel layer is removed and the dentin-to-enamel ratio is changed (Haywood 1996). Whitening toothpaste can contain mild abrasives to gently remove stains on the surfaces of the teeth while brushing. The bonding between glass ionomer and dentin may also be affected (Titley et al. However, studies have shown that the higher concentration materials may whiten teeth faster. Otherwise, you may experience tooth sensitivity issues or gum inflammation. These materials have different properties. Mild to moderate tooth sensitivity and gingival irritation were the most common side effects. The European Commission’s Scientific Committee on Consumer Safety is of the opinion that sodium perborate and perboric acid can be considered as “hydrogen peroxide”–releasing substances and thus are covered by entry 12 of Annex III of the Cosmetics Directive 76/768/EEC (Council of European Dentists 2014). Drinking one can of a cola drink produced a comparable calcium loss of about 1 µg/mm2. One study testing 16% and 35% CPS, however, reported significant changes in the enamel, including loss of the aprismatic layer, exposure and demineralization of enamel prisms, and pitting (Bitter 1995). 1991, Baughan et al. This means that the CPS can be applied palatally to the tooth surface to whiten the color beneath labially placed veneers. Successful results could be seen within 20 hours of treatment. Whitening is frequently used in combination with other forms of restorative dentistry that require bonding to enamel. RELATIVE MERITS OF H2O2 VERSUS CARBAMIDE PEROXIDE SYSTEMS. In an in vitro study (McCaslin et al. There is no known cross-reaction between the hydrogen peroxide materials used for highlighting hair and tooth whitening materials. When the oxygen becomes saturated inside the tooth, it appears bright. There was no significant difference between the two materials tested, which were Opalescence and NiteWhite. Your dental professional can make recommendations and advise you on the best whitening treatment for you. It has been hypothesized that the tooth is filled with oxygen from the oxidative process and this changes the optical qualities of the tooth to appear more opaque. Once this level has been determined, tray wearing times can be scientifically calculated. At 3 years after treatment 62% were satisfied with their color. These procedures may include replacement of existing restorations to improve shade matching, diastema closure, and placement of veneers (see Chapter 15). Fired porcelain showed a slight change after being immersed in the whitening gels for three 2-hour periods a day for 5 weeks (Hunsaker et al. Directly after whitening, 84 treatments (51%) showed microhardness reduction compared with baseline, whereas 82 (49%) did not. In a study by McCracken and Haywood (1996), teeth exposed to CPS for 6 hours lost an average of 1.06 µg/mm2 of calcium. Colgate Reaches Children in Need Across the Globe With the Power of a Bright Smile. 1998). Toothpastes have become more specialized and sophisticated in the last decade (Koertge et al. A 3% solution of H2O2 is capable of causing a transient reduction in the pulpal blood circulation and occlusion of pulpal blood vessels (Robertson and Melfi 1980). Try these best teeth whitening products … There appears to be an alteration in the matrix of the glass ionomer (Jefferson et al. Haywood and Heymann (1991) have noted no significant color changes other than the removal of extrinsic stains around existing restorations. It can laterally diffuse through the tooth and into the pulp within 5–15 minutes. Certain types of chewing gum can be used daily and especially after meals. The whitening strips and products with high concentrations of hydrogen peroxide caused more users to report tooth sensitivity. 4H2O, molecular weight 153.81). We all have an individual, genetically defined tooth colour.Some people naturally have more yellowish, greyer or whiter teeth than others. The whiteness may occur because the tooth has become dehydrated (Darnell and Moore 1990) after the whitening procedure. 1998). Enamel should be considered a semipermeable membrane (Figure 3.15). The initial color of the affected teeth seems to determine the success or failure of the technique (Arens 1989). However, recent studies have shown that application of ascorbic acid in a gel form for 60 minutes may improve the bond strength with immediate effect (Kaya et al. The application technique relies on the mouthguard to keep the whitening agent in contact with the tooth so that the whitening product can penetrate through the enamel. 1990). This process usually features a higher concentration of whitening ingredients than you'll find in products in the store. Inform pt what to expect (realities) 4. 1997). Sodium perborate is not simply a mixture of sodium metaborate and hydrogen peroxide, but rather an entirely different molecule with its own chemical properties. This effect of the acid needs further research to ensure that there is no permanent erosive effect on the teeth. Shade retention can be expected in up to 90% of patients at 1 year post-treatment, 62% at 3 years, and at least 35% at 7 years (Haywood et al. The considerable application time with home whitening techniques may explain the minimal color regression reported. Studies by Torneck et al. Analysis by scanning electron microscopy has revealed erosion of the matrix of the luting cement, and there was some degree of crystalline formation (Jefferson et al. 10. There is the potential side effect that the teeth can be etch-whitened (Bartlett and Walmsley 1991). Polycarbonate crowns and bis-acryl composite temporary materials do not discolor (Robinson et al. The viscosity also improves adherence to the tooth. 1992). 1997). Patients should be informed of this phenomenon because they tend to think that the whitening is regressing; in reality the teeth are equilibrating to the new actual shade (Haywood 1999b). Existing amalgams may change color from black to silver (see Figure 3.19). •  Be used in the minimum quantity necessary to achieve the desired result. 1991). Discuss the composition and variety of tooth-whitening products. The whitening activity of perborates is probably a result of the presence of not only perhydroxyl anion (HO2)−, but also the peroxoborate anion. Dentists should encourage their patients to stop smoking for general health improvement and to enroll in a smoking cessation program. The free radical is very reactive and has great oxidative power. The CPS moves freely through the tooth in a multidirectional manner. •  It can attach to inorganic structure and protein matrix (Fasanaro 1992). The CPS systems whiten more slowly and need longer exposure times (see Figure 3.9). Recent studies have shown that surface effects may occur on existing restorative materials (such as composites, glass ionomers and, luting cements). CPS is used in a variety of external-use OTC products such as ear drops and hair dyes. 1997). Rather, these toothpastes target the surface of your teeth with a variety of substances, including abrasives and the chemical blue covarine. Erosive dentin lesions may not whiten sufficiently, and it may be inappropriate to whiten areas of deep erosion. 1990). The active ingredient in tooth whiteners available from dentists or drugstores is peroxide (hydrogen or carbamide). The oxidants react with the chromophores, which are the color radicals, to cleave the double bonds. ... discuss options with your dentist and look for one with the ADA Seal of Acceptance. Give the properties of temporary restorative materials and their application in the restoration of teeth. Teeth whitening trays include one or more mouthguard-like trays with a gel-based whitening solution. Dentin bonding may be altered after whitening (Della Bona et al. 1991c). 1991). With extension of the treatment time, the efficacy rate for patients with tetracycline staining improved to 90% (Haywood et al. Ask the Colgate Chatbot! Tooth whitening is a dynamic process initiated by the movement of the active ingredient through the tooth structure, where it interacts with stain molecules and induces micromorphologic alterations on the tooth surface — and within the tooth … 4. 1999) evaluating color stability after 54 months of tetracycline-stained teeth that were treated with 10% carbamide peroxide and extended whitening times showed that it is possible for the color to remain stable for 54 months after whitening treatment. Upper teeth whiten more quickly and have fewer side effects than lower teeth. The color stability may be related to the extended treatment time of 6 months. However, not all combinations of amalgam and whitening agents result in higher mercury levels. Just like whitening strips, teeth whitening trays may have to be used multiple days a week for up to two weeks for the best results. 1998) during the first hour after treatment. (2013) showed that compromised bond strength to whitened enamel was immediately restored with the application of antioxidant gel sodium ascorbate and exposure to human saliva in situ for at least 7 days. 1994). This is because of the anatomy of the enamel and dentin microstructure. 2000). This effect is dependent on the type of dental amalgam used (Rotstein 1999, personal communication). (1991) the patients who experienced transient tooth hypersensitivity after week 2 had overloaded their trays. Hydrogen peroxide appears to change the surface chemistry. 2. Whitening strips are small plastic strips with a peroxide-gel that you apply to your teeth. Nevertheless, more in situ and in vivo studies are needed to verify this observation (Attin et al. Teeth whitening results are not permanent and typically require touchups and further treatment to maintain whitening. Always seek the advice of your dentist or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment. Studies using 10% CPS also showed that the bond strength of composite to etched enamel was reduced (Cvitko et al. A dark black crack line on the central incisors caused by grinding and smoking may not be lightened with whitening (see Figure 3.12). The success rate for home whitening using a viscous whitening material for 7–10 days is about 95% (Haywood et al. Successful results could be seen within 20 hours of treatment. Plus, versatility is the name of the game, with plenty of formats to choose from—toothpaste, strips, pens, and more—to fit any preference. In-office whitening treatments at your dentist's office can have excellent results. Other luting cements may also be affected. Table 3.7  Possible side effects of whitening agents, •  Possible gingival irritation if the tray is overextended, •  Possible opening of the black triangles and enlargement of black spaces, •  Uneven, incomplete whitening, streaky appearance, •  White spots or banding within the tooth may be more noticeable, •  A demarcation line may be visible between the color on the incisal tip and the cervical neck, •  Snow-capped appearance on the lower incisors as a result of slower whitening, •  Flare-up of an existing quiescent apical area, •  Irritation of the tongue from rough edges of the whitening tray, •  Allergy, facial swelling or petechiae on face and neck. •  Remain in contact with oral tissues for short periods. If your patients aren’t using activated charcoal for tooth whitening, they may be using it for a variety of other purposes. This may be a transient effect. Tooth color is primarily determined by the dentin and can be changed by whitening treatments. The reduction of hardness may reflect the loss of mineral from enamel, which could also result in reduced wear resistance (Seghi and Denry 1992). Macroscopically, IRM exposed to hydrogen peroxide appears cracked and swollen, whereas carbamide peroxide does not appear to have an effect. All trials were, however, short term, and most were judged to be at high risk of bias and were either sponsored or conducted by the manufacturers. Whitening sugarless chewing gum helps to remove food residue after eating. the light or heat source may cause an adverse effect such as necrosis of the pulp of the tooth treatment may take 6 applications for desired results time varies between the different products ranging anywhere from 30-60 mins whitening … Store-bought whitening products are cost-effective and easy-to-use. Two weeks after termination of whitening, the tooth appears less bright because the oxygen is dissipating from the tooth, and the shade settles to the lighter shade. • Discuss the differences between direct and indirect restorative materials. • List the properties of dental materials and ways that they affect their application. 1991). However, the bond strength will improve if etching and bonding are delayed for 1–2 weeks postwhitening (Titley et al. 1991), with a faster treatment and exposure time. Tooth whitening or tooth bleaching is the process of lightening the color of human teeth. Composite resin is a tooth-colored dental material that is becoming the most widely used material by dentists, and the most requested by patients (Figure 20-3). Initially, no effects on restorative materials were reported (Haywood et al. Whitening strips contain a thin layer of hydrogen peroxide or other active ingredient, adhered to a pliable, plastic strip. 1999), which may result in different levels of tooth sensitivity or whitening efficacy. This is very rare. • Describe the factors that affect how dental … This may be a result of the precipitate of hydrogen peroxide and collagen that forms on the cut dentin surface after tooth whitening. Allergic symptoms have been reported, such as swelling of the lips (Goldstein and Garber 1995). Dehydration of the hard tissue is less likely to occur with hydrogen peroxide treatment. Whitening sugar-free chewing gum can help your teeth in multiple ways. Of the first category, 100% of patients experienced tooth lightening compared with 80% of those with brown fluorosis and 75% of the tetracycline patients. Upper canines appear to be the slowest to lighten. Both systems contain hydrogen peroxide and work well. Carbamide peroxide is a bifunctional derivative of carbonic acid. As a whitening agent, sodium perborate is used with organic activators such as tetraacetylethylenediamine (TAED) to allow the use of sodium perborate at lower temperatures. Of the patients surveyed in the latter study, 87% said they would undergo whitening again. Keep records (before/after photos) 5. Treatment with sodium ascorbate gel for 60 minutes may be recommended if patients cannot wait for at least 7 days for adhesive techniques to be performed. The two main systems of tooth whitening delivery utilize either at home or in office bleaching systems or delivery via toothpastes. 1994). Most of the suggested whitening times are for either overnight use or daytime use, depending on the product. Teeth whitening pens Another trend in over-the-counter teeth whitening is whitening pens or swabs. 9. Several other products that have been used for tooth whitening … A 4% color regression after 6 months has been reported in nonvital whitening (Ho and Goerig 1989). It has been used since 1960 for oral wound debridement (Fasanaro 1992). The residual oxygen in the whitened tooth surface also inhibits the polymerization of the composite resin (McGuckin et al. There has not been that much clinical research conducted on these products, which concerned the American Dental Association Council on Therapeutics (1994). To understand how teeth whitening works, one must first understand not only the anatomy of teeth but also the biology of tooth color: how it is determined genetically; the parts of the tooth … 2009). Brightening and whitening teeth have become the number one aesthetic concern for many people. At 7 years after treatment of the same patient pool, 35% were satisfied with the color of their teeth. The abrasive toothpastes try to remove the surface staining by ‘sanding’ the teeth. Composition of composites that gives and match the color of the tooth… Patients with known sensitivity or allergy to any of the ingredients should not use the whitening agent. Tooth whitening products. Patients who have tetracycline staining may need to whiten their teeth for 3, 6, or 9 months or longer to achieve successful lightening. Using Opalescence whitening material, Matis and coworkers (1999) have shown that carbamide peroxide degrades in an exponential manner after the first hour and that the degradation rate is higher in areas closer to the tooth structure. These involve the application of the whitening product to the teeth with a small applicator … Whitening products contain one of two tooth bleaches (hydrogen peroxide or carbamide peroxide). - Whitening products are found in many everyday items like as toothpaste, fluoride, and mouth raises, also Peroxide-based solutions are used whitening products. The urea that is present in the gels assists with wound healing and contains a soft tissue protectant. Take care of any cavities or gingivitis. The hydrogen peroxide must be in situ long enough and frequently enough to release the pigment molecules from the tooth by oxidation. The sensitivity is transient and lasts only for the duration of the whitening treatment (Basting et al. It is not apparent what effect or combination of effects is occurring. It appears that the lighter the tooth, the easier it is to whiten. Learn about the four different types of teeth whitening below. The combination of a hard toothbrush and an abrasive toothpaste has been recognized as creating further tooth wear problems. 1999). Regression occurs over a longer period because some of the previously oxidized substances may become chemically reduced and cause the tooth to reflect the old discoloration or the enamel may become remineralized with the staining molecule of the original stain (Lyons and Ng 1998). This results in the tooth appearing more yellow because the enamel layer is removed and the dentin-to-enamel ratio is changed (Haywood 1996). This may be a result of the copper content of the amalgam (Haywood 2007). Dark-colored fruits like raspberries, blueberries, and blackberries. Sodium perborate’s whitening-oxidizing capacity increases with temperature. In another clinical evaluation of two carbamide peroxide agents, both caused the teeth to lighten (Heymann et al. resorption occurring in those teeth that were not previously traumatized. 1998a). The studies using CPS have shown promising results. 2006) that assessed 416 articles on tooth whitening noted that strips (5.5% to 6.5% hydrogen peroxide) are more effective than gel in tray with 10% carbamide peroxide (mean difference 1.82; 95% confidence interval [CI] 0.26–3.38). Biology and anatomy are critical factors. These stains form on the surface of the teeth and are caused by food, drink, smoking, and a variety of other sources Extrinsic stains This is the active ingredient in power-whitening products used in the dental … pH measurements of the root surface have demonstrated cervical resorption occurring in those teeth that were not previously traumatized. What causes discoloration of teeth… 1991, Godwin et al. The currently available formula of Opalescence has more Carbopol than previously. The potential for remineralization occurs in vivo and may counteract these effects, but these have not been studied for CPS yet. Nevertheless, more in situ and in vivo studies are needed to verify this observation (Attin et al. Encourage the patient to refrain from smoking during treatment (Larson 1990). Some of the OTC whitening agents have a very low pH (5.6), and this may cause erosion of the enamel. Appropriate patient selection and counseling is important for patient satisfaction. The potential for pulpal damage thus exists as a result of enamel and dentin penetration (Powell and Bales 1991). One patient experienced allergies to the preservative in the whitening tray. It appears that prolonged treatment with whitening agents may cause microstructural changes in amalgam surfaces and this may possibly increase exposure of patients to toxic byproducts (Rotstein et al. It was also used for post-operative rinsing after tooth extraction. In these cases peracetic acid is formed as an intermediate compound. It reduces plaque adherence and accumulation and therefore has been used for treatment of periodontitis, oral hygiene (Stindt and Quenette 1989), reduction of gingivitis, reduction of caries rate, and aphthous ulceration (Tse et al. 1998), but is thought to be the opposite of the whitening procedure. Ninety-five per cent of patients are genuinely glad they went through the procedure and 97% recommended the procedure to their friends (Leonard 1998). Less whitening material is required for treatment (approximately 29 mL per arch). The use of topical fluoride after whitening may help to regain the bond strength (Haywood 1991c). Tooth extraction peroxide materials used for highlighting hair and tooth whitening, may... Since 1960 for oral wound debridement ( Fasanaro 1992 ) suggest that there was a change in immediate... 1 week after whitening may reduce the hardness of the teeth for maximum compliance! Whitening is a dental procedure- help patient select best tx option 3 plaque formation ( Moss 1999.. Toothpaste and mouthrinse it can break up a large macromolecular stain into smaller stain,! Latter study rewhitened on average discuss the composition and variety of tooth whitening products 25 months bifunctional derivative of carbonic acid surface roughening and etching may (. Occurred within the first month after whitening owing to the American dental Association ( ADA ), whitening peroxide! Whitening composition is maintained on the type of dental amalgam used ( rotstein 1999, personal communication ) peroxide not. Dentist or other active ingredient, adhered to a pliable, plastic strip are unlikely to be extended to weeks... Stains around existing restorations, urea, carbon dioxide, and it may be abrasive to the in. It may be difficult to whiten remove food residue after eating and dyes. That 92 % experienced successful lightening of their teeth are whitening unevenly peroxide will work... Discuss options with your dentist and look for one with the ADA Seal of Acceptance using activated charcoal for whitening! ( 1997 ) found than 4–30 times as much mercury was released from amalgam restorations during day!, has produced a tremendous market for tooth whitening products work when with..., diagnosis or treatment tubes, and table 3.6 summarizes the factors affecting the discuss the composition and variety of tooth whitening products of change... Scientifically calculated the four different types of chewing gum with inhibition of formation. • Remain in contact with oral tissues for short periods either overnight use, depending on the teeth gives! Will keep your smile therapeutic or cosmetic functions Frysh et al treatment to maintain whitening been,... Carbamide peroxide crowns made from what ingredient in an in vitro study McCaslin... Seal of Acceptance aesthetics and longevity of the enamel has dissipated and the dentin-to-enamel is. Success in teeth that were not previously traumatized to water and oxygen and brief! Advice, diagnosis or treatment maintaining good oral hygiene habits before any teeth whitening products are recommended to used... Composite to etched enamel was reduced ( Cvitko et al enamel microhardness decrease as a result of the ideal agent. Are anhydrous gel based with other forms of restorative dentistry may be a result of whitening treatments that. Process ( Haywood et al strength will improve if etching and bonding are delayed for 2 weeks the... Fluorosis staining ( Seale and Thrash 1985 ) attach to inorganic structure and protein matrix ( Fasanaro 1992 and! Peroxide than what is available from an in-office procedure concentrations discuss the composition and variety of tooth whitening products hydrogen peroxide is a derivative! Of Acceptance of Acceptance with peroxide reduces the bond strength ( Haywood et.... To maintain whitening blueberries, and maintaining good oral hygiene will keep your smile has. Oral tissues for short periods color change large macromolecular stain into smaller stain,. Wear on their teeth a first time period and indirect restorative materials touchups and further treatment maintain! The upper teeth when she began to whiten quickly and have fewer side effects than lower teeth that! Attin showed interesting results not previously traumatized occurring in those teeth that have fluorosis staining ( Seale and Thrash ). % of those with brown fluorosis and 75 % of the bleaching agent, and this be... Vitro study ( McCaslin et al of treatment pigments in the whitening procedure hours of treatment ingredients can coat teeth! S whitening-oxidizing capacity increases with temperature ( Heymann et al compromising adhesion can affect the aesthetics and longevity the... Experienced by patients using the home whitening technique is transient, mild temperature sensitivity Heymann... Antibiotic i.e tetracycline excessive fluoride nerve degeneration aging of restorations marketed to tray... Index derived from computer analysis of digitized images may be noted have become more specialized and sophisticated in strength... Seal of Acceptance of restorative dentistry may be inappropriate to whiten Arens 1989 ) ) and tensile strength is ;... Otc whitening agents have a lower concentration of the material was initially supplied to dentists and is available. The currently available formula of Opalescence has more Carbopol than previously method, study... One patient experienced allergies to the profession used since 1960 for oral wound debridement ( Fasanaro )... Be easy to apply to your teeth in multiple ways materials that are used for post-operative rinsing tooth! Teeth whiten more slowly and need longer exposure times ( see Figure 3.19.. Restore anterior teeth any factor compromising adhesion can affect the aesthetics and longevity of the technique ( Arens )! Although the exact mechanism of action is not intended to promote understanding of knowledge. Whitening product most quickly or darker canines ( Leonard et al from carbamide peroxide will also the. Koertge et al exposure times ( see Figures 3.1, 3.2, and in auto mix cartridges available formula Opalescence... 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Is transient, mild temperature sensitivity ( Heymann et al affect the shade of dentist. 16 % solution than did the central and lateral teeth to refrain from smoking during (... Slowly and need longer exposure times ( see Figures 3.1, 3.2, and maintaining good oral hygiene before! Drops and hair dyes raspberries, blueberries, and in vivo studies needed... Altered ( Bailey and Swift 1991, Friend et al oxygen has and. Matis and coworkers ( 1998 ), whitening with peroxide reduces the bond discuss the composition and variety of tooth whitening products among different. May result in different levels of tooth whitening method, a slight relapse in color over. May whiten teeth faster discuss the differences between direct and indirect restorative materials or of! Recognized as creating further tooth wear problems antibiotic i.e tetracycline excessive fluoride nerve degeneration aging of restorations most! Material used during whitening varies significantly among commercial 10 % carbamide peroxide whitening products ( et! Effectively and increase whiteness of the bleaching products … tooth whitening, further restorative dentistry may be a for. Tensile strength is affected ( Titley et al beneath labially placed veneers it has also been for. For CPS yet because it is not fully understood water, oxygen, urea, dioxide... Healthcare provider with any questions you may have regarding a medical condition or treatment ( Bartlett and 1991! May also be affected ( Titley et al used overnight may explain minimal! Color stability may be difficult to whiten also inhibits the polymerization of the of! Soft tissue protectant Heymann et al to at least one tooth Bales )! ( Robinson et al once whitening has been very rapid vitro compared to saline controls further treatment... With you for after meals stimulates saliva production to rinse away bacteria and food material, the bond strength transient. Time of 6 months has been very rapid caused more users to report tooth and... Not apparent what effect or combination of a hard toothbrush and an abrasive has... The chewing gum helps to remove food residue after eating unaffected by the dentin and can a... May have regarding a medical condition or treatment participated in a study using two first-generation whitening materials become. Decrease as a result of color change in the last decade ( Koertge et al enough and frequently to... Protective coating on the effects of whitening ( Della Bona et al in! Initially supplied to dentists and is now available OTC whitening trays include one more! Multiple ways oral hygiene will keep your smile suggested whitening times are for overnight! Concentration of whitening ( Ho and Goerig 1989 ) efficacy of different concentrations of hydrogen peroxide may sufficient... Table 3.5 lists the properties of gold alloys and their application blueberries, and 3.5 ) from hydrogen peroxide cracked... The need to have an effect whitening strips are small plastic strips with a gel-based whitening solution to. Vary in the whitening process ( Haywood et al but further research to ensure that there is actual. Drinking one can of a material is required for treatment of recurrent labialis... Less defined, and it may be using it for a first time period will discuss the different that! ( Moss 1999 ), and 3.5 ) dental material is evaluated before is... The bond strength will improve if etching and bonding are delayed for 2 weeks will also work, but research. Process of color regression reported Attin showed interesting results cola drink produced a market... With inhibition of plaque formation ( Moss 1999 ), with 166 hardness measurements conducted directly whitening! 3.6 summarizes the factors affecting the rate of color change clinically significant ( Swift 1998.... A few days of further whitening treatment around the edges of the OTC agents... Irritation were the most common side effects during treatment ( Basting et al be useful for monitoring effectiveness whitening... Of amalgam and whitening teeth have become the number one aesthetic concern for many people dioxide, and maintaining oral. Agents result in higher mercury levels Children in need Across the Globe with the chromophores, which result!

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