Teeth Whitening

Today, many patients are not satisfied with their teeth color. For this reason, patients often apply to dentistry clinics with a request for whitening. The discolorations that occur on our teeth are divided into two groups: internal and external discolorations. While internal discolorations occur due to antibiotic use, trauma to the tooth, hereditary diseases and genetic factors, external discolorations occur due to excessive tea and coffee consumption, smoking, and consumption of foods and beverages containing coloring agents. At the same time, yellowing of the tooth color occurs with aging.

In the treatment of tooth discoloration, first of all, a detailed clinical and radiological examination should be performed, a detailed anamnesis should be taken from the patient and the cause of the discoloration should be determined. In the treatment of tooth discoloration, there are polishing/waxing, whitening and aesthetic restoration options. Before all whitening treatments, polishing, that is, the polishing process, is definitely applied to remove external stains.

Who can undergo teeth whitening?

Teeth whitening treatment is applied to patients who want to have white teeth, in cases of yellow-brown stains, yellowing of teeth due to aging, mild and moderate tetracycline (antibiotic use) discoloration, and in cases where the tooth color needs to be lightened before aesthetic restoration.

Whitening treatment is not applied in cases of poor oral hygiene, insufficient dental tissue, allergy and sensitivity to the whitening agent, gray coloration, lack of cooperation, metal coloration resulting from amalgam fillings, and in women who are pregnant or breastfeeding.

What are the whitening methods?

Whitening methods are divided into two as vital and nonvital teeth whitening. Methods performed on vital teeth are divided into three as office type, home type and over-the-counter products whitening.

Office Type Whitening

Office type whitening is a type of whitening performed in a dental clinic under the supervision of a physician using high concentrations of hydrogen peroxide and carbamide peroxide. In office type whitening, chemical or light-activated agents are used. Before whitening, the color of the teeth is determined with the help of a color scale. Then, external discolorations and additions on the tooth surface are removed with the help of a fluoride-free paste. Mouth retractors, cotton pads or rubber dams are used to protect the cheeks, tongue and gums. In order to prevent the whitening agent from leaking to the gum edges, the gingival barrier is applied and polymerized by following the gum edge. The whitening agent is left on the teeth for the recommended period of time in accordance with the manufacturer’s recommendations and then washed off the teeth. The color determination process is performed again with the color scale and the effectiveness of the whitening is evaluated. In order to evaluate the whitening more effectively, the beginning and end photographs should be taken.

Home Whitening

It is a whitening method in which agents containing low concentration carbamide peroxide are placed in a special tray by the patient and applied by the patient at home. For home-type whitening, a whitening tray is prepared by taking measurements from the patient. Before the tray is delivered to the patient, it must be tried in the mouth and its compatibility must be checked. Home-type whitening is usually performed for 7-14 days, depending on the duration and concentration.

Over the Counter Products

These types of products are products such as whitening toothpaste, whitening mouthwashes, whitening toothbrushes and flosses, whitening strip bands and whitening pre-made tray gels that patients use without the supervision of a physician. Even if these types of products contain low-dose bleaching agents, they can cause permanent sensitivity in long-term and unconscious use. Therefore, it is better to use them with the knowledge and recommendations of the dentist.

The bleaching applied to devital or non-living teeth is applied to teeth that have changed color as a result of root canal treatment. Sodium perborate, hydrogen peroxide and carbamide peroxide are used in this bleaching technique. Before the treatment, a periapical film is taken from the patient’s relevant tooth and the root canal treatment is evaluated. After the root canal filling material is lowered to 3 mm apical to the cement-enamel border and covered with glass ionomer cement, the bleaching gel is applied and the color changes are monitored by changing the gel at 3-5 day intervals.

Are there any side effects of whitening treatment?

Temporary sensitivity may be observed in teeth after whitening treatment. In its treatment, desensitizing agents containing sodium fluoride, potassium nitrate, pastes containing casein phosphopeptide amorphous calcium phosphate and non-steroidal anti-inflammatory drugs can be used. When the whitening gel touches the gums and cheeks, it may cause a white color change. However, the effect is temporary after the affected area is washed with plenty of water and vitamin E is applied.

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