Can You Whiten Your Teeth

Can You Whiten Your Teeth – Teeth whitening has become one of the most frequently requested dental procedures by the public due to media exposure for the perfect white smile.

. In the late 1980s, several companies introduced both home products and commercial teeth whitening products to the US market. have gained popularity among the masses who have come to demand a whiter, more perfect smile

Can You Whiten Your Teeth

. And now society has come to demand a whiter, more perfect smile, and in response more teeth whitening options have become available. This includes home products such as toothpaste, gels and foils, as well as office systems where products containing highly concentrated whitening agents are applied under professional supervision. The profession and the public are aware of some of the risks associated with teeth whitening, such as tooth sensitivity and gum irritation.

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. New research shows that there are other risks, such as hardening and softening of the tooth surface, greater potential for demineralization, decay of dental restorations, and unacceptable deformation of dental restorations. New research also focuses on optimizing the whitening process to reduce tooth sensitivity and increase whitening consistency.

There are different methods of teeth whitening, each with its own process. The effectiveness of these different methods depends on the specific deformity of the tooth being treated. The causes of tooth decay can be classified into two main groups (see Figure 1):

Factors such as genetics, age (yellowing of teeth due to enamel wear over time), antibiotics, high fluoride levels, and developmental disorders, and may begin before tooth eruption, include intrinsic discoloration, sometimes called intrinsic staining. Some dental restorations can stain the tooth after the tooth has erupted.

External stains, sometimes called extrinsic stains, are mainly caused by environmental factors, including smoking, dyes in drinks and food, antibiotics, and metals such as iron or copper. Coloring compounds from these sources are absorbed into the acquired dentin or directly onto the tooth surface, causing staining. See the picture. 1. For stain examples from this source.

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Note. Examples of exterior painting: a. Smoking B. Wine stains; and G. Food stains Examples of internal color: D. Yellowing with age; e. Corrosion; F. Orthodontic white spot lesion; G. mild fluorosis; h. amalgam recovery; I. Tetracycline stain; J Genetic (amelogenesis imperfecta); K. and non-critical colors.

. It produces substances known to be effective bleaching agents. Bleaching mechanisms include degradation of extracellular matrix and oxidation of chromophores in enamel and dentin. However, hydrogen peroxide has local adverse effects on tooth structure and oral mucosa. The low daily doses used for teeth whitening in the clinical setting do not cause the usual acute and subacute toxic effects. Genotoxicity and carcinogenicity occur only at concentrations never encountered during dental treatment. Some transient adverse effects on the oral mucosa and digestive tract have been reported if the product is swallowed. Local effects on the oral mucosa and dental tissues may occur during whitening such as pulp sensitivity, cervical resorption, selected components of dental restorations and changes in the enamel surface. Most of the local effects depend on the technique and concentration of the products used so far, but since the whitening results obtained are not stable, repeated treatments add negative effects. The decision to use bleaching or not and to control the effects of bleaching should be in the hands of dentists, and certainly not now, since cosmetics are sold without restrictions despite the potential health risks of peroxide.

. Bleaching can be done using a chemical reaction to physically remove stains or lighten the color of teeth

. Bleaching is defined here as the chemical degradation of chromogen. The active ingredient in most bleaching products is hydrogen peroxide (H2O2), supplied as either hydrogen peroxide or carbamide peroxide.

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. Carbamide peroxide is a stable complex that decomposes on contact with water to release hydrogen peroxide. Because carbamide peroxide releases hydrogen peroxide, most teeth whitening chemicals are hydrogen peroxide.

Tooth stains consist of colored or darkly shaded compounds, called chromogens, that accumulate on the teeth (intrinsic) or on the teeth (extrinsic). Chromogens are divided into two classes. Large organic compounds that have double bonds in their chemical structure, as shown in Figure 2A; and metal compounds. Bleaching of organic compounds with hydrogen peroxide involves interaction with double bonds to oxidize the double bond as shown in Figure 2B. This makes the chromogen a light colored compound. Bleaching of metallic compounds is very difficult. Better cosmetic options can be veneers, bonding, or crowns. There are some commercial products that contain sodium hypochlorite (NaOCl), which reacts with the double bond of a chromogen like peroxide, as shown in Figure 2C.

New research shows that aggressive tooth staining can lead to increased tooth sensitivity, changes in tooth microstructure, and restorative changes. Aggressive bleaching can chemically react with composite restorations, glass ionomer cements, sealants and ceramic crowns, thereby reducing their stability.

Note: The chemistry of chromogen bleaching. A. β-Carotene is an example of an organic chromogen that has multiple conjugated double bonds; b Chemical reaction of hydrogen peroxide with the double bond of chromogen. and G. Chemical reaction of sodium hypochlorite with the double bond of chromogen.

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Different products are sold to remove specific stains. Broad categories include: cleaning products, such as smokers’ toothpastes, which contain high amounts of detergents and abrasives that help remove chromogen from the tooth surface; bleaching agents that lighten colors by reacting with chromogens; And both clean and white products are added. More severe or complex blemishes are best treated professionally, while over-the-counter products can be used in mild cases.

. The treatment time required to reach the final stage of tooth whitening depends on the exposure time and the concentration of the whitening compound. This endpoint depends on the type of whitening, typically 1 to 2 shades for cleansers and over-the-counter (OTC) gels and commercially applied products.

There are many teeth whitening systems. The following procedure is according to the American Academy of Cosmetic Dentistry

. This procedure uses a tray containing carbamide peroxide bleaching gel that is applied day or night for 2 to 4 hours.

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. Generally, following the manufacturer’s instructions, teeth whitening will be visible after a few days, lightening the teeth by 1 or 2 shades.

Tray-based teeth whitening products can be made at home under the supervision of a dentist. The most popular whitening method is to use dentist-prescribed carbamide peroxide or hydrogen peroxide in over-the-counter trays.

. The dentist usually advises and monitors the patients and thus prevents possible side effects or adverse events of the bleaching process, including excessive whitening of abnormal colors or darkening of the restoration around the tooth. Two significant challenges remain with home bleaching. Most people can find carbamide peroxide or hydrogen peroxide in non-specialty trays at their local grocer or chemist. They then proceed to whitening using these relatively inexpensive gels and solutions in well-placed trays made by dental providers. In addition, many available whitening products such as gels, strips, dye solutions, gums and other products make it possible for people to bleach excessively.

. The result of these “user-initiated” and “user-whitening” procedures is that the tooth appears too white and the surrounding dental restoration, such as a resin-based composite or tooth-colored crown, appears too dark. Later, home users commonly complain of ill-fitting restorations and often have to replace otherwise acceptable restorations with materials compatible with bleached teeth.

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In agreement with the previously mentioned studies, Night Guard Vital Bleaching using the manufacturer’s recommended 10% carbamide peroxide bleaching solution is effective and safe with minimal side effects. Additionally, at the end of the study, 82% of participants reported long-lasting shadows without side effects.

. The whitening effect lasted for 47 months in 82% of patients, with no side effects reported at the end of the study.

In-office whitening is possible to whiten teeth faster because the product provides a higher concentration of peroxide than over-the-counter (OTC) products. Therefore, the gingival tissues are usually preserved before drug application, but after the procedure tooth sensitivity is normal and tooth color returns relatively quickly.

. Some products claim to increase oxidation of chromogens by exposure to heat or intense blue light of wavelengths between 480 nm and 520 nm to activate the product on the teeth, resulting in a rapid chemical reaction. Some experts use laser systems to speed up chemical reactions. This use of lasers is considered “off-label” use of laser systems in dentistry by the US Food and Drug Administration.

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