Tooth bleaching

Tooth bleaching can often be accomplished on natural teeth. Discoloration of the teeth can occur during formation of the teeth due to the taking of tetracycline during the ages of 3 to 12, too much flouride in the food or water during the same ages, or congenital factors. Teeth also naturally turn darker as we age. Bleaching works best when the discoloration is uniform on the teeth (all the teeth are equally affected and the discolation is not blotchy or in bands). Teeth that are not ammenable to bleaching can be lightened with veneers if the teeth are otherwise in good condition. Since crowns cannot be lightened, it is inadvisable to bleach teeth adjacent to crowns that match the discolored teeth since they will appear dark next to the bleached teeth.

There are two common methods of bleaching teeth. One can be done by the patient while the other is done in the dentist's office. Both techniques will be discused here.

At-Home Bleaching

The procedure for bleaching the teeth at home still starts in the dentist's office. The dentist must make a carrier for the bleach called a "tray".

Tray being filled with bleaching agent.(17K jpeg)This tray is a clear plastic made from a plaster cast of the teeth. It fits over the teeth with a measured space between the tray and the tooth surface to be bleached. Trays made using "do-it-yourself" kits are inferior because they cannot have this controlled space and the bleaching is less uniform or effective. Poor fit of the tray also can cause irritation of the gums

Tray with bleaching material placed over the teeth.. (13K jpeg)

After the tray is placed in the mouth it is worn two or three hours. Wearing the tray longer than this does not increase the effectiveness of the treatment

Teeth before bleaching. (36K jpeg)

Change will gradually occur over a period of one to two weeks.

Same teeth after bleaching.(18K jpeg)

The speed of bleaching and uniformity of the result varies widely among patients. Once the desired whiteness is acheived, the tray with the bleaching material should continue to be used periodically to maintain the desired effect. Failure to do this usually results in the teeth gradually getting darker again.

In-Office Bleaching

If one individual tooth needs to be bleached to match the others, for faster results, more difficult to bleach teeth or more lasting result, in-office bleaching can be done. During this procedure the teeth are isolated from the gums with a sheet of latex rubber. This is needed because the bleaching agent used in the office is much stronger than the home method bleach and can bleach the gums temporarily if it touches them.

Teeth isolated with a latex rubber dam. (7K jpeg)

Floss is tied around the teeth to help seal the dam.

The teeth are thoroughly cleaned. (9K jpeg)

Afterwords the teeth are conditioned with a mild acid.

The teeth are covered with gauze saturated with the bleaching agent. (7K jpeg)

A special light is shone on the teeeth for a specified interval. (15K jpeg)

Teeth before in-office bleaching. (9k jpeg)

Note the difference between the before and after views.

Teeth after in-office bleaching. (10K jpeg)

Note the difference between the before and after views.

Special thanks to Dr. Anthony Gegauff and Ultradent Inc.for the images on this page.

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