BLEACHING

BY:
DR. ZAWARA MARIAM

BLEACHING
DEFINTION:The

lightening of the color of the tooth through the

application of a chemical agent to oxidize the organic
pigmentation in the tooth is referred to as bleaching.

CLASSIFICATION:VITAL

IN-OFFICE

NON-VITAL

NIGHT GAURD IN-OFFICE WALKING BLEACH

TECHNIQUE

NON- VITAL BLEACHING

This technique describes the bleaching of teeth that

have become discolored by the diffusion into the

dentinal tubules of hemoglobin breakdown products
from necrotic pulp tissues
INDICATIONS:1)
Discolored non-vital teeth
2) Well condensed GP root filling
3)
No clinical or radio graphical signs of periapical disease
CONTRA INDICATIONS:1.
Heavily restored tooth
2.
Staining due to amalgam

PROCEDURE
Place rubber dam to isolate

the teeth
Clean the teeth with
pumice
Remove coronal
restoration and pulp
chamber restoration
Remove root filling
12mm apical of the clinical
crown
Place RMGIC liner to seal
the GP

Blend sterile saline with

sodium perborate and fill

the pulp chamber within
2mm of cavosurface margin
Blot the mixture with
cotton pellet
Place temporary sealing
material
Area must remain isolated
to evaluate the adequacy of
the seal for 5 min
Remove rubber dam

Replace the sodium

perborate dressing
weekly
After successful
bleaching place 2mm of
Ca(OH)2 and cavit
2 weeks later remove
cavit and Ca(OH)2
Restore the tooth with
composite

VITAL BLEACHING:- In-Office

This technique involves the external application of

hydrogen peroxide to the surface of tooth followed by

its activation with a heat source.
Indications:

very mild tetracycline staining without obvious banding

Mild flourosis
Yellowing due to ageing
Single teeth with sclerosed pulp chamber and canals

PROCEDURE: IN-OFFICE
Place Vaseline on lips and gingival tissues
Isolate the teeth with rubber dam
Maintain adequate seal by ligation of dam

with waxed dental tape.

Apply the H2O2 containing paste/gel on
the teeth
Halogen light to generate heat to
accelerate the oxidation
Rinse the teeth and remove the rubber
dam
Treatment done weekly for 2-6 weeks

VITAL BLEACHING:-Night gaurd

This technique involves the daily placement of carbamide

peroxide gel into a custom fitted tray of either the upper

or lower jaw
Indications:

Mild flourosis
Moderate flourosis as adjunct to hydrochloric acid
Yellowing due to ageing

Reaction:

Carbamide peroxide(10%) breaks down to form H2O2 (3%) and

urea(7%)
Urea and H2O2 due to their low MW diffuse through enamel and
dentine

TECHNIQUE
Take an alginate impression and make

working model
Make a splint and instruct patient on
how to apply gel into the mouth guard
and after insertion wiping out of excess
material
Worn at night and remove in the
morning
Clean the splint with brush and store it
in container
After 2 weeks check that the patient is
comfortable.

THANKYOU FOR YOUR PATIENCE