IN OFFICE DENTAL WHITENING PROCEDURES
Cleaning of the teeth or scaling
Dental scaling and polishing done to remove tartar and any surface stain a few days before whitening procedure is an important first step. We do not want bleeding gum after heavy scaling to disturb the bleaching procedure. After waiting a few days, teeth are generally clean and gum is healthy for this procedure. Even if you are not planning for cosmetic whitening, healthy gum is a must have for good dental health.
At this stage, you may want to start using desensitizing toothpaste at home. Temporary sensitivity is a common side effect of whitening. Using desensitizing product before the procedure may help make the procedure more comfortable. Sometimes, non steroidal anti-inflamatory drug is taken to reduce post treatment sensitivity.
Touch up cleaning
When patient come for the whitening session, some touch up cleaning to remove plaque or new stain before starting will be done. Bleaching agent work by being in direct contact with tooth surface.
Determining pre bleaching shade
A shade guide is used to determine your dental shade before starting. The shade is recorded in your notes. It is also common for photos to be taken to record pre bleaching shade
As bleaching agents are peroxide based, they are caustic in nature. Therefore, the 20 front teeth that will be whiten will be isolated. The few things that are used in doing this are
i.Liquid dam- This is a type of gel in a syringe, applied around your gum margin. Once applied, a bright light is used to ‘light-cure’ the gel to harden it. Once harden, a hard barrier is formed to protect the gum from any bleaching material that will seep onto the gum.
ii.Lip and cheek retractor- This retractor or plastic guard to pull lips and cheek tissue away so they do not come in contact with bleaching agent. Before putting the retractor on, lip balm or vaselin is applied around the lips to help keep your lips moisturize an comfortable throughout the treatment
iii.Face bib- The face bib is a piece of tissue paper- like barrier to cover skin around your cheek and chin for further protection
iv.Gauze and cotton roll- These are placed strategically between your lips and gum to retract the lips and to soak up saliva that may come in contact with bleaching agent
v.Tinted protective eyewear- It is always good to wear a protective eyewear for any dental procedure. This is no different since caustic material bright light will be used.
Application of whitening agent
After all protective barrier are in place, bleaching agent is placed on dried tooth surface. They may be in gel form or powder and liquid form. Sufficient amount is used to cover surface of teeth to be whiten.
Activation of whitening agent
Most proprietory brands of whitening agent has its protocol for activation. The most common type being use of a source of bright light to increase bleaching agent effectiveness. Some brands in the market do not need to use a bleaching light.
Reapplication of bleaching agent
Bleaching agent are left in place to work for 5 to 15 minutes each time before being removed and new layer of agent are applied. This is repeated 3 to 5 times
Thoughout this duration of time, patient’s mouth is kept dry as dental nurse will carefully suction away saliva
Ending of whitening session
To wrap up the whitening session, all agents are suctioned and wiped off tooth surface. All protective barrier removed and patient is to rinse.
Determining post bleaching shade
The same shade guide is used to record post bleaching shade so as to compare between before and after treatment.
Post treatment fluoride therapy
A layer of high concentration fluoride gel is applied all over teeth surface. This therapy help to remineralised teeth surface and reduce sensitivity. This gel is left there for a few minutes and patient is advised not to rinse or eat for half an hour.
Follow up review and maintainance
Choose a whitening package that come with home whitening maintainance kit so you can use it whenever there is slight relapse in shade. The whiter shade will not last forever. It may last from 6 months to 2 years. The range for this time is wide because the relapse in shade is gradual and dependant also on patients maintaince care and diet intake.