DH 32: dental materials Test #4

Terms in this set (193)

-Referred to as power whitening (bleaching)
-Uses higher concentration of hydrogen peroxide 15% - 35%
-Soft tissues and eyes must be protected
--Rubber dam or paint-on resin dam - protect gingiva, tongue and facial mucosa with petroleum based lubricant
-May use bleaching light, resin curing lights, or laser

****Teeth to be whiten using power whitening must be isolated with a rubber dam. Often a light -or heat activated method accelerating the bleaching process is utilized, but their effectiveness has been questioned. When whitening the teeth with a light the patient's eyes are to be protected with appropriate safety glasses. Hydrogen peroxide is applied in a gel form and delivered to the teeth from a syringe, it is activated with heat using a variety of lights. The in-office products contain a chemical that absorbs light and warm the bleaching product. Care must be taken not to damage the pulp of the teeth. In addition teeth should never be anesthetized with local anesthesia because this would prevent the patient from responding if the teeth started to get to warm. Laser whitening uses a laser beam either argon or carbon dioxide after the whitening agent is applied. In addition to activating the whitening agent the laser beam interacts with the dark stains to neutralize them but it becomes less effective in neutralizing stains as the tooth whitens. It is the most rapid method of whitening. Must wear special safety goggles to protect eyes from laser beam. It must be used with more caution than the other lights used in whitening. It increases intrapulpal temperature more rapidly and can cause dental pulp necrosis. Laser should never be used at full power when whitening teeth.
-comes from to tight of tray or from the whitening agent itself
-Tray - trim and scallop tray so that it ends on teeth and not gingiva
-Whitening agent alone treat-with neutral sodium fluoride or potassium nitrate, discontinue treatment
-Light may result in reversible pulpitis
-Free radicals from hydrogen peroxide have been linked to cancer, do not over use or excessively use whitening agents

***Tooth sensitivity and gingival irritation are the most frequently reported side effects of whitening. Both side effects are transient lasting no more than a few days after treatment is discontinued. Gingival irritation may occur when whitening agents come out of the tray and accidently get on the gingival tissue during a power whitening treatment. To prevent use rubber dam or resin dam. With patient applied trays make sure trimmed properly and not to rigid or tight on teeth. Tooth sensitivity is effectively treated by discontinuing treatment. If necessary you may prescribe a fluoride treatment. If you suspect patient may have sensitivity pre-treat with fluoride before beginning whitening process. Potassium nitrate toothpaste two weeks prior during bleaching has been documented as an effective method of preventing sensitivity
During the bleaching process. Any bleaching product using peroxides will produce free radicals. Free radicals have been linked with cancers. With time and abusive usage of bleaching products side effects can be discovered. Patients with risk factors or oral cancer, tobacco and excessive alcohol use should avoid abusing whitening products.
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