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-inflammatory drug is taken to reduce post treatment sensitivity.
Touch up cleaning
- When patients come for the whitening session, some touch up cleaning to remove plaque or new stains will be done before starting. Bleaching agents work by being in direct contact with tooth surface.
Checking pre-bleaching colour shade
Determining pre-bleaching shade
- Before starting, your dental shade is determined using a shade guide. 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 whitened will be isolated. The few things that are used in doing this are
- Liquid dam - This is a type of gel in a syringe, applied around your gum margins. Once applied, a bright light is used to 'light-cure' the gel to harden it. Once hardened, a hard barrier is formed, protecting the gum from any bleaching material that will seep onto the gum.
- Lip and cheek retractor - This retractor or plastic guard is to pull lips and cheek tissue away to not expose them to the bleaching agent. Before putting the retractor on, lip balm or Vaseline is applied around the lips to help keep your lips moisturised and comfortable throughout the treatment
- Face bib - The face bib is a piece of tissue paper- like barrier to cover skin around your cheek and chin for further protection
- 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 the bleaching agent; and
- Tinted protective eyewear - It is always good to wear a protective eyewear for any dental procedure. This is no different since bright light will be used for steps in the procedure.
Applying the whitening agent
Application of whitening agent
- After all protective barrier are in place, bleaching agent is placed onto dried tooth surface. They may be in gel, or powder-and-liquid form. Sufficient amount is used to cover surface of the teeth to be whitened.
Activating the whitening agent with special light
Activation of whitening agent
- Most proprietary brands of whitening agents have their own protocol for activation. The most common type via the use of a source of bright light to increase effectiveness of the bleaching agent. 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 is applied. This step is repeated 3 to 5 times.
- Thoughout this duration of time, patient's mouth is kept dry, as a dental nurse will carefully suction away saliva
Ending of whitening session
- To wrap up the whitening session, all agents are suctioned and wiped off the surface of the tooth. All protective barrier are removed and the patient is to rinse.
Checking the results after teeth whitening
Determining post bleaching shade
- The same shade guide is used to record post-bleaching shade 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 remineralize 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.
Making sure your teeth is well taken care of
Follow up review and maintenance
- Choose a whitening package that comes with home whitening maintenance 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 it depends on patients maintaining care and diet intake as well.
Article written and contributed by:
Dr. Yap Li Ling - DDS (UKM), MFDS RCSEd (UK)