This document summarizes dental bleaching procedures. It discusses the causes of tooth discoloration, the history and types of bleaching agents used, and factors that influence bleaching like the type of bleach and concentration. Potential adverse effects are outlined such as tooth sensitivity, gingival irritation, and effects on tooth structure. Contraindications for bleaching like pregnancy, decay, and exposed dentin are also summarized. The document provides an overview of dental bleaching techniques, agents, and considerations.

1. Dental Bleaching
.By
Mina Mwafaq Majeed

2. INTRODUCTION

3. Is one of the most commonly used dental aesthetic clinical
procedures. This treatment offer higher self-stem to patients with
minor consequences to teeth and gingival tissues when it is well
indicated and performed.
Dental bleaching

4. Etiology of tooth discoloration
Patient-Related Causes Dentist-Related causes
A.Extrinsic stain A.Endodontically related
1. Foods and beverages 1. Pulp tissue remnants
2. Tobacco products 2. Intracanal medicaments
3. Chemicals from mouth rinse , toothpaste 3. Obturating materials
B.Intrinsic stain B.Restoration related
1.Pre-eruptive causes 1. Amalgams
a-Systemic disases 2. Pins and posts
b. Medications 3. Composites
c-Endemic fluorosis
2.post eruptive causes
a.Pulp necrosis
b.Intrapulpal haemorrhage
c.clacific metamorphosis
d.Age

5. 1.foods and beverage
Patient-Related Causes
2.Tobaco product
Extrinsic Stain

6. 3. Chemicals from mouth rinse , toothpaste
Patient-Related Causes

7. Patient-Related Causes
Intrinsic stain
1.Pre-eruptive causes
Bluish discoloration due to
Alkaptonuria
Medications
Endemic fluorosis

8. 2.post eruptive causes
Patient-Related causes
Pulp
necrosis
Intra-pulpal haemorrhage
Calcific metamorphosisAge

9. A.Restoration related
Dentist-Related causes
1. Amalgams
2. Composite resin
3. Composites
3. Pins and posts

10. B. Endodontically related
Dentist-Related causes
1.Pulp tissue remnants
2. Intracanal medicaments
3.Obturating materials

11. History of bleaching

12. Bleaching agents
1.Hydrogen peroxide
2.Carbamide peroxide
3.Sodium perborate

13. • It is a colourless liquid with a bitter taste that is highly soluble in
water to give an acidic solution1.Hydrogen peroxide
• Carbamide peroxide (CHIN/20 • H202) is an organic compound containing
hydrogen peroxide and urea2.Carbamide peroxide
• It is stable when it is dry. but in the presence of acid, warm air or water, it
decomposes into sodium metaborate. hydrogen peroxide and nascent oxygen3.Sodium perborate

14. Mechanism of Bleaching

15. Composition Of Commercial Bleaching
Thickening agents: Carbopol (carboxypolymethylene) is the most
commonly used thickening agent in bleaching materials. Its
concentration is usually between 0.5% and 1.5%.
A
Carrier: Glycerin and propylene glycol are the most commonly used
carriers in commercial bleaching agents.B
Surfactant and pigment dispersant: Gels with surfactant or pigment
dispersants may be more effective than those without them.C
Preservative: Methyl, propylparaben, and sodium benzoate are
commonly used as preservative substances. They have the ability to
prevent bacterial growth in bleaching materials.
D
Flavoring: Flavorings are substances used to improve the taste and the
consumer acceptance of bleaching products.E

16. Factors influencing tooth whitening
Types of bleach
Heat and light
Concentration and time of bleaching agent
Other factors

17. 1. Vital tooth bleaching
a) Thermo / photo bleaching (In-office treatment)
b) Mouth guard bleaching (Home bleaching)
2. Non-vital tooth bleaching
a) Thermocatalytic techniques (In-office bleaching)
b) Walking bleach technique
c) Laser- activated bleaching
Type of bleaching technique

18. a) Thermo / photo bleaching (In-office treatment)
Vital tooth bleaching

19. b) Mouth guard bleaching (Home-bleaching)
Vital tooth bleaching

20. a)In-office Non-vital tooth bleaching
Non-vital tooth bleaching

21. b)Walking bleach technique
Non-Vital tooth bleaching

22. b-1. Opalescence Endo
Non-Vital tooth bleaching

23. c) Laser-activated bleaching
Non-Vital tooth bleaching

24. 1.Tooth sensitivity
2.External cervical root resorption
Adverse effect of bleaching

25. 3.Gingival irritation
4.Chemical burns
Adverse effect of bleaching

26. 5-Effects on tooth structure
a)Effects on enamel structure
a-1.Surface texture
Adverse effect of bleaching

27. a-2.Mechanical and chemical properties
Adverse effect of bleaching

28. b)Effects on dentine structure
b-1.Surface texture
b-2.Mechanical and chemical
properties
Adverse effect of bleaching

29. a)Effects of bleaching agent on
sealing ability of composite
restorations
b)Effects on bond strength of
composite resin restoration to
tooth structure
Effects on composite resin restoration

30. Tooth whitening for the under-18- year old patient

31. Contra-indication
 Patients’ high expectations.
 Pregnancy

32. Contra-indication
 Decay and periapical lesions

33. Contra-indication
 Sensitivity, cracks and exposed dentine.

34. Contra-indication
 Existing crowns or large restorations in the smile zone.

35. Contra-indication
 Elderly patients with visible recession and yellow roots

36. Thank