This document discusses tooth whitening/bleaching procedures including their history, materials used, and different techniques. It provides an overview of in-office bleaching, night guard bleaching, and non-vital bleaching. In-office bleaching involves applying a 30% carbamide peroxide gel to the tooth surface for 15-20 minutes. Night guard bleaching uses a custom tray and 10-20% carbamide peroxide worn for several hours a day. Non-vital bleaching bleaches internally discolored non-vital teeth using 30% carbamide peroxide packed into the pulp chamber. The document also briefly discusses a varnish whitening system and tooth jewellery cosmetic enhancement called

2. TOOTH
WHITENING/BRIGHTENING
PROCEDURES
The lightening of the color of a tooth
through the application of a chemical agent
to oxidize the organic pigmentation in the
tooth is referred to as bleaching.

3. Degradation of high molecular weight
complex organic molecules that reflect
specific wave length of light responsible for
the color of the stain into lower molecular
weight and less complex molecules that
reflect less light is called lightning.
Bleaching is used as sole treatment of choice
or in conjunction with other treatment
modalities to brighten a whole smile.

4. HISTORY
Bleaching was unsuccessfully used in the
middle ages
Modern bleaching technique began in
1918.Abbot used the combination of
superoxol and heat.
1958—Prarson—intra pulpal bleach
1967--Nutting and Por—walking bleach

5. 1978—superoxol +heat + light
1989—Haywood .& Hayman (night guard
vital bleaching,10% carbimide peroxide)
1996—laser tooth whitening officially
started with the approval of ion laser
technology Argon and CO2 lasers to be
used with a potential system of chemicals

6. BLEACHING MATERIALS
Oxidizing agents
Hydrogen peroxide bleaching solution and gels.
Ph : highly acidic
Conc 3-3.5%
Carbamide peroxide based bleaching agents
also called
Urea hydrogen peroxide,
Carbamyl peroxide,
Perhydrol urea
Conc : 3-45%
Ph :5-6.5

7. HOW WOULD YOUR PATIENTS LIKE THEIR SMILE ?
A SMILE CONNECTS

8. More and more people would like lighter teeth. Not
surprising –as nothing can improve a smile like
bright white teeth

9. IN OFFICE VITAL TOOTH
BLEACHING
Vital tooth bleaching
is one of the least
invasive, most
conservative and
most effective
procedure to
dramatically improve
the esthetic
appearance of patient
smile and self-
confidence.

10. Light enamel discolorations
Mild tetracycline discolorations
Endemic fluorosis discolorations
Age related discolorations
Indications

11. Severe dark discoloration
Severe enamel loss
Hypersensitive teeth
Presence of caries
Large/poor coronal restoration
Contraindications

12. Familiarize the patient with
– Probable cause of discoloration
– Procedure to be followed
– Expected out come
– Possibility of future re-discoloration
Take radiographs
– Detect all carious lesions
– Defective restorations and proximity of pulp
horns
Procedural steps

13. Evaluate tooth color
– With shade guide
– Take clinical
photographs before
and through out
treatment.

14. Apply a protective
cream to the
surrounding gingival
tissues and isolate
the tooth with a
rubber dam and
waxed dental floss
ligature.
Do not inject local
anesthetic.

15. APPLICATION OF 30%
CARBAMIDE PEROXIDE ON
THE TOOTH SURFACE
MATERIAL IS ALLOWED TO
STAY FOR 15-20 MINUTES

17. PRE AND POST OPERATIVE
BEFORE
BEFORE
AFTER
AFTER

18. NIGHT GUARD BLEACHING/ HOME
BLEACHING TECHENIQUE
Introduced by
Haywood and
Haymann in 1989
Dentist prescribed
home bleach
technique.
Bleaching tray ,/
material prepared and
dispensed along with
follow up appointment
for check up.

19. MATERIALS USED

21. Tray :step by step
Alginate impression
of the arch to be
taken.
Model prepared
Block resin applied
on the labial surface
of the teeth to be
bleached to form a
small reservoir for the
bleaching agent.

22. BIOSTAR MODEL AND TRAY
MATERIAL IN POSITION
MOULDED TRAY BLEACHING TRAY MATRIX

23. BRUSHING FLOSSING
APPLICATION OF BLEACHING
MATERIAL
INSERTION STORAGE

25. Familiarize the patient
with the use of bleaching
agent and wearing the
guard, instruct the patient
that this procedure should
be performed 3-4 hours
per day or over night.
Recall the patient every 2
weeks to monitor stain
lightening.10%
carbamide peroxide is
used for this technique
,this can be later
increased to 16%,or up to
20% as per the case
reqirements.

26. AFTER
AFTER
BEFORE
BEFORE

27. Vivastyle paint on
THE PROFESSIONAL VARNISH SYSTEM
FOR WHITENING TEETH

28. Vivastyle paint on is insoluable in water. Consequently,
the varnish is not prematurely washed off the teeth by
saliva.
Vivastyle paint on contains 6% carbamide peroxide
when applied. This component releases oxygen , which
gently lightens stains. Once it has dried, its
concentration is about five times higher.
Why use a varnish system ?

29. STEPS OF APPLICATION
Available as standing tube with brush and
dispensing dish for single use

30. Brushing and flossing of teeth before application of
varnish

31. DRYING WITH BLOTTING
PAPER
APPLYING PROTECTIVE
GEL

32. Vivastyle paint on is applied directly to the teeth
with a brush and allowed to dry for 30 seconds

33. The dried varnish remains on the teeth for 20
minutes and is subsequently removed with a
toothbrush.

34. APPLICATION OPTIONS
Once daily for 20 min. over a period of 14 days.
Twice daily for 20 min. over a period of 7 days

35. CLINICAL RESULTS
-Noticeable whitening of teeth after just a few days
-Less irritation

36. Significant whitening of teeth after treatment with Vivastyle Paint on

37. Advantages
professional tooth whitening without a tray, as
– Patients find tray application uncomfortable
– Patients are looking for a more cost-effective
alternative
smooth integration into daily schedule
gentle application
touching up of previously whitened teeth

38. NON VITAL BLEACHING
Intra coronal bleaching of Endodontically
treated tooth

39. Radiographically assess the status of the
periapical tissues and the quality of
endodontic obturation.Endodontic failures
or questionable obturation ,should always
be retreated prior to bleaching.
Technique

40. Evaluate tooth color with a shade guide and
take a clinical photograph

41. Isolate the tooth
All restorative material from the
access cavity removed to expose
dentin and refine the access.

42. Cavit and GIC
base at least 2
mm thick to
cover the
endodontic
obturation.

43. Pack the pulp
chamber with 30%
carbamide peroxide
Seal the access with
IRM at least 3mm for
a good seal.
Recall after 2 weeks.
Instruct the patient

44. PRE AND POST OPERATIVE

46. Diamonds are forever, Skyce
is just for cosmetics.

47. MEDICAL EXPERTISE ON COSMETIC
PROCEDURES
Dentists of today are finding that more and more
people who consult them are no longer really patients.
They are individuals who desire perfectly aligned,
sparking white teeth, and who may even ask for tooth
jewellery. These cosmetic procedures have to be
accomplished by professionals with professionals
products.
Vivadent has developed the skyce system of tooth
jewellery, which enables dentists to satisfy this cosmetic
demand according to dental requirements.

48. STUNNING JEWELLERY ON HEALTHY
TEETH
Patients want a sparking smile and dentists
want teeth to be healthy. Dentists are committed to
maintaining the health of teeth at all costs.
The dental jewellery is bonded onto the tooth in
the same way as an orthodontic bracket.

50. SLIGHT ETCHING; STRONG BOND
Retentive pattern is produced on the enamel using
37% phosphoric acid.

51. Placement of flowable composite, the right consistency

52. Lifting the skyce using a probe tip with bonding agent

53. Skyce bonded to the tooth with flowable composite

54. Skyce is bonded to the tooth with the transparent Flowable
composite
Skyce must be encircled by a little Flowable composite to
ensure micromechanical retention.
Skyce
Flowable Composite
Tooth

55. TWO COLOURS; TWO SIZES
Skyce is made of crystal glass.
It is available in two different colours and sizes: “crystal” and
sapphire blue”, 1.8 mm or 2.5 mm in diameter.