Professional Documents
Culture Documents
net
An Efficient Approach to
In-Office Tooth Whitening
T
oday, more and more patients are requesting a This article demonstrates the use of an in-office
whiter, brighter smile. Conservative smile en- whitening product (Pola Office+, SDI North America Inc)
hancements are routine procedures in many den- that uses a 37.5% hydrogen peroxide gel. Pola Office+
tal practices, and the most common and controlled can be used with or without a bleaching light, as it does
method for quickly changing someone’s smile is in-office not require activation. Although a light is not necessary,
tooth whitening. Vital tooth bleaching is a viable and re- a bleaching light or a standard heat-emitting curing light
alistic option for many patients as a means to improve can accelerate the bleaching process. In published litera-
their smiles and their overall appearance. ture investigating the effects of light activation of whiten-
Based on what I have seen in my practice, the incidence ing agents, researchers have noted that the addition of
of tooth discoloration seems to be increasing. Tooth discol- light can increase the tooth-whitening effect of peroxide,
oration is the result of aging, disease, or exposure to a vari- even in concentrations as low as 15%.5 It was noted that
ety of agents, including foods and beverages. Intrinsic stains peroxide and light treatment significantly lightened the
result from defects during tooth development, fluorosis, or color of teeth to a greater extent than did peroxide or light
the use of tetracycline.1 Extrinsic stains, on the other hand, alone, with a low and transient incidence of tooth sensi-
are localized in the pellicle and are generated by the reaction tivity.5 Other investigations have also found that color
between sugars and amino acids or are acquired from the re- changes are significantly affected by an interaction of
tention of exogenous chromophores in the pellicle.1 bleach and light variables.5
The success of whitening regimens of varying durations
using peroxide agents has been well documented in the lit- Case Presentation
erature for treating both extrinsic and intrinsic stains.1-4 A 35-year-old male patient presented with a chief com-
However, to reduce intrinsic stain and change the inherent plaint of teeth that were “too yellow and dark” (Figure
tooth color, professional tooth-whitening products that 1). After a thorough examination that included radi-
rely on proven technologies (such as 35% hydrogen per- ographs and intraoral digital photographs, it was deter-
oxide for in-office power bleaching or 10% to 15% car- mined that no pathologies were present that would
bamide peroxide for at-home bleaching) have traditionally contraindicate vital tooth bleaching. The patient was then
been used.3 Over-the-counter products that whiten educated and informed about the variety of tooth-bleach-
through the actions of surfactants, abrasives, anticalculus ing alternatives available, including home bleaching with
agents, and low levels of hydrogen peroxide have been a customized tray and over-the-counter products. The pa-
used to whiten extrinsically stained teeth and/or to help tient elected to whiten his teeth through the in-office (Pola
maintain bleaching effects after professional treatment.3 Office+) tooth-whitening system.