External Marketing
External marketing is traditionally referred to as advertising. This is a form of patient education that may be accomplished through several venues, some of which may be restricted by the dictates of the local dental jurisdiction. No matter what type of advertising is selected, repetition of a simple message is absolutely vital to the success of any advertising campaign. Unless the dentist is willing to carry out a continuous organized program over a period of at least several months, he will...
SuperoxolHeatLight Bleaching
The major problems with this technique are due to the heat and light that are required to activate the superoxol to an acceptable reaction speed, and the corrosive nature of the solution. The recommended operating temperatures are up to 60 C 140 F for vital teeth, and up to 71 0 C 160 F for nonfatal teeth. This is well beyond the comfort range for facial skin. The rubber dam will provide some thermal protection, but over a long appointment the discomfort may be considerable. The eyes also have...
Spectrophotometry
Perhaps the most sophisticated and accurate method of tooth shade measurement is the colorimeter. For simplicity in manufacturing, the colorimeters in the past have mostly been of a tristimulus variety. For repetitive measurements on the same tooth under the same lighting conditions, such a unit is effective. Better still is a full-spectrum colorimeter, one which can determine the exact reflective spectra of the tooth being matched. Such a machine is being developed by Bertin and Cie. of France...
Materials
There are a several somewhat similar materials which can be used for the home tooth whitening procedure. While they may superficially appear to be equivalent, the authors caution that differences do exist between the various products. Differences exist, for instance in pH, viscosity, concentration, and even composition. In addition, there are possible interactions between the whitening agent and the tray material itself. Doubtless, every material will have its proponents and detractors. In the...
References
1. Weitzman SA, Weitberg AB, Stossel TP, Schwartz J, Shklar G. Effects of hydrogen peroxide on oral carcinogenesis in hamsters. J Perio. November 1986 57 ll 685-688. 2. Goldstein RE. Dentists note concerns and advice about vital tooth bleaching - interview. Gen Dent. January February 1990 8-11. 3. Cobe HM. Investigations of a new ehemotherapeudc agent hi the presence of blood. Oral Surg. June 960 13 6 678-685. 4. Ambrose ER. Sound clinical procedures for amalgam restorations. JCDA. 1960 26...
Prophylaxis
Routine scaling and prophylaxis will eliminate plaque, calculus, and extrinsic staining. This step by itself may achieve a significant degree of tooth whitening, and provide enough positive reinforcement to the patient so that he will more readily undertake a whitening treatment. A standard prophylaxis employing a bristle brush and coarse prophylaxis paste will remove not only the debris, but approximately 10 microns of the outer layer of the enamel. A rubber cup removes a bit less. This can be...
Clinical Technique
The tooth whitening procedure actually begins with patient evaluation, since a thorough medical and dental history should be performed before initiating any therapy. In addition to the usual health history, however, information should be taken regarding the causes of the patient's present condition, as well as the patient's hopes and expectations of the treatment. Photographs should be taken prior to any treatment, including even a prophylaxis. This set of photographs should include at least...
PostEruptively Caused Discolorations
Age. Several non-pathologic conditions which are related to the process of aging work to gradually discolor the teeth over time. The natural process of gradual pulp withdrawal with the formation of secondary dentin causes the development of a yellowish-brown color.22 Treatment This is perhaps the strongest indication for tooth whitening. The results are the most rapid, and predictable. Standard vital tooth whitening should be used for these cases. Dental Metals. The most ubiquitous source of...
Intrinsic Discolorations Created During Odontogenesis
Alkaptonuria. Alkaptonuria is also known as phenylketonuria and ochronosis. It is a recessive genetic deficiency resulting in incomplete oxidation of tyrosine and phenylalanine, causing an increased level of homogentisic acid. This condition sometimes causes a dark brown pigmentation of Lhe permanent teeth.6 Treatment Tooth whitening can lessen or even eliminate the discolorations. In. severe cases the teeth may need additional esthetic procedures to achieve perfection. Amelogenesis Imperfecta....
Dangers in Current Techniques SupcroxolHeatLigh I Technique
The prospect of a treatment posing danger to a patient or to the oral environment is of particular concern when embarking on an elective procedure. The corrosive nature of super-oxol and its potential deleterious effects on various tissues are a definite drawback to the superoxol heat light bleaching system. The tooth, which is more intimately and deliberately exposed to the bleaching agent than any other tissue, is the most at risk. The concerns about chemical and thermal intrusions on the...
Introduction
In 1985, Dr. John Munro of Crossville, Tennessee, had been experimenting with solutions to whiten teeth. With his chemistry background, he had the idea that there were solutions available which could safely and effectively whiten teeth for patients. Over a period of two years, Dr. Munro treated about 40 patients with different solutions, documenting the clinical results of each solution. In 1987, Dr. Munro presented his ideas to Omnii International, a pharmaceutical and dental company. A group...
Link J. Discolouration Of The Teeth In Alkaptonuria And Parkinsonism. Chron
1. Dawes C, Jenkin GN, Tonge CH. The nomenclature of the integuments of the enamel surface of teeth. Br Dent J. 1963 115 65. 2. Gatil KA. Histochemistry and scanning electron microscopy of tooth integurnental material in humans. Per-iodont 1975 46 415. 3. Vogel IV. Intrinsic and extrinsic discoloration of the dentition. J Oral Med. 1975 30 99-104. 4. Freedman GA, McLaughlin G. Color Atlas of Porcelain Laminate Veneers. St. Louis lshiyaku EuroAm erica 1990. 5. Eisenberg E, Beroick SM. Anomolies...
Idiopathic Pulpal Recession A
tooth may, on occasion, display idiopathic pulpal recession. Such teeth remain vital, but usually display a yellow to brown darkening. The appearance is often one of a non-vital tooth, but the tooth's actual condition can be differentiated on the basis of vitality testing. Such teeth will usually show greatly diminished pulp chamber size radio-graphically. Treatment Standard tooth whitening procedures should be instituted if the desired result is an overall whitening of all the teeth. This will...
The Safety of Tooth Whitening
One of the most important concerns for any new dental procedure is its safety. The dentist must have absolute confidence and security in the dental treatments being recommended to his patients. Safety is normally established in one of two ways the product can be tested on animals in order to predict its toxicity in humans, or in the case of a material that has previously been used for human treatment, Lhe record of the product can be examined for deleterious side effects. As may be expecLed,...
Historical Background
The desire for whiter teeth is not completely a recent phenomenon. In Biblical times it was considered that the person who whitens the teeth of his neighbor is better than the person who gives him milk to drink.1 Theophrastus of Ancient Greece wrote in the third century B.C. that it was considered a virtue to shave frequently and to have white teeth. If there was any attention paid to dental hygiene and appearance during the middle ages, there is no surviving documentation. Life spans were...
Gerald McLaughlin George A Freedman
Ishiyaku EuroAmerica, Inc. Publishers Copyright 1991 by lshiyaku Euro Am erica, Inc. All rights reserved. No part of his publication may be reproduced or transmitted by any means, electronic, mechanical, or otherwise, including photocopying and recording, or by any information storage or retrieval system, without permission-in writing-from the publishers. 716 Hanlcy Industrial Court, St.Louis, Missouri 63144 PIIONR ORDERS CALL TOM. Fit BE 800 MED 1921 Library of Congress Catalogue Number...