Bleaching

Question 1

What is the mechanism of action for bleaching?

Answer 1

• The tooth is a semi-permeable membrane
• Peroxides have low molecular weight
• Peroxides penetrate the enamel and dentin quickly

Question 2

How long does it take for peroxides to reach the pulp?

Answer 2

5-15 minutes

Question 3

True or False: Peroxide levels are very high and you must be careful not to damage the pulp.

Answer 3

False, levels are low enough to not damage the pulp

Question 4

10% carbamide peroxide is equivalent to _____ % hydrogen peroxide.

Answer 4

3.5%

Question 5

True or False: Peroxides have high molecular weights.

Answer 5

False

Question 6

True or False: Peroxides penetrates the enamel and dentin slowly.

Answer 6

False

Question 7

Which is more stable: hydrogen peroxide or carbamide peroxide?

Answer 7

carbamide

Question 8

Hydrogen peroxide is active for _______ mins.

Answer 8

30-60

Question 9

How much carbamide peroxide is released in 2 hours?

Answer 9

50%

Question 10

Peroxide breaks down _______ and leads to less color.

Answer 10

bonds in the chromafore (aka its a loss of color, not an addition of “whiteness”)

Question 11

Bleaching is effective for ____ and ______ stains.

Answer 11

intrinsic and extrinsic

Question 12

True or False: Cementum does not bleach.

Answer 12

True

Question 13

Can patients with recession bleach?

Answer 13

Yes, there will be sensitivity and the areas of cementum will not bleach, but enamel portions will.

Question 14

What type of peroxide is in whitening rinses?

Answer 14

hydrogen peroxide (low%)

Question 15

What type of peroxide is in whitening toothpaste?

Answer 15

carbamide peroxide (low%)

Question 16

What type of peroxide is in whitening gum?

Answer 16

NONE (mostly abrasive action)

Question 17

What type of peroxide is in whitening paints?

Answer 17

carbamide or hydrogen peroxide (10-18%)

Question 18

What type of peroxide is in white strips?

Answer 18

Hydrogen peroxide (5-14%)

Question 19

True or False: Rinses, toothpastes, gum, and paints have minimal whitening.

Answer 19

True

Question 20

Dentist prescribed whitening products will generally contain ______ carbamide peroxide.

Answer 20

10-35%

Question 21

What percentage of carbamide peroxide is best for overnight wear?

Answer 21

10%

Question 22

In office bleaching in commonly ______ % hydrogen peroxide and it requires gingival ______.

Answer 22

25-38%

isolation

Question 23

True or False: The use of light when bleaching will dramatically improve the results.

Answer 23

False

Question 24

How long does “in office” whitening usually take?

Answer 24

about an hour

Question 25

What is the most common side effect of whitening?

Answer 25

hypersensitivity

Question 26

What is the second most common side effect of whitening?

Answer 26

gingival irritation

Question 27

What is the best way to reduce sensitivity associated with whitening?

Answer 27

two weeks of using toothpaste that contains potassium nitrate

Question 28

True or False: There is always about 1/2 shade rebound one week after completing the bleaching process.

Answer 28

True in office session: 2 shade rebound trays: 1/2 shade rebound

Question 29

What is the most important thing to discuss with patients prior to beginning whitening treatment?

Answer 29

realistic expectations (every tooth has a maximum degree of whitening and a maximum rate of change)

Question 30

______ shades will whiten more easily than _____ shades.

Answer 30

``` red/yellow blue gray (SLOWWWWW changes) ```

Question 31

Whitening treatment can last as long as _____ years depending on multiple factors.

Answer 31

1-3

Question 32

What is the average treatment time?

Answer 32

2 weeks

Question 33

What are the patient instructions for tray whitening?

Answer 33

1. Brush teeth 2. load a small amount of gel onto facial aspect of each tooth 3. Wear tray according to determined time 4. Remove tray, clean with brush and cool water

Question 34

According to OSU Protocol, what should you do if a patient inquires about whitening?

Answer 34

Ask 5 listed questions

Question 35

According to OSU Protocol, what are the contraindications for whitening?

Answer 35

1. patients with extremely large pulps 2. exposed root surfaces 3. severe loss of enamel 4. pregnancy 5. Allergies to peroxide

Question 36

According to OSU Protocol, what needs to be completed prior to whitening?

Answer 36

a complete prophylaxis

Question 37

Before payment is made, the patient must _______.

Answer 37

read and sign the consent form

Question 38

A payment for ______ is necessary before fabrication of the trays.

Answer 38

one arch

Question 39

How long should you wait after whitening procedure before placing any anterior restorations?

Answer 39

2 weeks

Question 40

What is the first appointment for?

Answer 40

taking impressions

Question 41

What is the second appointment for?

Answer 41

fitting the trays and dispensing the whitening gel

Question 42

What is the third appointment for?

Answer 42

2 weeks after second appt. assess the completion of whitening

Question 43

Patients must sign the _____ and the _____.

Answer 43

consent form and progress notes

Question 44

The consent form should be placed in the folder behind the _____ tab.

Answer 44

green

Question 45

If a patient comes back for a fourth appointment and the saturation point has not yet been met, do they have to pay for additional syringes?

Answer 45

NO, no payment necessary...just obtain a faculty signature

Question 46

Do patients pay for touch-up bleaching after appointment four?

Answer 46

YES, they will be given 3 more syringes after faculty receives the cashier's receipt