Flashcards in Discolouration of teeth Deck (33)
Aetiology of discolouration
Extrinsic factors causing tooth discolouration
Intrinsic factors causing discolouration of enamel
a) trauma, idopathic, caries
b) amelogenesis inperfecta, flourosis, systemic illness, idiopathic
Intrinsic factors causing discolouration of dentine
a) necrotic pulp, metal ions, root canal filling materials, caries,
b) dentinogesis imperfecta, tetracycline, bilirubin
Amelogenesis imperfecta manifestations?
Treatment of discoloured anterior teeth
Enamel micro abrasion
Indications for micorabrasion?
White/brown intrinsic blemishes in outer layer of enamel
Turner teeth (hypoplasia)
Prior to veneers
Non-vital teeth or tetracycline staining (within the dentine)
Sodium bicarbonate and water paste on rubber dam around teeth
Etchant for 15 secs and wash off
Repeat up to 10x
Fluoride gel on teeth to mineralise
Polish with toothpaste
HOw can vital tooth whitening be characterised?
Over the counter - toothpaste
In-surgery - heat and light - 15% carbamide peroxide gel
Tray-based - 15% carbamide peroxide gel over night
Problems with over the counter teeth whitening?
Self-diagnosis - may be careis
Indications of vital whitenign?
Severe extrinsic stain
Age related discolouration
Contraindications for vital whitening?
Severe enamel loss
How does teeth whitening work?
Consequence of whitening?
If you do it too long - enamel breakdown
Materials used for in-surgery tooth whitening?
Phosphoric acid (etch)
Tray-based whitening materials?
Carbamide peroxide gel 10% = 3% hydrogen peroxide
Effects of whitening on teeth?
Mild sensitivity to temperature changes
Cellular pulp changes
Dameg to enamel
PH of solution
Bond strength to composite
Saftey concerns of tray whitening?
JE may be permeable to carbamide peroxide - exposure to lots of cells
Why should <18 years not use vital whitening?
Larger pulp chambers
Little secondary dentine
Poorer plaque control (?)
Increased potential for pulpal hyperaemia
Heat should not be used
What is the maximum hydrogen peroxide dose prescribed by dentist for whitneing?
Advantages of non-vital tooth whitening
No lab assistance
Materials/methods of non-vital whitening?
Thermo-catalytic --> heat source, light or probe release oxygen from bleaching agent
Walking bleach --> oxidising process allowed to proceed gradually over days - seal carbamide peroxide gel in for a week repeatedly
Inside/outside bleach --> bleach tray and open access cavity
Indications for non-vital whitenign?
Adequate obturation (remove GP to gingival margin)
No radiological disease
No lareg restorations
Not staining caused by restorative materials (amalgam not reversible)
Fluorosis/tetracylines not appropriate
Describe walking bleach technique
Access cavity and pulp chamber restorations removed - GP to gingival margin
Freshen dentine inside pulp chamber, etch chamber
carbamide peroxide gel into cavity, cotton wool placed over
Seal with GIC
Return in a week
Complications of non-vital whitening?
External cervical resorption
Failure to whiten
Brittleness of tooth crown
Describe inside/outside non-vital whitening technique
Access pulp chamber
squirt carbamide peroxide gel inside
Place beaching tray on and squirt into bleaching tray (inside and outside the tooth)
Indications for inside/outside NV whitenign?
Single root filled tooth
No signs of pathology
Adequate OHI and able to clean tray
Arguments for enamel reduction in primary teeth for veneer prep?
Decreases likelihood of over contouring
Better bond strength to composite