Outcome 4 - Tooth Whitening

Question 1

Indications for Tooth Whitening Procedure:

Answer 1

1. Extrinsic Stains - tooth whitening can remove these stains, restoring the natural whiteness of the tooth
2. Aging and Wear
3. Intrinsic Stains - more challenging to treat, but tooth whitening procedures can still be effective in improving the appearance

Question 2

How does Aging & Wear effect tooth appearance?

Answer 2

With aging and routine wear and tear, the enamel of the teeth may wear down, causing them to become more transparent.

As enamel thins, the yellowish colour of the underlying dentin becomes more visible, leading to dull or yellowed appearance of teeth.

Question 3

What are intrinsic stains?

Answer 3

Discolourations that occur within the structure of the tooth, affecting the dentin and enamel.

Can result from..
-Trauma to tooth
-aging-related changes
-exposure to tetracycline antibiotics during tooth formation
-ingestion of fluoride

Question 4

Tooth Whitening vs. Vital Bleaching

Answer 4

Tooth whitening refers to non-invasive methods of lightening stained or discoloured teeth, often acheived through over-the-counter whitening products or pro dental procedures.

Vital bleaching involves the use of chemicals to penetrate the enamel and whiten the teeth, typically performed under the supervision of a dental professional.

Question 5

What are the primary whitening agents found in tooth whitening products?

Answer 5

hydrogen peroxide (HP) and carbamide peroxide (CP)

Question 6

What is Hydrogen Peroxide composed of?

Answer 6

HP is a chemical compound composed of two hydrogen atoms and two oxygen atoms. H2O2

Question 7

How does Hydrogen Peroxide work?

Answer 7

When applied to teeth, hydrogen peroxide breaks down into water and oxygen molecules. The oxygen molecules penetrate the enamel and dentin, oxidizing and breaking down the molecules responsible for tooth discolouration.

Question 8

What is the concentration of Hydrogen Peroxide used?

Answer 8

Used in various concentrations ranging from 10% to 22% depending on the type of whitening procedure (in-office, at-home, or over the counter)

Question 9

What is the composition of Carbamide Peroxide (CP)?

Answer 9

CP is a compound composed of hydrogen peroxide and urea. It breaks down into hydrogen peroxide and urea when applied to the teeth.

Question 10

How does Carbamide Peroxide work?

Answer 10

Similar to HP, carbammide peroxide relases oxygen molecules that penetrate the tooth structure, oxidizing and breaking down stains.

Question 11

What is the concentration of Carbamide Peroxide?

Answer 11

Used in concentrations ranging from 10% to 44%, with higher concentrations typically used in at home whitening products.

Question 12

Peroxide-Free Whitening Agents

Answer 12

Some whitening products utilize alternative whitening agents that do not contain peroxide. These agents incllude ingredients such as sodium bicarbonate, potassium nitrate, or activated charcol. They work through different mechanisms, such as abrasion or adsorption to remove surface stains from the teeth.

Question 13

Light Activated Whitening Agents

Answer 13

Some in-office whitening procedures incorporate light or laser activation to enhance the whitening process. These procedures often use hydrogen peroxide or carbamide peroxide as the primary whitening agent, with the light source accelerating the breakdown of the peroxide molecules and enhancing the oxidation process.

Question 14

Whitening Strips and Gels

Answer 14

These products combine peroxide-based whitening agents with adhesive strips or gels that adhere to the teeth, allow for controlled application and prolonged contact with the tooth surface.

Question 14

Whitening Toothpaste

Answer 14

Typically contains mild abrasives and chemical agents (such as hydrogen peroxide or baking soda) to help remove surface stains and lighten tooth colour over time.

Question 15

Professional vs. Over-the-Counter Products

Answer 15

Professional whitening products typically contain higher concentrations of whitening agents and may be applied under the supervision of a dentist for more controlled and effective results.

OTC products such as whitening toothpaste, strips and gels may contain lower concentrations of whitening agents and are designed for at-home use without professional supervision

Question 16

In-Office Professional Whitening

Answer 16

This involves a dental visit where a dentist or dental hygienist applies a high-concentration bleaching gel directly to your teeth. They may use a light or laser to activate the gel and enhance its effectiveness. In-office whitening typically provides immediate and noticeable results.

Question 17

Take-Home Whitening Kits

Answer 17

Dentists can provide custom-fitted trays and whitening gel for at-home use. The gel usually contains a lower concentration of bleaching agent compared to in-office treatments, allowing for gradual whitening over several days or weeks. Take-home kits offer convenience and flexibility, but results may take longer to acheive compared to in-office treatments.

Question 18

OTC Whitening Products

Answer 18

These include whitening toothpaste, strips, gels, and mouthwashes available at pharmacies and stores. While OTC products are more affordable and accessible, they typically contain lower concentrations of bleaching agents and may produce less dramatic results compared to professional treatments. Additionally, some OTC products may not have undergone the same level of safety and efficacy testing as professional treatments.

Question 19

Whitening Toothpaste

Answer 19

Whitening toothpaste contains abrasive particles or chemicals that help remove surface stains and lighten the colour of teeth over time. However, they may not be effective for deeper stains or significant whitening.

Question 20

Natural Whitening Remedies

Answer 20

Some people use natural ingredients like baking soda, activated charcoal, or hydrogen peroxide for tooth whitening. While these methods may have some whitening effects, they can also be abrasive and may cause damage to tooth enamel if used incorrectly.

Question 21

Dental Assistant’s Role in Teeth Whitening Procedures:

Answer 21

1. Patient Education and Preparation
2. Recording Patient Information
3. Shade Selection
4. Taking Impressions and Fabricating Custom Trays
5. Application of Whitening Agents
6. Monitoring and Assisting During Treatment
7. Post-Tratment Care and Follow Up
8. Documentation and Record-Keeping
9. Continuing Education and Training

Question 22

Patient Education and Preparation for Teeth Whitening Procedures

Answer 22

-Explain the teeth whitening procedure to patients, inluding the benefits risks and expectations
-Provide instructions on pre-whitening care such as oral hygiene practices and dietary restrictions
-Answer any questions or concerns the patient may have regarding the procedure

Question 23

Application of Whitening Agents - DA role

Answer 23

-Prepare whitening agents according to manufacturer instructions, ensuring accurate measurements and proper mixing
-Assist the dentist in applying whitening agents to the patient’s teeth, whether in-office or at-home procedures
-Guide patients on how to properly apply whitening agents at home, including filling trays and inserting them into the mouth

Question 24

DA Monitoring and Assisting During Whitening Procedure Treatment

Answer 24

-Monitor the patient during the in-office whitening procedure, ensuring their comfort and safety throughout the process -Assist the dentist with any additional tasks or adjustments needed during the whitening treatment

Question 25

Why are post op instructions important after a teeth whitening procedure?

Answer 25

They are crucial for ensuring optimal results and minimizing discomfort or complications.

Question 26

Post Op instructions following whitening procedure

Answer 26

1. Oral Hygiene - resume regular hygiene immediately after to prevent irritation of teeth and gums (use soft bristle brush and non abrasive toothpate to aavoid damaging enamel) 2. Diet & Nutrition - avoid consuming dark-coloured or staining foods/drinks for at least 24-48 hours after wards as teeth may be more susceptible to staining -limit intake of acidic or abrasive foods that may cause tooth sensitivity or discomfort 3. Sensitivity Management - common to expirence temporary sensitivity following a whitening procedure. Provide patient with desensitising toothpates or gels to alleviate discomfort, avoid hot/cold food/drinks. If sensitivity persists or worsens, call the office. 4. Tobacco and Alcohol - avoid smoking or using tobacco products following procedure as it can compromise the results, limit alcohol drinks as it may contribute to the dehydration and increase sensitivity 5. Follow Up Care - schedule follow up apt to assess treatment outcomes and address and concerns 6. Maintenance - provide recommendations for maintaining the results of procedure 7. Oral Health Monitoring - encourage patients to maintain regular dental check ups and cleaning 8. Additional Instructions - any instructions specific to the type or procedure performed, ensure they know how to use take home products

Question 27

Steps for Inserting Whitening Trays Correctly

Answer 27

1. Prepare the Whitening Trays 2. Apply Whitening Gel 3. Insertion Technique 4. Proper Alignment 5. Excess Gel Removal 6. Check Comfort and Fit 7. Duration of Wear 8. Post-Insertion Care 9. Follow-Up Instructions

Question 28

How to Prepare the Whitening Trays

Answer 28

-Ensure that the whitening trays are clean and dry before inserting -Check the trays for any sharp edges or rough areas that may cause discomfort and smooth them if necessary

Question 29

How to Appply Whitening Gel

Answer 29

- Apply a small amount of whitening gel into each compartment of the tray, using a syringe or applicator provided -Place a pea-sized drop of gel ino the front portion of each tooth impression in the tray. Using too much gel can lead to excess overflow and irritation of the gums

Question 30

Whitening Tray Insertion Technique

Answer 30

-Hold the whitening trays by the sides, ensuring that the gel-filled compartments are facing towards the teeth -Assist the patient in gently inserting the whitening tray over the upper teeth first, positioning it evenly and ensuring that the edges of the tray are fully seated against the gums -Use the same technique for lower teeth

Question 31

How to Ensure Proper Alignment of Whitening Tray

Answer 31

-Ensure that the whitening tray is properly aligned with the teeth and sits securely in place. The patient shoul feel a slight pressure against the teeth/gums, indicating a snug fit -Instruct patient to use their fingers to press lightly on the front surface of the tray, ensuring even contact with teeth

Question 32

How to remove Excess Gel from Whitening Tray

Answer 32

-Remind the patient to use a clean tissue or cotton swab to gently wipe away any excess gel that may have squeezed out of the tray onto the gums/lips -Emphasize the importance of keeping the whitening gel confined to the tooth surfaces to avoid irritation of the soft tissues

Question 33

How to Check Whitening Trays for Comfort/Fit

Answer 33

-Ask the patient if they feel any discomfort or pressure points caused by the whitening tray. If necessary, adjust the tray slightly to alleviate any areas of irritation. -Ensure that the patient can speak and swallow comfortably with the whitening tray in place.

Question 34

How Long to Wear Whitening Trays

Answer 34

-Instruct the patient to wear the whitening trays for the prescribed duration specified by the dentist, typically ranging from 30 minutes to overnight. -Provide a timer or recommend setting a reminder to help the patient keep track of the whitening session duration.