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Dental Materials > Tooth whitening > Flashcards

Tooth whitening Flashcards

1
Q

if small initial caries are sealed over during the sealant process or if bacteria is trapped underneath, what will happen

A
  • numerous studies have shown that neither of these will increase the chance of caries development or caries growing beneath the sealant
  • several studies have also shown that the number of bacteria in small, existing caries lesions that had been sealed decreased dramatically with time
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2
Q

when is the caries-active period/ideal time for sealant placement

A
  • ages 6-15 years
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3
Q

what teeth are indicated for sealants

A
  • deep pits and fissures

- preferably in recently erupted teeth (less than 4 years)

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4
Q

what are contraindications for dental sealants

A
  • lack of pits and fissures
  • apparent occlusal decay
  • inter proximal decay
  • insufficient eruption of tooth
  • soon to be lost primary tooth
  • poor patient cooperation in dental chair
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5
Q

what is a filled material

A
  • has particles in the matrix
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6
Q

what is an unfilled material

A
  • no particles in the matrix
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7
Q

what is fluoride release

A
  • some types of sealants release fluoride after polymerization
  • theory: fluoride released from the sealant creates a fluoride rick layer at the base of the sealed groove, helping remineralize incipient enamel caries
  • topical fluoride should not be applied to the enamel surface immediately before a sealant procedure, but may be applied immediately after
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8
Q

what is the purpose of filler material

A
  • to reduce occlusal wear
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9
Q

is there a difference between filled and unfilled sealants in their ability to penetrate fissures and their microleakage

A
  • they both penetrate the fissures equally well

- no difference in microleakages

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10
Q

where should sealants not be placed

A
  • on cuspal slopes
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11
Q

explain general tips for sealants materials

A
  • replace caps on syringes and bottles immediately after use
  • do not expose the materials to elevated temperatures
  • do not store materials in proximity to eugenol-containing products
  • most etchant and sealant materials are designed to be used at room temp
  • check manufacturers recommendations
  • shelf-life of most sealant products at room temp ranges from 18-36 months
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12
Q

what are some precautions for acrylate resins

A
  • acrylate allergies - do not use on a patient with a known allergy
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13
Q

what needs to be done immediately after placing an acrylate resin

A
  • rinse for 30 seconds
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14
Q

what is tooth whitening

A
  • known as vital bleaching, tooth whitening is a non invasive method of lightening dark or discoloured teeth
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15
Q

what are indications for using a tooth whitener

A
  • extrinsic stains from:
  • poor oral hygiene
  • foods: soy sauce, chocolate
  • cigarette smoking
  • drinks: coffee/tea, red wine
  • age discoloured teeth
  • intrinsic stains such as:
  • mild tetracycline stains
  • mild fluorosis
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16
Q

what do tetracycline, minocycline and fluoride stains look like

A
  • tetracycline: brown, grey, black bands
  • minocycline: brown, gray
  • white, brown spots or bands
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17
Q

what does trauma during tooth development appear as

A
  • blue, black, brown
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18
Q

how does plural canal obliteration appear

A
  • yellow
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19
Q

how does pulp necrosis with hemorrhage appear

A
  • gray, black
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20
Q

how does pulp necrosis without hemorrhage appear

A
  • yellow, gray-brown
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21
Q

how does trauma during pulp extirpation appear

A
  • gray, black
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22
Q

how does tissue remnants in the pulp chamber appear

A
  • brown, grey, black
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23
Q

how do restorative dental materials that have affected the pulp appear

A
  • brown, grey, black
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24
Q

how do endodontics that have affected the pulp appear

A
  • gray, black
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25
Q

what colour do aging stains appear

A
  • yellow
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26
Q

what colour will poor OH appear

A
  • yellow, brown, green, black
27
Q

what colour will coffee, tea and food stains appear

A
  • brown to black
28
Q

what colour will tobacco products stain teeth

A
  • yellow-brown to black
29
Q

what is the chemical makeup of whitening products

A
  • active ingredient
  • non-hydrogenated peroxide system
  • gel base
  • thickener: carbopol
  • flavouring agents
30
Q

what are the active ingredient options for whitening products

A
  • carbamide peroxide
  • hydrogen peroxide
  • urea peroxide
31
Q

what are the non-hydrogenated peroxide system options for whitening products

A
  • sodium chloride
  • oxygen
  • natrium fluoride
32
Q

what is the gel base for whitening products

A
  • with one or a mixture of propylene glycol, glycerin, and water
33
Q

how does bleaching work

A
  • penetration: product passes through the enamel to the dentin, oxidizes pigments in the dentin resulting in a whiter colour
  • acceleration: low-intensity hear, high intensity light (curing light), high-intensity plasma arc light
34
Q

what is the in office bleaching procedure

A
  • high concentration gel: 35% carbamide peroxide
  • dental dam: place over all teeth to be whitened
  • gingival protection: additional gingival protection with petroleum jelly or paint-on light-cured dental dam materials
35
Q

what is power bleaching

A
  • using a strong bleach (35%)
  • activated by a high-intensity light
  • one visit usually suffices (always inform client that it may take more than one visit to reach the desired colour)
  • 45 mins to 1 hour
36
Q

what happens to the colour of teeth when the pulp dies

A
  • necrotic pulpal tissues or hemoglobin from blood in the pulp leaks into the dentinal tubules
  • chemicals from these tissues cause the staining (eg iron sulfide from hemoglobin)
37
Q

what is the beginning of the in office bleaching for non vital teeth process like

A
  • isolate with rubber dam: prevents burning of soft tissues

- remove the restoration from the endodontic access cavity: the hole through which the root canal therapy was done

38
Q

what are the 2 techniques for non-vital bleaching

A
  1. non-vital bleaching technique: superoxol = 30% hydrogen peroxide solution. place in the pulp chamber on a saturated cotton pellet. hot instrument is plunged into the cotton several times to activate the peroxide
  2. walking bleach technique: made in office bleaching gel or paste with amosan (sodium peroxyborate monohydrate and 30% hydrogen peroxide). seal into the pulp chamber with a temporary restoration for 2-5 days. remove bleaching material. place a composite restoration
39
Q

what is an in office and at home tooth whitening procedure

A
  • material placed in a thermoplastic custom tray that the patient wears for a designated period
  • for the 10% to 16% carbide peroxide gels, the wear schedule would be an hour, twice a day for the first week and once a day for the second week
  • for the 20-22% mixture, 1 hour a day for a 2 week period
  • for the hydrogen peroxide 15-30 minutes, 2 or 3 times a day for a 2 week period
  • carbamide peroxide = 35%, 30 mins 1x/day for 1-2 weeks
40
Q

what are concerns to keep in mind with in-office/at home bleaching trays

A
  • always stop when desired results are obtained
  • remember whitened teeth will fade after a few days
  • need to be touched up every 6 months
41
Q

what are tooth whitening strips

A
  • thin, flexible strips coated with an adhesive hydrogen peroxide whitening gel
42
Q

what is the application like for tooth whitening strips

A
  • patient peels off the backing like a band-aid and presses the strip to the facial anterior teeth
  • the remaining portion of the strop is folded onto the lingual surface
43
Q

what are possible complications to tooth whitening

A
  • thermal hypersensitivity: patient may experience sensitivity to heat and cold after removal of tray and material. the use of sensitive toothpaste is recommended
  • tissue irritation: gingival tissue exposed to excess gel caused by improper tray fit. recommend to patient not to overfill tray with material and remove and excess after seating the tray
44
Q

what is the dental hygienist’s role in tooth-whitening procedures

A
  • aid in recording the medical and dental history
  • assist in making shade selection
  • take intraoral photographs before and after
  • take and pour up preliminary impressions for tray
  • fabricate and trim tray
  • provide post-op instructions
  • assist in weekly and biweekly clinical visits
45
Q

what are patient instructions for tooth-whitening procedures

A
  • brush and floss before tray placement
  • place equal small amounts of gel in tray, labial surfaces (all the teeth that you would like to bleach), probably not the molars since we do not see them, therefore the patient should be aware that they are just wasting the material if they bleach that far back…
  • do not overload as excess gel may irritate tissues and throat
  • place tray over the teeth and seat gently
  • any excess material that comes out let the patient know they can use a q tip or face cloth to wipe it away from the gingiva
  • do not eat, drink or smoke when wearing the tray
  • wear tray for recommended time
  • let the patient know that they may experience some sensitivity (they can brush with sensodyne or a fluoride gel)
  • if the patient experiences any problems, discontinue use and sinus with the health care professional
  • clean tray under running water with unscented soap. shake off excess water and place in storage container. leave lid open to air dry
46
Q

how should you store bleaching products

A
  • in a cool and dry location out of direct sunlight

- refrigerate

47
Q

who is bleaching not recommended for

A
  • pregnant or lactating
48
Q

what should you avoid when you’re bleaching

A
  • coffee
  • tea
  • red wine
  • dark soft drinks such as coke, Pepsi, root beer
  • berries
  • tobacco
49
Q

how long does bleaching last

A
  • usually about 1-3 years
  • re-staining requires occasional bleaching as a touch up, usually every 6 months
  • keep bleaching trays so you only need to buy additional bleaching material and not the trays as well
50
Q

what are 4 contraindications to bleaching

A
  1. allergies: allergic to components of the bleaching materials or the tray material
  2. sensitive teeth: clients with extremely sensitive teeth
  3. existing tooth colour restorations: clients who do not want to replace existing restorations
  4. unrealistic expectation
51
Q

what is a mouth guard and what are the 2 types

A
  • guard = anything that gives protection
    two types:
    1. sports guard: mouth guard that protects the teeth while the patient is playing sports
    2. night guard: mouth guard that protects the patients teeth at night. usually while the patient is grinding
52
Q

what is a stock guard

A
  • an over the counter mouthguard
  • thick and poor fitting
  • uncomfortable to wear
  • not adapted to patient’s bite
53
Q

what is a flexible thermoplastic material guard

A
  • an over the counter mouthguard
  • horseshoes shape
  • soften in boiling water
  • place in mouth while still moldable
  • hand adapted to the teeth and arch
  • adapted to the bite by closing
  • cut away excess material with heavy duty scissors
54
Q

what is the process of in office fabrications of mouthguards

A
  • impressions
  • study casts
  • thermoplastic material is heated on vacuum former
  • thermoplastic heated material is adapted to the cast
  • fit is excellent
  • bite is comfortable
55
Q

what are instructions regarding mouth guards

A
  1. rinse the sport guard prior to wearing it
  2. do not leave the sport guard in direct sunlight as it could melt or deform
  3. after use place in a bath type container and do not leave on top of counters because pets can get at them and chew them
  4. to freshen up to sport guard you can soak it in mouthwash or 50/50 water and vinegar
  5. make sure you tell your patient not to chew on the sports guard as it will distort and may not fit as well
  6. during the mixed dentition stage, the sport guard will have to be changed every year and could even be more than that as the loss of teeth can make it not fit anymore
  7. for adults, it is recommended that the sports guard be changed every 2-3 years
56
Q

what is the purpose of night guards

A
  • the guard doesn’t stop the grinding habit, but it prevents further:
  • wear of the incisal and occlusal surfaces
  • chipping of the enamel
  • fracture of cusps
57
Q

occlusal splints

A
  • when mouthguards are used to treat TMJ, it is known as a splint
  • the casts are usually mounted on an articulator for a precise fabrication of the guard
58
Q

what are the 2 types of material used in night guards

A
  1. hard acrylic (methylmethacrylate resin and monomer)
  2. thermoplastic sheets of polyethylene: these are the ones made in office. they are thicker plastic than the bleaching trays
59
Q

what is NTI

A
  • nocioceptive trigeminal inhibition
  • provides a one-point anterior contact
  • does not permit any occlusal contact
  • prohibits cuspid contact regardless of how much lateral mand movement the wearer may exhibit
60
Q

what are the uses of NTI

A
  • reduces migraine and stress headaches as much as medications (statistically shown)
  • allows jaw to grow, therefore good for children and teens who grind and clench
61
Q

what is the proper home care for NTIs

A
  • clean daily
  • clean as soon as taken out of the mouth
  • rinse thoroughly; remove saliva
  • brush with liquid unscented soap
  • use a denture brush or hard bristled toothbrush
  • final rinse
  • shake off excess water
  • store in container with air holes to dry
62
Q

what are NTIs approved through the FDA for

A
  • headache reduction

- TMD

63
Q

are there any side effects to NTI

A
  • no side effects:
  • periodontal
  • gingival inflammation
  • movement of teeth
  • injury to TMJ
  • tooth sensitivity
64
Q

in conclusion what are the 3 types of in office fabrications from study casts

A
  • bleaching trays
  • sports guards
  • night guards

Dental Materials (18 decks)

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