Teeth whitening: the progress of the last 25 years

To win tooth whitening as the beginning of the dental treatment of his popularity after the publication of the article "mouthguards for teeth whitening" authorship Van Haywood and Harald Heymann, увидевшей light in the year 1989, in which the authors of the Home-Bleaching technique, a long distance and the best result of this therapeutic Intervention. Further investigations of many authors have procedure the efficacy and safety of whitening, such as the reduction of the risk of complications, since the Protocol is modified such Intervention, with the years, more and more, and more, and even the Manipulation of increasingly clinically controllable. So in this article we will talk about how the approaches to the bleaching of the teeth in the last quarter of a century in terms of studies, clinical observations and experimental studies.

Teeth

Also, taking into account the 25-year history, Bleaching as a specific dental service is gaining more and more popularity among the patients, the continuous improvement of the techniques and used during the execution of the procedure materials (green wall, 2001). Already in the 1880s, high concentrations of hydrogen peroxide were used to a smile expression, use strong, in our time, for similar purposes, night mouth guards, which are used quite safely at home.

The history of the popularity of Kapp for the whitening was quite exciting: the American dentist Bill Klausmier in 1968, recommended that his patients Night mouth guard-ретейнеры-peroxide-solution fill, in order to reduce the volume of hyperplasia of the gums (Heywood, 1991a), and imagine his surprise to notice as he started after half a year, that not only the gums of the patient appearance much better, but also your teeth will be significantly whiter. It is an accidental discovery, as in the course of time and the discovery of Penicillin, allowed for many patients the desired aesthetic result of the correction to achieve your smile without iatrogenic interventions.

To say forty years Klausmier that in his practice none of his patients not in need of a tooth-powder treatment due to the effects of the bleaching, and the method of night-time applications with the use of peroxide compound remains one of the safest variants of this procedure. Currently Klausmier transferred the responsibility for the conduct of studies of the effects of the procedure of bleaching Van Haywood, which he employs today.

Early Studies

Early studies on different aspects of the whitening process only focuses on the study of the safety and efficacy of this Manipulation. Professor Yiming Li from the University of Loma Linda, the came in the last 20 years of his life he devoted to the study of the peroxides such as bleach Agent to the clear conclusion that this compound is chemically cave safe substance for the tissue of the mouth, if the use of such controlled treating dentist (Li, green wall, 2013).

In the 1990s, the question of bleaching a large number of researchers employed, and therefore also the number of publications on various aspects of this method, more than a few thousand. In the course of the extensive study on the question of sensitivity, notes on the observed in 85% of patients after the procedure of bleaching, it was found that very important is the application of chemical agents, and the pulp is, in the area of the procedure performed. So, on vital teeth, the applied chemical agent can be carried within 5 to 15 minutes, while Bleaching requires a prior commitment to the implementation of the endodontic treatment.

Whitening methods

There are two basic varieties of teeth whitening procedures:

  • Night by carbamide peroxide.
  • during the day, by hydrogen peroxide.
How have the principles?

The main guidelines of bleaching were in the year 2011 in the structure of the regulations the safety of use of cosmetic products in 2012 (Directive 2011/84/EC with the amendments to the Directive 75/768/ECC), with effect from October 2012. According to this normative document, the use of products from 0.1% to 6% of hydrogen peroxide, it is not prohibited for persons under the age of 18 years, if such directed to the prevention and treatment of illness or injury. At the same time, the products contain less than 0.1% of hydrogen peroxide, such as, for example, oral tools, Conditioner, toothpaste and Whitening Agents are quite safe to use and freely available on the commercial market.

Dental products of hydrogen peroxide are in a volume of 0.1 – 6% used only under careful clinical supervision, taking into account all possible factors risk factors for certain pathologies and complications. In addition, the use of agents can be limited for the bleaching in the frequency and in the time, and since such control is difficult, the data of chemical agents should not be directly accessible for direct buyers. The appointment of such substances can only be carried out in the context of dental treatments, and only on medical prescription, to monitor the effect of this procedure on each of the repeated visits of the patient. In addition, the first use of such products.under the direct supervision of a dentist, can correct it in the later of the algorithm of this method for the patient, and he carefully explains all the important aspects of such Manipulation

The use of products, the hydrogen peroxide, whose concentration is higher than 6%, is strictly prohibited, unless for prophylactic or therapeutic purposes. Such as, dentists, according to certain Standards, patients are generally any substances prohibited for bleaching with hydrogen peroxide concentrations of about 6%.

Whitening a single dark tooth

Approaches for bleaching vital and the other teeth have improvements changed in the last 25 years, this procedure increases the expectations of the patient, as popular is the white color of the teeth become, despite the complexity of some procedures disappeared, the age limit of the method, and to develop in some people, even pathological obsession with bleaching began. However, the approaches to the application of cluttered and segmented Kapp changed, such as individual therapeutic algorithms bleaching with various gels, wet agent (potassium nitrate), solutions of various concentrations, the effect of the ozonation, or laser technology.

At the present time for a single tooth whitening uses segmented mouth can be protective, but to assess the implementation of the manipulation is appropriate, it is important that Bleaching potential and the opportunities of the problematic tooth. First of all, you need to ensure that the conditions under which the use of mouth guard ensures the implementation of the whitening procedure on the affected tooth and then to the relatives; if you don't hold such a principle – that of a dark tooth in front of the background, partially bleached and relatives is even worse.

A single tooth whitening

In the case of violations in the structure of the tooth, the deposition of secondary and tertiary dentine, which is bleeding in the space of the pulp, as well as deposition of iron from the formed blood clot begins, all of this leads to a change in the crown in one or even in two tones, in comparison with the adjacent normal teeth. In the past it was believed that these teeth go through the process of conversion of calcium and, therefore, require the obligation to carry out the endodontic treatment (Haywood, 2010). But as it turns out, and a whitening may be sufficient, the restoration of adequate aesthetic profile of the smile.

Special Teeth

Standard technique, called the gradual brightening and for the first time, the change of Nutting and Poe in 1965, in our time, and now, the combined use of sodium and 35% by weight solution of hydrogen peroxide. These two substances do not have the best effect in your strength equal to 50% of the action of the peroxide, the mixture is much too aggressive in contrast to the proposed mixture of chemical agents. According to the European Standards, use hydrogen peroxide with a concentration of about 6% is prohibited, the more so, if the implementation of the procedure of bleaching is planned in the area of the tooth with the Trauma of the story – in this case, the risk of cervical Resorption, which is described widely in the literature (Cvek, Lindwall, 1985; Hierthersay 1999).

New protocols bleaching see the mandatory use of compound for the bleaching of different design – full and partial: 16% solution of carbamide peroxide is in the room, root canal treatment, while the Patient is in the mouth dress protection for the bleaching, so that the process of the restoration of the tooth, both from the outside as well as inside. William Liebenberg in the year 1997 even offered open access cavity in the tooth, so that the Patient with the help of a syringe and was able to self-bleach install in the room root canal treatment for weeks of course. Thereafter, the Patient back to the dentist, a full cleaning of the camera and its restoration by a special cement.

bleach

Perspective Future: Whitening Paint

A new Trend in the improvement of the procedures of teeth whitening whitening is the use of varnish, containing 6% solution of hydrogen peroxide. Thanks to the feature of this product, it blends well with the fabrics of the tooth, and for the actual delivery of the active chemical agent to the tissues of the tooth enamel and Dentin. After the application of the active substance on the surface of the teeth and an additional hydrophobic layer of silane applied to wear in addition, yet, which helps the peroxide to keep on the site. After 30 minutes or an hour, the whole substance to remove from the surface of the teeth by cleaning with the toothbrush. To develop in addition, further enzymatic approach to recovery of tooth color, provided that there is a mixture of two different agents during the process – carbamide-peroxide and лактопероксидазы that Bleaching allows the activation of chemical agents.

The long-term nature of the effect of tooth whitening

According to the research, if strictly to the Protocol whitening procedure, the resulting effect to be stable for 17 years. However, the majority of patients often this Manipulation is repeated by each of 3 years. When you reach the maximum whitening potential of the teeth, in the course of the re-Intervention rate in a significantly shorter period of time in the range of 3 to 7 days usually takes.

Whitening through life

After the first treatment, provides that in the future the Patient at regular intervals, this Manipulation is repeated whitening, as the white appearance of the teeth. On average, about 25 years of the life of the patient is not recommended that more than 4-5 of such whitening procedure, with the obligatory periodic execution of a professional oral hygiene and other preventive measures, the use of Whitening toothpaste and a restriction in the intake of food and drinks, in which corrosive dyes.

Obsession with teeth whitening, or bleachorexia

In the last 25 years, it was possible to whiten teeth to such colors, which also is not typical for the classical scale-colors Vitus Cathedral. So on the market appeared new samples-and-white pattern, which is carried out and a comparison of the achieved results of the treatment, as well as the selection of the specific shades of ceramics, or composites, in dental treatment. In some patients in the throes of the General popularity of whitening procedures syndrome bleachorexia (Kelleher, 2014), or a pathological obsession with whitening teeth can develop, often in connection with various disorders and low self-esteem. Every dentist should be able to identify such patients among their patients. One of the leading symptoms of obsession tooth whitening this is your shadow, in which they will appear white sclera own eyes, which are positioned often as the Master color. Such patients have to be convincing in the absence of the need to re-the procedure of bleaching, and spend with them the educational work.

08.08.2018