This is the process of tooth whitening where vital teeth are
bleached by direct contact with an agent such as Carbamine peroxide. In certain clinical situations, bleaching can
be done as a more conservative option than ceramic crowns or veneers.
Power Bleaching
The bleaching of vital teeth can occur inside the surgery
(power bleaching) or outside the surgery (nightguard vital bleaching). Dr Kuschner does not favour power bleaching
as this is done with high concentrations of bleaching solutions placed directly
on the teeth, often supplemented by a light source to enhance the peroxide
release. The dentist cannot exactly control
the amount of lightening of teeth. There is a possibility of soft tissue damage
and a greater risk of post-operative sensitivity.
Nightguard Bleaching
Nightguard or "take
home" bleaching is a more commonly used technique. It is less expensive for the
patient. It involves the use of a 10-15%
solution of Carbamine peroxide in a gel form, delivered to the tooth surface by
a custom made plastic bleaching tray.
This technique is approved by the ADA (American Dental
Association). Patients normally sleep
with the nightgurad in place for 7-10 nights.
The process is safe and the results are generally excellent. If the teeth become sensitive, patients are
advised to bleach alternate days.
It must be noted that old fillings and crowns do not
bleach. It might be necessary to redo
certain white fillings after bleaching.
If a patient requires crowns, the rest of the teeth in the arch can be
bleached. The crowns can be matched to
the new lighter colour. It is
recommended that the teeth be re-bleached at home for one night every 8-10
weeks to maintain the result. Certain
factors such as diet and smoking can have a negative effect on the long term
results.
Clinical examples where the upper jaw is bleached
first. The lower jaw serves as a
control.
Dr Cliff Kushner
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Procedures 
