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References

Dadoun MP, Bartlett DW. Safety issues when using carbamide peroxide to bleach vital teeth – a review of the literature. Eur J Prosthodont Rest Dent. 2003; 11:9-13
Haywood VB, Heymann HO. Nightguard vital bleaching. Quintessence Int. 1989; 20:173-176
Morris CDN. Tooth whiteners – the legal position. Br Dent J. 2003; 194:375-376
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General Dental Council. Position statement on tooth whitening. http://www.gdc-uk.org/api/files/Tooth-Whitening-Position-Statement.pdf (Accessed 11 July 2016)
Official Journal of the European Union (OJEU). 2011; 36-38
Sharma DS, Sharma S, Natu SM, Chandra S. An in vitro evaluation of radicular penetration of hydrogen peroxide from bleaching agents during intra-coronal tooth bleaching with an insight of biologic response. J Clin Paed Dent. 2011; 35:289-294
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Dental Bleaching: An Update

From Volume 45, Issue 1, January 2018 | Pages 44-50

Authors

Raheel Malik

BDS(Lond), BSc(Hons)

General Dental Practitioner, Private Practice, Notting Hill. Programme Director, Clinical Tutor and Lecturer, Aspire Dental Academy

Articles by Raheel Malik

Abstract

Bleaching is a commonly sought aesthetic treatment. In recent years there have been changes to the legal aspects of dental bleaching. This article provides an overview of dental bleaching, the changes that have occurred and how they may affect the provision of this treatment. The article also discusses tray design, sensitivity and adhesive bonding, and summarizes the most common bleaching protocols currently used.

CPD/Clinical Relevance: Clinicians should be aware of dental bleaching legalities and the methods and techniques used to treat discoloured teeth.

Article

A subjective perception of tooth discoloration, or of having an unattractive natural tooth colour, can entice a patient to seek aesthetic enhancing procedures such as tooth bleaching. This safe1 treatment was popularized by Haywood and Heymann in 1989.2 They published a protocol on placing carbamide peroxide in custom-fabricated trays to lighten teeth.2 Today, the basic principles remain the same, although there have been many modifications to the procedure. The active ingredient in bleach is hydrogen peroxide (H2O2), either contained or released. There are several products available on the market and these differ in flavour, stabilizers, anti-sensitive agents, delivery, storage and marketing of the product. Regardless of who supplies the H2O2, if it is kept on the teeth for long enough whilst also adhering to a safe protocol, most teeth will bleach.

Methods available for bleaching teeth include the following.

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