How do you remove those unaesthetic amalgam stains?

Patients frequently complain about the appearance of upper premolars which are badly stained following the placement of a large amalgam restoration. In the absence of any recurrent caries it can be difficult to justify removing the sound but stained tooth tissue and further compromising the tooth. In the past patients have even requested a full coverage crown be placed on this already weakened tooth.

This interesting paper describes a very simple technique which, if it has not been considered previously, may form a useful part of a clinician's armamentarium. Under local anaesthesia the amalgam was removed to expose the stained tooth tissue. A 35% hydrogen peroxide bleaching gel was then applied to the exposed tooth tissue in three 15 minute increments. Between each application the tooth was washed and dried. A temporary restoration was applied and the bleaching process repeated one week later. Immediately following the second bleaching a posterior composite restoration was placed conventionally.