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Video Details
Bleaching Teeth, Current Status - Part 4

Description:
In part 4 of this series, Dr. Ronald Goldstein continues his presentation on the state-of-the-art of bleaching in esthetic and restorative dentistry. In this section Dr. Goldstein covers the considerations that must be addressed when bleaching patients with Tetracycline or Minocycline stained teeth. In addition, Dr. Goldstein also outlines long-term clinical considerations required for maintenance of patients receiving bleaching therapy. The management of patient expectations are also discussed.

Date Added:
2/25/2009

Author(s):

Ronald Goldstein, DDS Ronald Goldstein, DDS
Dr. Ronald Goldstein is currently Clinical Professor of Oral Rehabilitation at Georgia Regents University College of Dental Medicine in Augusta, Georgia, Adjunct Clinic...
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Questions & Comments
Ronald Goldstein - (4/18/2010 3:54 PM)

Most all of the negative effects of bleaching do revolve around sensitivity and that is why I strongly recommend taking radiographs before deciding to bleach teeth. Studying the size of the pulps can help determine if the patient will be sensitive. Other potential problems involve bleaching teeth that will not receive a positive result such as teeth that have a great amount of translucency because they may actually appear 'darker' rather than lighter as the tooth is bleached. Also teeth that have considerable microcracks may result in a 'splotchy' look with the cracks becoming even whiter than the rest of the enamel. I have not seen negative results from over use with the exception of some soreness of the gingival tissue especially when the bleaching trays are not trimmed properly. I normally begin with a 10% bleach unless the patient is older or has extremely receding pulps, and then go up in strength as the patient continues for about 6 weeks. As far as number of times they can be bleached in office that depends on results and anticipated need for the patient. At home bleaching can be done as the patient feels the need for more lighter teeth. However, both need to be monitored to make sure the bleaching is working. Finally, althought it is difficult to begin bleaching at a young age, again the size of the pulp can dictate when to start....plus the need for the young person to have lighter teeth.

Andrew Spath - (4/18/2010 10:15 AM)

Dr. Goldstein you never mentioned negative effect of bleaching other than sensitivity. Have you seen many long term negative effect from over use? What percentage bleach are you sending your patients home with? Do you implement any rules as far as how many times a year patients can bleach or at how young of an age?

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