Chapter 43 - Tooth Bleaching (Clinical Practice of the Dental Hygienist, 14th Edition)

Vocabulary flashcards covering key terms and concepts related to tooth bleaching, staining, materials, techniques, and clinical considerations.

Bleaching

Process that uses free radicals to break down chromogens, with color change that can extend into dentin.

Whitening

Any process that lightens the color of teeth.

Chromogens

Molecules in foods/drinks that alter reflected light and stain teeth by binding to enamel or the salivary pellicle.

Staining

Chromogens adhere to enamel, causing color change and often darkening of teeth.

Extrinsic staining

Staining on the outer enamel surface.

Intrinsic staining

Staining within the tooth structure.

Chromogenic staining

Staining caused by chromogens; can be extrinsic or intrinsic; bacteria may produce chromogens.

Dentin

Underlying tooth material whose yellow or gray color can show through enamel due to translucency.

Enamel

Outer tooth layer; its thickness and translucency influence tooth color and how dentin color shows through.

Dentin color

Yellow or gray color of dentin contributing to overall tooth color.

Translucency

Degree to which enamel lets underlying dentin color show through, affecting color.

Hydrogen peroxide

Whitening agent with a short working time; lower pH; can cause demineralization/erosion with extended use.

Carbamide peroxide

Whitening agent with longer working time; higher pH; slower release; can be used at home; generally less sensitivity.

pH

Measure of acidity/basicity; hydrogen peroxide has a lower pH than carbamide peroxide, affecting demineralization risk.

Demineralization

Loss of mineral content from enamel, a risk with acidic bleaching agents.

Erosion

Mineral loss from the tooth surface due to acids; related to low bleaching agent pH.

Dehydration

Temporary lightening of teeth color caused by loss of water during bleaching.

Color stabilization

Color typically stabilizes about 2 weeks after bleaching.

Microabrasion

A technique to remove white spots and may improve results when used with bleaching.

Desensitization

Measures to reduce sensitivity before, during, and after bleaching.

Potassium nitrate

Desensitizing agent in toothpaste to reduce sensitivity during bleaching.

Sodium fluoride

Used in prescription-strength toothpaste and varnish to aid remineralization and reduce sensitivity.

Desensitizing dentrifice

Desensitizing toothpaste containing potassium nitrate or fluoride used during bleaching.

Fluoride varnish

Professional fluoride varnish applied post-bleaching for mineral protection.

Scalloped trays

Bleaching trays with scalloped edges to protect gingiva and exposed root surfaces.

Unscalloped trays

Bleaching trays without scalloped edges; more comfortable but risk overfilling.

Professionally dispensed trays

Custom-fitted trays made using impressions/casts for accurate fit.

Over-the-counter trays

Prepped by patients at home; bulkier with less precise fit.

Shade guide

Tool with multiple shade ranges (up to ~29) used to select tooth shade.

Manual shade selection

Shade matching done under natural or corrected lighting, after extrinsic stain removal.

Digital shade guide

Electronic devices that provide objective shade records.

Tetracycline stains

Gray/brown discoloration; may require longer bleaching; severe cases may need veneers.

Minocycline stains

Stains that may respond to bleaching but require longer treatment.

Fluorosis stains

White spots; microabrasion may help; bleaching response can vary.

Nicotine stains

Stains that commonly respond to bleaching about 80% of the time.

Brown staining

Typical brown tetracycline-related stain; often lightens with bleaching.

Gray stain

Dark gray discoloration; most difficult to lighten.

Dentinogenesis imperfecta

Inherited dentin defect; bleaching usually has little effect; restoration often required.

Amelogenesis imperfecta

Inherited enamel defect; bleaching often limited; restoration may be needed.

Microcracks

Cracks in enamel; may whiten more than surrounding areas after bleaching.

Anterior lingual amalgams

Restorations on the tongue-facing surfaces; bleaching can make them more visible.

Dental caries

Decay; these areas are not typically whitened by bleaching.

Dark canines

Canines that bleach well and may become lighter.

Aging

Age-related changes; translucent areas may be more noticeable after bleaching due to contrast.

Translucent teeth

Teeth with high translucency; bleaching can affect translucency, especially at incisal edges.

Porcelain veneers

Alternative cosmetic option when bleaching is insufficient for severe staining (e.g., severe tetracycline).

Light-activated bleaching

Bleaching activated by light; contraindicated for light-sensitive patients and those on photosensitive meds.

Box 43-2 – Light-activated bleaching contraindications

Avoid in patients with light sensitivity, on photosensitive medications, or exposed to UV from certain lights.

Minocycline stains

Stains from minocycline that may require longer bleaching to improve.

Root exposure

Bleaching may not effectively lighten teeth with exposed roots.

Dentinogenesis imperfecta and amelogenesis imperfecta

Inherited dentin/enamel defects that show limited bleaching response.

Microabrasion after bleaching

Microabrasion techniques can be used post-bleaching to improve color stabilization.