There are many factors which affect the results of home tooth whitening. These factors affect home teeth whitening due to various reasons and can vary from person to person. However the most common factors affecting the results of teeth whitening are listed as under:
1. History of severity with result to the teeth for bleaching.
2. White spots.
3. Translucency of teeth.
4. Amount of gingival recession & root surface exposed.
Make the patient aware of the treatment he or she is undergoing, the procedure followed and the results.
1. Assess the tooth color with a shade guide.
2. Take pre operative photographs.
3. An alginate impression is made of the arch to be bleached. Make the cast and mark the outline for the guard on the model. Place the two layers of die relief on buccal aspects of cast teeth and form a small space or for the bleaching agent.
4. Fabricate a 2mm thick soft vaccum form plastic matrix, and adjustments are made.
5. To see the proper fit, try it in patients’ mouth.
6. Place the bleaching agent in the space of the teeth to be bleached.
7. Reinsert the mouth guard and remove the excess bleaching agent.
8. Train the patient to use and wearing of the mouth guard. Its done 3 – 4 hours a day & some recommend wearing the guard at night to get better results.
9. Guide the patient not to use the guard while eating.
10. Recall the patient every 2 weeks to check the results. If complications like
11. irritation, oral lesion, etc and treatment is then stopped immediately.
Bleaching Trays Prepared From Cast Trays Loaded With Material
1. Poor patient or case selection: patient having any kind of emotional or psychological problems, and if the patients not ready for the treatment.
2. Dentinal hypersensitivity: extra care and protection is done before carrying the bleaching procedure.
3. Extensively filled teeth
4. Teeth restored with tooth colored material like composites etc., as these instead of lightening become more prominent after the process
5. Teeth which have hypoplasia: in this along with bleaching go for – micro abrasion, composite resin bonding, ameloplasty.
6. In cases of restorations that are defective – bleaching is not carried out, in case of root canal not well obturated, discoloration resulting from metallic salts (as in silver amalgam).
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