Single-Tooth Bleaching

Today, having white teeth is no longer a luxury. Many bleaching agents are here to help the consumer on this matter. Even gels or pads that are used practically at home before going to a party are now over the counter.

Though, there is a discoloration problem that does not go away no matter what we do – and the problem affects one single tooth. When asked about such discoloration issues, people generally speak of an impact onto their incisor teeth, either a bicycle accident or a smashed ball when they were young. Minor breakages and cracks are generally encountered at the tip of the discolored tooth.

Sometimes people are directly at unease due to the discoloration, but sometimes they just accept it, believing that one of their teeth is “yellower than others”.

HOW TO DIAGNOSE DISCOLORATION

First, any past incidences of trauma onto the teeth should be inquired. In fact, frequently breaking hard substances with incisor teeth is actually an incidence of trauma. This is why every detail concerning a particular tooth should be inquired.

Palpation and percussion tests should be done during the check-up. (Does the patient feel pain when hit on a particular tooth or when they received pressure onto the tooth?)

VITALITY TEST

It should be checked whether or not a particular tooth is alive. It should be determined if the tooth is responding to the minor electricity test. Ice test, too, helps in this aspect.

RADIOGRAPHIC ASSESSMENT

The vital part of the tooth is studied via the X-Ray of the discolored tooth.

HOW DOES DISCOLORATION OCCUR?

There are sacs of veins and nerves that feed teeth, located inside teeth and called Pulpa chambers. Following a trauma, this region bleeds and the blood leaks into the dental tissue, making it bruise or go yellow, just like a bruising finger.

There are certain forms of discoloration that do not appear on X-rays. In addition, the darkening inside the tooth after a trauma does not always occur and sometimes the tooth could be yellower than the adjacent teeth due to the yellowish layer located on the vital dental tissue and below the enamel getting thicker following a trauma.

51% of such teeth responded normally (Robertson et al. 1996), and 40% of them remained vital and did not show signs on any X-rays, maintaining their healthy status.

TREATMENTS

In the event of a tooth losing its vitality, root canal treatments should be applied before bleaching. Here, the most important issue on which the dentist should decide is whether a single-tooth bleaching or bleaching a particular tooth while bleaching every teeth could work.

SINGLE-TOOTH BLEACHING

After the root canal therapy, whitening gel is applied to cover the tooth neck where the discoloration is most evident. This gel is activated either via a laser, or a source of light and heat. Sometimes, by trapping the gel into a particular tooth, the tooth is bleached. Total arc bleaching method is used when each and every tooth is to be whitened. In the household or office type bleaching techniques, the technique used for single-tooth bleaching is used in combination. Sometimes, the whitening gel is applied onto different teeth in different concentrations. The concentrations of 20-35% for the discolored tooth and 10% for other teeth may be used. Furthermore, by leaving the crown empty after a root canal therapy, the household type bleaching gel is applied with the special apparatus in the evening, in a way that it covers the back side of a tooth by going into it. For the single-tooth yellowing of a living tooth, while allowing the gel to reach the particular tooth; if the bleaching procedure is to be applied, any contact of the gel with every teeth, except for the single tooth in question, is avoided. Or, gel application with different concentrations could be done in this case, as well.