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Friday, July 24, 2009

Whitening a Non-Vital Tooth - Step By Step

Dear Readers,

Non-vital whitening is performed when teeth do not have live nerves.

Whitening starts with a dental examination.
The dentist will assess the condition of the teeth structures and the root canal.

It is very important that the tooth does not show any symptoms clinically, and also that endodontic treatment (also known as root treatment) is well done. This can only be seen on a X-ray image. X-ray examination is therefore required.
If the dentist concludes that bleaching can be done, he or she will start the procedure.

There are several STEPS:

1. The colour of the teeth must be recorded and documented

2. On the tooth that will be bleached, on the side of the tongue a hole is made - the whole filling is removed. The pulp chamber is cleaned and about 3 mm of the root canal filling is removed.
This will provide enough space for the root canal to be sealed and prevent leaking of the whitening gel to the root canal and the periodontal area. It is advisable to seal the root canal with glass-ionomer cement about 2 mm thick.

3. Isolate the tooth with a gingival barrier or rubber dam

4. Applying the bleaching gel to the pulp chamber and to the labial or buccal surface of the tooth

5. Using a curing light - this will activate the gel. The gel is allowed to work between 10-15 minutes and then it is removed using the suction. The gel can be applied up to three times per session.

6. After the last treatment, the gel is removed first by suction and then by rinsing.

7. The tooth is then restored with a temporary filling.

8. The result must be observed one week later. If necessary, bleaching may be repeated so the tooth becomes as white as the ones around it.

9. When the result is satisfactory, the material is removed and a permanent white (composite) filling is applied.

Truly yours,
Dr.Trenkova, DDM



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