Course Code: DEN 055 Current Trends in Dentistry

Student’s Activity Sheet #2

Macariola, Mikhaela Riletta D.

Name: _________________________________________________________________
EI
Section: ____________ Schedule: ________________________________________Class number: _______

Date: ________________

Lesson title: Vital Bleaching Materials:

Lesson Objectives: Pen, eraser, highlighters, module
1. At the end of this module, students will understand how References:
bleaching is done on vital teeth Sturdevant’s Art and Science of
2. To help students understand the Operative Dentistry 6th ed.
Consumer Guide to Dentistry

Productivity Tip:
Clean up the clutter! Keep your study place tidy. This helps your brain organize information better and faster.
*** TO PREPARE YOU FOR THE BOARD EXAM, STUDY THE RESTORATIVE/OPERATIVE
DENTISTRY SECTION OF YOUR REVIEWERS (MOSBY, WELLS, DENTAL DECKS AND RUDMAN)

A. LESSON PREVIEW/REVIEW
Introduction (2 mins)
Teeth whitening has been gaining a lot of popularity in today’s generation. Everybody wants that pearly
white smile. In the practice, there are a number of ways to achieve that; from procedures done in the
clinic to procedures that can be done at home. Today’s lesson will focus more on teeth bleaching on
vital teeth. Let’s get on it!
Activity 1: What I Know Chart, part 1 (3 mins)
What I Know Questions: What I Learned (Activity 4)
Application a chemical agent
1 what is the mechanism of action
of

No idea to oxidize the organic

of teeth bleaching? pigmentation in the tooth.

2 what restorative material exhibits Am algam

No iden discoloration when exposed to a Dental alloy
bleaching chemical?

Hydrogen peroxide 3 what chemical is used in home peroxide

applied bleaching? Hydrogen

B.MAIN LESSON
Activity 2: Content Notes (13 mins)
The lightening of the color of a tooth through the application of a chemical agent to OXIDIZE the
organic pigmentation in the tooth is referred to as bleaching. In-office bleaching of vital bleaching was
first reported in 1868. By the early 1900s, in-office vital bleaching had evolved to include the use of heat
and light for activation of the process.
INDICATIONS FOR VITAL BLEACHING
teeth intrinsically discolored due to aging
Discoloration due to trauma
Teeth that has a poor endodontic prognosis due to calcific metamorphosis

This document is the property of PHINMA EDUCATION

 Course Code: DEN 055 Current Trends in Dentistry
Student’s Activity Sheet #2

Name: _________________________________________________________________

Section: ____________ Schedule: ________________________________________Class number: _______

Date: ________________

Discoloration due to certain medications

Before and after restorative treatment to harmonize the shades with those natural teeth.
Teeth exhibiting yellow or orange intrinsic discoloration seem to respond best to vital bleaching,
whereas teeth exhibiting bluish gray discolorations often are considerably more difficult to treat in
this manner.
VITAL BLEACHING TECHNIQUES
IN OFFICE BLEACHING OUT OF OFFICE BLEACHING

Also known as POWER BLEACHING DENTIST PRESCRIBED, HOME-APPLIED

TECHNIQUE/ DENTIST-DISPENSED TAKE HOME
WHITENING TRAYS (nightguard vital bleaching)
Performed by: DENTIST in the clinic Performed by: PATIENT

Chemical applied: 30-35% hydrogen perxodie Chemical applied: 10-15% carbide peroxide

**additives such as METALLIC ION-PRODUCING **carbamide peroxide degrades into 7% HYDROGEN

MATERIALS or ALKALINIZING AGENTS can speed PEROXIDE and 3% UREA
up oxidation process
Treatment process: Treatment process:
1. vaseline/cocoa butter is applied to lips and gingival
1. Dentist makes customized night guard fitting the
tissues. patient perfectly
2. Rubber dam is applied to isolate teeth. 2. Patient applies a thin bead of bleaching material
3. 30-35% hydrogen peroxide applied on teeth for into the night guard along the facial aspects
30-45 minutes corresponding to the area of each tooth to be
**in instances where solution may leak out of the bleached. Bleaching material is stays in contact
rubber dam, patient is instructed to report any with teeth overnight.
burning sensation on lips and gingiva 3. Excess bleaching material should be removed to
4. solution is rinsed. avoid chemical burns on soft tissues
Treatment duration: Treatment duration:
Wekly treatment for 2-6 weeks If night guard is worn overnight every night, treatment
may last for 1-2 weeks
If patient cannot tolerate overnight treatment, an
alternative time that is convenient for patient should
be arranged.
Due to the property of hydrogen peroxide, If either of the two primary adverse effects occur (e.g.,
POSTOPERATIVE SENSITIVITY should be sensitive teeth or irritated gingiva), the patient should
anticipated. Non-steroidal analgesic and anti- reduce or discontinue treatment IMMEDIATELY and
inflammatory drug may be administered. contact the dentists that the cause of problem may be
POLYMETHYL METHACRYLATE RESTORATIONS - identified and treatment approach modified. The
the only restorative material that produces yellow- dentist may prescribe desensitizing agents to help
orange discoloration when exposed to carbamide alleviate sensitivity associated with bleaching.
peroxide. All temporary crown should then be made
with BISACRYLIC MATERIALS to avoid discoloration

This document is the property of PHINMA EDUCATION

 Course Code: DEN 055 Current Trends in Dentistry
Student’s Activity Sheet #2

Name: _________________________________________________________________

Section: ____________ Schedule: ________________________________________Class number: _______

Date: ________________

OTHER OUT OF OFFICE BLEACHING TECHNIQUES:

Whitening Strips- thin, flexible membranes coated with bleaching gel. no mixing needed and pretty
convenient to use. Not as effective as customized tray bleaching since saliva easily mixes with the gel
and dilutes its potency. Chemical used: 14% hydrogen peroxide
Brush on whiteners- used directly after meals that come in the form of pens with brush-on or foam tip
applicators.
Whitening Toothpaste- they contain more abrasives such as silica, aluminum oxide, calcium carbonate
and baking soda
ADVANTAGES OF IN-OFFICE VITAL BLEACHING
Dentist has total control of treatment
Soft tissue is better protected from the process
Technique has the potential for bleaching teeth more rapidly
DISADVANTAGES OF IN-OFFICE VITAL BLEACHING
Cost
Unpredictable outcome
Unknown duration of treatment
ADVANTAGES OF DENTIST PRESCRIBED,HOME APPLIED VITAL BLEACHING
Lower concentration of peroxide
Ease of application
Minimal side effects
Lower cost because of reduced chair time (time allotted patient is sits in the dental chair)
DISADVANTAGES OFDENTIST PRESCRIBED,HOME APPLIED VITAL BLEACHING
Reliance to patient compliance. If patient is not diligent, treatment duration may be prolonged
Longer time treatment
Potential for soft tissue changes with excessively extended use
Activity 3:
INSTRUCTIONS: to help you better understand this topic, please watch this video on Youtube.
Take note of the steps and the materials used then answer the questions below:
https://www.youtube.com/watch?v=drI4D9g6Ig4
1. Aside from night guard bleaching, using the vacuum to make customized acrylic trays for
patients, name 4 other conditions in which custom trays/ splints are used in as an adjunct to
treatment.
Activity 4: What I Know Chart, part 2 (2 mins)
Now that we’re done with our main discussions, please go back to “What I know chart” and answer the
“What I Learned” column. Use a spare paper if space is not enough.
Activity 5: Check for Understanding (5 mins)
*** To prepare you for the Dentistry Licensure Exam, some questions in this short quiz (and possibly the
following ones) will be taken from specific Dental reviewers provided for you at the beginning of this semester.
Please take the time to read your reviewers to be familiar with the answers and the rationale.
*** all question were thoroughly screened to make sure that it is cohesive with the topic at hand.
Please answer the short quiz below by ENCIRCLING THE LETTER OF THE CORRECT ANSWER to
check your understanding of today’s discussion. Check your answer with the answer key provided. Write
your score in this paper.

This document is the property of PHINMA EDUCATION

 Course Code: DEN 055 Current Trends in Dentistry
Student’s Activity Sheet #2

Name: _________________________________________________________________

Section: ____________ Schedule: ________________________________________Class number: _______

Date: ________________

1. The primary factor in developing the outline form or a composite resin restoration on the proximal surface of
and anterior tooth is:
A. The position of contact b. E relationship of adjacent tooth c. He aesthetic required
⑧
D. The extent of the carious involvement
2. Finish of the enamel margin at the gingival cavosurface on a cavity prepared for amalgam is
A. Not indicated because of the poor tensile strength of amalgam
⑧
B. Accomplished by creating a steep cavosurface bevel
C. Not required since no stress is placed on the restoration in this region
D. Accomplished by removing all unsupported enamel rods and prisms
3. Bitewing radiograph are useful diagnostic tool to the detection of
A. Class I restoration Ob. Proximal surface caries c. Caries of the facial surface
d. Caries of the lingual surface
4. Which of the following is generally recommended for etching tooth structure?
A. Males acid 0 b. Phosphoric acid c. Hydrofluoric acid d. Tartaric acid
5. Which of the following materials has the highest linear coefficient of thermal expansion?
A. Amalgam B. Direct gold c. Tooth structure ⑧ d. Composite

C. LESSON WRAP-UP
A. Work Tracker
You are done with this session! Let’s track your progress. Shade the session number you just
completed.

!
B. Think about your Learning
Please answer the following questions:
1. What part of the lesson was difficult for you to understand?
____________________________________________________________________________________

2. What strategy have you used so that the case study was easy for you to answer?
___________________________________________________________________________________
FAQs
How much does TAKE HOME VITAL BLEACHING cost?
answer: on average it costs around 10,000-15,000php
How much does IN-OFFICE VITAL BLEACHING cost?
Answer: around 15,000-20,000php.
**Some dentists charge higher due to additional materials and the type of bleaching material use. In the market
there’s a wide variety of bleaching materials to choose to so charges would differ greatly from one dentist to
another.
Is it okay to do a restorative treatment after bleaching?
Answer: studies show that right after bleaching procedures there is a reduced bonding strength due to
residual oxygen or peroxide residue in the tooth that INHIBITS THE SETTING OF BONDING RESIN. It is
advisable to do restorative treatment a week after bleaching procedures

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