Tooth whitening

General Information: according to information accumulated deuring recent years, the home whitening method with transparent plates was found to be the most effective and most comfortable with the least complications.

When to whiten:
To begin with, it is recommended to whiten only one of the jaws, to enable the patient to see the difference between the two. 
As information in literature about tooth whitening during orthodontic treatment is insufficient, it is preferable to perform whitening in one of two stages:

a)  Prior to treatment - in the event that attachments are included in the treatment, it is possible to supply the patient with the Attachment Template for whitening before bonding the attachments (the composite of the attachments will prevent successful whitening.)

b)  At the end of treatment - together with the last aligner, after removal of the attachments.

Duration of whitening:
Home appliaction for an hour a day for a period of 2-4 weeks, depending on the severity of the case.

Whitening substance:
The whitening substance is a thick transparent gel supplied by various companies in syringes of 1.8-3ml., in concentrations of varying degrees.
In general, the concentration of the active substance (peroxide) in the home whitening gel varies from 2 - 8%; sometimes, the gel appears in a compound called Carbamide Peroxide, more concentrated, although only one fifth of the listed concentration is peroxide.
In the event that the patient has gingival recession and bone is exposed, which can become sensitive to the treatment, whitening should be commenced for the first week with substance of lower concentration (2-3% being 10-15% Carbamide Paroxide) and if there is no sensitivity, then higher concentrated substance can be introduced in the following weeks.

How much gel in the aligner?
The patient should be shown how to inject the gel into the bottom of the aligner (in the area of the teeth edges) like toothpaste about 3 mm. thick. The patient should be instructed to place the aligner to cover the teeth entirely so that excess substance oozes at the margins thus ensuring whitening at the neck part of the teeth. The excess substance should be wiped with a tissue for the patient's comfort.

Side effects:
Tooth Sensitivity: in the event of sensitivity, the patient should be instructed to reduce the application time to half an hour a day and on alternate days. The patient should also be given less concentrated substance and be informed that ths sensitivity will pass in a few days.
Gingival Sensitivity: highly concentrated substance may cause slight sensitivity in the gums. This should be treated as recommended in such instances.

   Before Whitening:                              After Whitening

                              

     

"The whitening of the neighborhood: "
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