Role Of Restorative Dentistry
Attractive teeth have always been the typical patients primary concern
. In the past, dentists were often dismayed by a patients disappointment in a perfect restoration, painstakingly crafted of the finest gold or other material, with minimized enamel reduction and long-lasting preservation of function. The patient, of course, had hoped the restoration would mimic the appearance of original teeth. Today, by taking full advantage of new materials and techniques, dentists can often meet or even exceed such expectations.
What most people really want, however, are teeth that make them look younger, healthier, and more attractive. Thirty years ago, patients considered dentists both allies in the prevention of dental problems and friendly repair professionals when such problems inevitably occurred. Today, dentists are increasingly becoming the professionals to whom people turn first for advice and assistance on improving their appearance.
Major Cause of Discoloration:
Superficial changes affecting only the enamel surface:
These usually are caused by habitual use of highly colored foods or beverages such as tea, coffee, and cola, all of which can cause tenacious brown to black discolorations. Smoking tobacco cigarettes, cigars, or pipes produces a yellowish brown to black discoloration.
Bleaching can be an effective treatment modality for this type of discoloration. If the mottling is serious enough, the enamel may be chalky, without the glaze and luster of a normal tooth. If staining is accompanied by pitting and other surface defects, bleaching is best viewed as a useful adjunctive treatment preceding bonding or veneering. If fluorosis has caused severe loss of enamel, bleaching should not be used at all.
Tooth color changes Due to Aging:
Change in tooth color, as well as tooth form and texture, almost inevitably accompany aging. Most newly formed teeth have thick, even enamel which modifies the base color of the underlying dentin. That bright, milky white appearance seems to be the ideal in todays society. Unfortunately, all of the numerous genetic, environmental, medical, and dental causes described above move teeth further away from that ideal, and aging intensifies all of their effects food and drink have a cumulative staining effect, and these and other stains become even more visible in the older patient because of the inevitable cracking and other changes on the enamel surface of the tooth, within its crystalline structure, and in the underlying dentin.
Creating a Dental Team to Help Shape and meet Increased Patient expectations:
Bleaching is an appropriate adjunct to cosmetic contouring, orthodontics and plastic and reconstructive surgery. One of the unexpected advantages of using bleaching with these procedures is that it creates new communication, understanding, and referral patterns between many different specialists.
We are beginning to see the dentist become the initial health care provider to whom people bring their wishes, sometimes expressed quite tentatively, for a more attractive appearance.
Application of bleaching materials
There are several differences in the actual bleaching procedure depending on the etiology and severity of the discoloration.
1.The number of treatments required will differ. For teeth stained by coffee, tea, or other substances, for many cases of fluorosis-stained teeth; or for the yellowing associated with aging, a dramatic difference can appear in only one or two visits. For tetracycline-stained teeth, three or more visits are generally required, even if combined with an out-of-office matrix technique.
2.The bleaching solution itself will vary, depending on the severity of the stain. For most bleaching, a 30% to 35% concentration of hydrogen peroxide is used, following mild etching to enhance penetrability.
3. The method of applying the bleaching solution to the teeth also will differ, depending on the cause of the discoloration. For evenly distributed extrinsic or tetracycline stains, the bleaching solution is usually applied by infusing gauze draped over the teeth. For the more heterogeneous stains of fluorosis, paint the bleach on the tooth directly in order to localize it according to the pattern of staining.
Advantage of Bleaching used alone:
For most patients, the preeminent advantage of bleaching is its relatively low cost. That leads many patients to inquire about bleaching is the fact that no tooth structure is reduced to achieve tooth whitening. The bleaching to acquire lighter teeth is the fact there is no need for continuous replacement, as with restorative alternatives. there will be no chipping or fracturing of the nature bleached teeth, as tends to occur with restorative modalities. Many patients also appreciate the minimal office time made possible by combining an initial in office procedure. Bleaching chief advantage is its minima; invasiveness, which requires no alteration of tooth structure or loss of enamel, yet produces the desired improvement in appearance.
Disadvantages of bleaching used alone:
The effect of bleaching on natural teeth is not permanent, compared to crowns and veneers, which can be restored to their original brightness through cleaning; this is particularly significant when the staining is caused by behaviors the patient is unwilling to give up, such as smoking or drinking coffee and tea. It requires more than one or two sessions. Compared to bonding, for instance, the average patient may need to return for several sessions of in office bleaching.
by: hawary2
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