Home bleaching involves impressions of your mouth. A thin gumshield is made and is worn usually at night time for at least 3 hours for 3 weeks. In this gumshield a bleaching agent called carbamide peroxide is placed by the patient (on the instructions of the dentist). After each bleaching session you clean the gumshield under the tap and brush your teeth. Other than some hot and cold sensitivity during the bleaching procedure there are rarely any complications to bleaching.
Current European Community Directives mean that products releasing more than 6% Hydrogen Peroxide are NOT permitted. Bleaching is unlawful in under 18’s. These regulations were adopted in October 2012. In practical terms this means a maximum of 15% carbamide peroxide is permitted. Bleaching products are only allowed to be prescribed by a registered dentist. This means that many high street shops offering bleaching are in breach of current regulations.
Bleaching is a surface treatment and will only be partially successful if the main tooth discolouration is in the inner layer of tooth substance. This is NOT apparent just by looking at the teeth so it is possible to undergo the whole bleaching procedure and NOT obtain a big improvement in colour. In addition bleaching affects natural tooth substance it does not affect restorations eg crowns, veneers or fillings. This means that if you have a heavily restored mouth that bleaching may not be suitable for you, if you bleach you may end up with some very light teeth next to teeth of a different colour and the end result may look poor. In addition bleaching in such circumstances may mean that you will require much in the way of additional dental treatment. This may have a detrimental effect on your dental health. There must always be a balance between health and appearance!
Internal bleaching is sometimes required in root treated teeth, which in many cases have had to be root treated as the nerve has been damaged due to acute trauma eg being hit in the face by a hockey ball. What happens is that the pulp (which has nerve and blood vessels) bleeds into the surrounding tooth darkening it. The patient is left with one very dark tooth surrounded by normal coloured teeth.
Internal bleaching takes at least two visits. The dentist drills a hole into the back of the affected tooth and inserts a walking bleach of carbamide peroxide. The hole is sealed and this procedure is repeated about every fortnight until the desired colour is reached. The access hole is then restored with composite (white filling material).