Tetracycline Stains on Teeth: Effective Treatment for Those in Need
By: Arthur Glosman DDS
For those adults old enough to remember childhood in the 50s, tetracycline stained teeth may seem relatively commonplace as the potent antibiotic was used so very often by doctors. In fact, just about any person born prior to 1980 may have been affected by this drug’s staining effects as it was often given to women during pregnancy. In these cases, the teeth were stained permanently during their initial development as the drug would calcify in the teeth’s enamel and generate permanent gray or brown stains over the entirety of each tooth. Another form of staining appeared as horizontal stripes in varying degrees of darkness and depth.
Given that these stains were deeply ingrained in the teeth, few restorative options existed to cover the effects of the tetracycline. Only through veneers or crowns were those affected able to remedy their stained teeth, and often the cost of these procedures would drive people away from ever pursuing treatment. These days, while the options mentioned are still available and have advanced in their own great ways to better the field of cosmetic dentistry, there is also another treatment regimen that your cosmetic dentist can perform that is best known to lift even the most ground in stains like those left by tetracycline. That treatment is called deep bleaching.
Deep Bleaching: The Answer to Intransigent Stains
Deep Bleaching is a cosmetic dentistry procedure that consists of a multi-step protocol combining both in-office bleaching and at-home bleaching. The combination of these two whitening protocols performed meticulously has the best chance of leading to a beautifully white smile that will last if taken care of post treatment.
The treatment begins with a trip to your cosmetic dentist’s office, at which time the dentist will take a very detailed impression or your teeth and gum line. Using these impressions, the dentist will send out for custom-made vinyl trays with reservoirs for bleaching gel. When used, the trays will compress directly along the gum line so as to keep the bleaching gel sealed inside and on your teeth alone, protecting your gums from irritation and preventing mixture with saliva.
Next, a return visit to your cosmetic dentist is required to condition your teeth so they will be more permeable to oxygen and hence better receptive to whitening. During this visit, your teeth are polished with pumice powder then double coated by a desensitizing/conditioning agent. Now, your custom bleaching trays are filled with a low concentration peroxide gel and pressed onto your teeth for approximately 20 minutes. Those with naturally sensitive gums may have rubber dams and retractors in place at this time in order to prevent irritation. After the gel has set for 20 minutes, the tray and teeth are cleaned of the gel and then another 20 minute gel application is done. Once the second application of gel is done, the teeth are rubbed again with two coats of a desensitizing agent.
At this time, you are sent home with your trays and a set of ample carbamide peroxide gel to be used nightly for 14 consecutive days. The gel is used with the trays overnight as the body will produce less saliva to potentially interfere with the peroxide’s effectiveness. The goal during this time is both whitening and, again, making your teeth more permeable to oxygen
At the end of your at-home treatment period, you return to your cosmetic dentist for the final step: a standard in-office teeth whitening. With retractors and rubber dams in place, the dentist will decide to use a weak or strong bleaching gel based on how well your teeth have progressed from the at-home whitening treatment. This procedure will take about an hour in your cosmetic dentist’s office, but when its over your teeth will be the brightest they’ve ever been.
Now that your initial whitening is complete, the maintenance is up to you. Based on your individual habits you will continue to use your custom at-home bleaching trays as sparsely as every 3 months or as often as every two weeks (for those consuming red wines, sodas, coffee, and/or smoking on a daily basis). As long as these instructions are followed your smile will maintain the brightness it received from the initial treatment series.
Dr. Glosman DDS is a practicing aesthetic and reconstructive dentist located in Beverly Hills California. You can read more about him in the Summer 2009 Cosmetic Dentist Review at Dr Arthur Glosman Featured Cosmetic Dentist Review or visit his website at www.arthurglosmandds.com
by Dr. A. G.
