Dentes claros. Claro? Produto: MIX ONE Supreme 35%

Having aligned, healthy, beautiful and clear teeth is everyone's dream. A healthy and beautiful smile brings a pleasant sensation to those who see it and improves the self-esteem of those who have it. Teeth whitening has been the subject of many questions by dentists and, especially, by patients who long for more beautiful teeth. In recent decades, much information has been transmitted regarding the best technique for achieving white teeth, without damaging the dental structure or causing sensitivity. Within the whitening techniques for vitalized teeth (without root canal treatment), we can choose the home whitening technique (always supervised by a dentist), the in-office whitening technique or a combination of both. Of course, none of these techniques should be performed without knowledge of the mechanism of action of the whitening agents, the diagnosis of the etiology of the color change and the correct indication for whitening. The most common causes of tooth color change are divided according to their etiology into: extrinsic changes and intrinsic changes. Extrinsic changes are caused by pigments that adhere to the external surface of the teeth due to eating habits such as drinking coffee, tea, beverages and foods with artificial coloring, smoking and poor oral hygiene (accumulation of plaque and tartar). Often, a simple prophylaxis performed by a professional followed by guidance on proper oral hygiene may be the treatment of choice. 1,2 Intrinsic changes are those located deep within the dental structure and may be congenital (changes that occur during tooth formation such as dentinogenesis imperfecta, enamel hypoplasia and fluorosis) or acquired, such as tetracycline stains, severe jaundice, fetal erythroblastosis (pre-eruptive, i.e., before the teeth appear in the oral cavity), dental trauma, metal impregnations, intracanal medication, infiltration restorations, aging (post-eruptive, after the teeth erupt in the oral cavity).

The etiology of the color change and its intensity will guide the professional in the correct indication of the treatment and its predictability, whether it be through whitening, replacement of restorations, composite resin veneers, porcelain veneers or full porcelain crowns. With the increasing advancement in dental whitening techniques, new products have been developed to facilitate this procedure. Some industries already provide whitening agents for use in the office without the need for light activation; however, it is extremely interesting for the professional to have a low-intensity laser at their disposal to treat sensitivity if it occurs. The clinical case report below demonstrates how these products can facilitate the daily routine of the professional for the in-office whitening technique. A 29-year-old female patient came to a private clinic complaining of “yellowish” teeth (Figure 1). After a thorough clinical examination to diagnose the etiology of the color change and possible signs of sensitivity to dental whitening, the patient was instructed regarding the type of whitening to be performed and signed an informed consent form with the appropriate explanations. Dental whitening was indicated by a supervised in-office technique, using the MIX ONE Supreme® dental whitening gel – Villevie (35% hydrogen peroxide). This product combines practicality and speed of application since it does not require the use of a light source for activation or the need for mixing and handling. Prophylaxis was performed with Villevie prophylactic paste (Figure 2), without oil. The application of the whitening gel after placement of the gingival barrier is facilitated by using a brush and without the need for mixing the product (Figure 3). The gel should be applied evenly to the vestibular surface of all teeth to be whitened (Figures 4 and 5). After two sessions with 2 applications each (15 minutes per application), we can see the results in Figures 6 and 7. The use of reliable whitening materials, knowledge of the procedure to be adopted, in addition to mastery of sensitivity and correct indication of the technique, by the dentist, will certainly lead to safe and reliable results.

Bibliographical References 1) Nathoo S. The chemistry and mechanisms of extrinsic and intrinsic discoloration. J Am Dent Assoc 1997;128:6S–10S. 2) Macpherson LMD, Stephen KW, Joiner A, Schafer F, Huntington E. Comparison of a conventional and modified tooth stain index. J Clin Periodont 2000;27:424–30. 3)Okuda WH. Using a modified subopaquing technique to treat highly discolored dentition. J Am Dent Assoc. 2000 Jul;131(7):945-50