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Michael Farrow discusses how to treat and prevent the problem of sensitivity before, during and after tooth whitening treatment.
Tooth and gum sensitivity is a common problem amongst patients, and something that is often an issue for those undergoing tooth whitening treatment. Teeth can become sensitive during or after whitening treatment due to the perfectly safe chemical and thermal changes that occur during the process.
Dentine hypersensitivity caused by oral health problems such as receding gums, exposed dentine, cavities or a cracked tooth need to be addressed and treated before any whitening treatment can begin. Having whitening treatment can exacerbate such sensitivity problems which are often undiagnosed and that are why a detailed pre-treatment patient assessment is so essential to find any underlying issues.
When assessing patients for whitening surface treatment, there are some important questions they need to be asked:
Other contraindications for whitening include pregnant or locating women, children under the age 18, deep surface cracks r fracture lines, extensive restorative work and severe fluorosis.
Reducing or eliminating sensitivity
Once assessed it is necessary to fully explain the method of treatment and give patients a realistic idea of the end results and ensure their consent. Offering patients day or night home whitening treatments that combine a high water content to reduce dehydration with a fluoride-releasing agent plus built-in desensitizers, is also an important first step to reducing any issue of sensitivity.
A rang of strengths enables clinicians and patients to choose a suitable level of active whitening agent which will suit day or night application. While a higher concentration of hydrogen peroxide makes it possible to deliver tooth whitening results with a shorter tray wear time, if sensitivity is an issue it is recommended to use a slow release, lower concentration (10 per cent carbamide peroxide) 0f whitening gel. Patients need to be made aware of the possibility of sensitivity during the whitening process, but also be reassured that there are effective solutions to the problem such as desensitizing gel that can be applied before and after each treatment that works quickly to tackle any discomfort.
A gel such as pola sooth from SDI that contains sustained-release potassium nitrate which works to block pain, plus fluoride which reduces sensitivity and further remineralises the teeth does not interfere in any way with the whitening process. Using a gel with high viscosity also makes it easy to apply and remains safely in the tray during treatment.
If patients follow their clinician`s and manufacturer`s instructions carefully, the majority will have no side effects. If patients do experience temporary sensitivity (dull or sharp, sensitivity to hot or cold) it will subside after several hours of stopping treatment and will not leave any residual problems. In addition, the wear times can be shortened or made less frequent and teeth can be treated with desensitizer to sooth the problem. Having confidence in your whitening system to overcome sensitivity issues is so important when it comes to offering whitening to patients. Using marketing and education materials make patients more aware of the different options available to them so that they can make an informed choice. Tooth whitening can be a sensitive issue, so it`s important to choose a whitening system that offers an option to suit every patient.
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