Teeth Whitening – The impact of toothpaste and gels on enamel, dentine and pulp

Boutique Biomin Toothpaste

Boutique Biomin Toothpaste should be used 2 weeks prior to whitening, and throughout the whitening process. It can be used after the whitening is completed to help maintain white teeth and reduce the symptoms of sensitivity. 1 2 3 4 5 6 7 Full examination. Brush with Boutique Biomin Toothpaste for 2 weeks prior, and throughout, the whitening process. Photographs with time stamp and shade tab. Restore any exposed root dentine with composite or glass ionomer. Use one of these chair-side desensitisers on any sensitive areas, as directed in the instructions. Use Sensodyne Toothpaste in the whitening trays overnight for 3 nights prior to whitening. Select the correct gel by speaking with your patient to see what is best suited to their lifestyle. Boutique Biomin Formula Boutique Biomin formula contains a new generation of bioactive glass, incorporating fluoride, phosphate and calcium ions which are released gradually over 12 hours. As it dissolves, the glass structure precipitates as fluorapatite which aids remineralisation of tooth enamel. Fluorapatite is more stable and resistant to acidic attack than hydroxyapatite formed by previous generation bioactive glass. Biomin particles chemically bond to calcium in the enamel, and as they dissolve the ions occlude exposed dentinal tubules which prevents hydraulic conductance, and reduces sensitivity. Biomin is engineered for ‘smart activation’ in acidic environments, such as following consumption of certain food and drink. Low pH causes the bioactive glass to dissolve more rapidly, neutralising the acid, restoring pH balance and replacing lost minerals

Whitening Gels

BOUTIQUE BY DAY 6% HYDROGEN PEROXIDE This gel is designed for wearing for 1.5 hours per day. Standard kit is 4 x 3ml syringes and should last around 3 weeks.

BOUTIQUE B1 GUARANTEE 16% CARBAMIDE PEROXIDE This gel is designed for 4-6 hours wear per day. B1 kit is 8 x 3ml syringes and should last around 6 weeks. Our Boutique trays must be used to claim the guarantee and you must follow the B1 protocol (downloadable from our website)

BOUTIQUE HYBRID PRO 4.25% HYDROGEN PEROXIDE 4.25% CARBAMIDE PEROXIDE This gel is designed for 3-4 hours of wear overnight. lPro kit is 4 x 3ml syringes and should last around 3 weeks. This kit provides a double action formula which delivers an instant hit of whitening via the peroxide, and a prolonged whitening effect from the carbamide. 

BOUTIQUE BY NIGHT 10% CARBAMIDE PEROXIDE This gel is designed for 4-6 hours wear per day. Standard kit is 4 x 3ml syringes and should last around 3 weeks. This kit is for patients who have sensitive teeth.

BOUTIQUE BY NIGHT 16% CARBAMIDE PEROXIDE This gel is designed for 4-6 hours wear overnight. l Standard kit is 4 x 3ml syringes and should last around 3 weeks.

The impact of gels

Teeth whitening is one of the most researched cosmetic procedures in the world and has a wealth of evidence to support the effectiveness and safety of the take home technique, if correct protocols are observed. There are many studies that exist which demonstrate the effects of peroxide on the various layers of the human tooth.

Enamel Enamel is not significantly affected by the use of peroxide based products. A study by Leonard, et al, in 2001 assessed the effect of 10% carbamide peroxide on the surface morphology of enamel after 2 weeks, and again after 6 months, using electron microscopy at 2000 times magnification. There was no significant effect on the surface of enamel immediately after whitening and it did not worsen over time.

Dentine Dentine is affected more by the whitening process than enamel tissue. Spyrides GM, et al, study from 2000 showed that dentine bond strength decreased by as much as 76% post whitening. Further research from Na-Young Jeong, et al, in 2006 showed that 2 weeks was sufficient to allow the dentine to recover and bond strengths returned to near the same as pre-whitening levels. Always schedule any restorative work at least 2 weeks after the patient has finished whitening. If there is any immediate bonding required, soaking the dentine in a 70% ethanol solution for 2 minutes can restore bond strengths to near pre-whitening levels.

Pulp Owing to the sensitivity associated with tooth whitening, it is often wrongly assumed that whitening causes pulpal damage. JO Fugaro, et al, did a study in 2004 on the reaction of pulpal tissue to two weeks use of 10% carbamide peroxide. The findings from this study demonstrated that 10% carbamide peroxide can cause mild, localized pulp reactions, however, these did not affect the overall health of the pulp tissue and were reversible within two weeks post-treatment. Therefore, two weeks of treatment with 10% carbamide peroxide is considered safe for the pulp. Another study by Cohen showed that hydrogen peroxide up to 35% concentration was harmless to the pulp. It is a safe assumption that no long term harm will come to the pulp from the concentrations of whitening solution that are used in home whitening.

Are your patients ready for a whiter, brighter smile?