Insufficient root canal treatments, trauma to teeth or dead nerves can all be reasons for teeth to become discoloured. Thanks to internal bleaching, teeth can be whitened with the help of bleaching agents – hydrogen or carbamide peroxide. There is no need to let a single discoloured tooth ruin you smile and your confidence. Let the specialists in our clinic in the heart of the medical district in London help you.
Why Wimpole Street Dental Clinic in London?
Having healthy, white teeth is an important factor for smiling with confidence. Discoloured teeth can affect your smile greatly. Whether internal whitening, in-office or home whitening or a combination of them – the dentists and dental hygienists in our clinic in London have a combined experience of several thousand whitenings performed to get you a first class result.
A patient with a well fitting crown. However, as the tooth underneath the crown was heavily discoloured, the crown appeared to dark and grey.
The old crown was removed and an internal bleaching of the remaining tooth was conducted.
The whitened tooth stump after 3 sessions of internal bleaching.
Now, the new crown has a similar colour as the adjacent teeth.
Why do teeth discolour?
In most cases the cause of a discolouration in non-vital teeth is the presence of broken down parts of the tooth’s nerve. The main tooth nerve is surrounded by thousands of small dentine canals. When a tooth nerve dies – resulting in a non-vital tooth – small blood particles from the former tooth nerve accumulate in these canals, this can lead to discolouration of the tooth from the inside which compromises your smile. Even following root canal therapy around 10 per cent of patients are unhappy with the appearance of their root filled tooth.
What are the options to cover a dark tooth?
There are several options to treat discoloured teeth:
When using implants, dentures or bridges the discoloured tooth will be removed permanently. Veneers, partial crowns or full crowns can be used to enhance your smile, change the shape and texture of the teeth. However, all these options require removal of tooth tissue via a dental drill to prepare the tooth for the addition of a veneer, partial or full crown. An alternative can be to use dentist led whitening procedures to improve your smile. In cases of root canal treated teeth internal bleaching (or non-vital bleaching) can be used.
Teeth whitening or bleaching is one of the most common cosmetic dentistry treatments performed by a dentist or dental hygienist. Still sometimes it might be difficult to get a good result with internal bleaching. Below you will find a detailed step-by-step description how internal whitening is conducted successfully.
What is needed to start a successful internal whitening?
- A sufficient root canal treatment without any sign of an inflammation
- Good oral hygiene and healthy surrounding gums
- A sufficient restoration in place or planned to be done in due course
- Classifying the tooth with good long-term prognosis
If the previous root canal treatment is not sufficient, the tooth must be treated again by an endodontist (a specialist for root canal treatments). If the gums are inflamed increasing personal dental care and a professional dental hygiene session can provide a solution. The diagnosis – if you are suitable – will be determined during an initial consultation with special focus on the endodontic situation.
How does internal teeth whitening work?
If the initial consultation established that the above conditions are met, or if all the endodontic and periodontal treatments have been successfully performed, parts of the root filling material that seal the canals is removed. Then the top part of the root canal treatment is sealed with an adhesive composite filling. The remaining cavity is filled with hydrogen peroxide or carbamide peroxide (the actual internal bleaching agent). The cavity is then sealed. A week later you will have to come back to our dental surgery and we check the bleaching result. Very often the treated tooth could still be dark and we will have to repeat the bleaching process. In our experience in most cases a total of three bleaching appointments is needed. Once the desired colour has been achieved we neutralise the bleaching reaction and the tooth is sealed with a composite filling or a dental restoration, e.g. a partial crown or a veneer. This finish depends on the loss of tooth material and the risk of the treated tooth cracking. The result achieved will remain the same for many years.
Step-by-step procedure of the internal bleaching treatment
- Initial consultation with a dentist, radiographs and charting of the gums
- Deciding upon which treatment is suitable (in surgery teeth whitening / bleaching, internal bleaching, crowns, veneers, fillings, etc.)
- If needed, re-treatment of the root canal treatment and dental hygiene
- Photography, shade taking and smile analysis
- If needed taking impressions and constructing a whitening tray
- Removal of the top part of the root canal material
- Sealing the top part of the root canal with an adhesive filling
- Placing the whitening agent (hydrogen peroxide or carbamide peroxide) inside the tooth
- Seal the tooth with a temporary composite filling
- Wait one week and re-examine the discolouration
- Repeat bleach technique until the whitening result is satisfactory
- End bleaching procedure by filling the tooth cavity with a tight filling
Are there any risks for this procedure?
Bleaching, tooth whitening or internal tooth bleaching are among the safest procedures in dentistry. However, like in any other medical treatment there are some risks involved. For internal tooth bleaching of non-vital teeth the gel used to whiten the teeth (mostly hydrogen peroxide) can extremely rarely lead to bone resorption, resorption of tooth material or gum inflammation. To prevent the gel from leaking a tight seal of the root canal treatment with an adhesive filling is imperative. Furthermore, it is important that minimal tooth substance is sacrificed by the dentist in order to achieve a white result too quickly.
How much does internal tooth whitening cost?
To whiten a discoloured dead tooth using three sessions costs £450 (£150 per visit).
Along with in-office bleaching / tooth whitening, the internal tooth whitening procedure is one of the simplest ways to enhance your smile, it’s an easy and effective dental treatment with excellent results. But it must be done following the correct protocol. The whitening treatment is completely painless and the whitened teeth can provide very desirable results for patient and dentist alike.