Introduction

Esthetics play an important role in dentistry today.  Because of an increased emphasis on beauty and health, cosmetic dentistry has been thrust to the forefront of many practices.  Most dental patients desire bright and properly colored teeth, especially in the upper anterior region of the mouth.  They seek esthetically pleasing appearances that enhance their self-esteem and confidence.¹

One of the fastest growing areas of cosmetic dentistry is the management of discolored and/or hypoplastic dentition.  Whitening offers a conservative, simplified, and economical approach to changing the color of teeth.  As a result, tooth whitening has become one of dentistry’s most popular esthetic treatments.  Acceptable whitening techniques include a dentist-prescribed in-office technique, a home-applied technique,^2,3 or a combination of the two.  The in-office whitening technique generally uses a 35% hydrogen peroxide whitening agent that can be heated or non-heated.

In the area of cosmetic dentistry, a number of techniques have been employed to fight the discoloration of teeth.  These are as follows:⁴

• Bleaching of teeth
• Complete bonded crowns
• Porcelain laminate veneers
• Composite bonding or veneering
• Micro-abrasions of enamel surfaces with hydrochloric acid
• Home-applied or patient-applied bleaching gels and in office procedures

The dentist-prescribed home-applied technique most commonly uses a 10% or 15% carbamide peroxide gel.⁵

In recent years, the use of office monitored, at-home bleaching systems has increasingly gained acceptance by the dental profession.  This procedure can lighten teeth and enhance the appearance of anterior teeth at a reasonable cost with a minimum amount of chair side time.⁶

The at-home bleaching products contain 10% to 15% carbamide peroxide or urea peroxide as the main ingredient.  In the bleaching process, carbamide peroxide reacts with water to release hydrogen peroxide, which, in turn, liberates free oxygen radicals to remove stain and produce a whitening effect.⁷

Although office monitored, at-home bleaching systems are relatively quick and inexpensive treatments, little is known about the safety of a 10% carbamide peroxide system on gingivae.¹

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Citation Number: Vol. 4, No. 1, Page 033