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Dental Materials DH 104 Lecture 3
Objectives • Explain the difference between professionally supervised home bleaching and use of OTC products
Lab objectives: Shade Selections / Preventive & Bleaching Materials • Describe fluoridation process and compare the benefit and differences of other fluoride delivery techniques • Apply pit and fissure sealants competently • List the indications and contraindications of sealants for patient use • Describe the types, agents, and mode of action for sealants
Recognize causes of tooth sensitivity and recite causes for tooth sensitivity and etiologies of stimuli that elicit pain response • Compare and contrast natural defense mechanisms to the hydrodynamic theory • Communicate the use, benefits, and home care patient instructions for sealant applications to the patient • Describe the application and armamentarium used for sealants • Discuss the retention, wear, and replacement of sealants • Demonstrate competency in the technique of sealant application
List the various materials used for treating sensitive teeth • Describe patient selection and management of tooth sensitivity and communicate the use, benefits, and home care instructions for desensitizing agents to the patient • Competently apply desensitizing agents • Discuss and demonstrate the technique for bleaching shade selection
Otc bleaching products • Bleaching strips 6%-10% carbamide peroxide • Paint-on bleaching pastes- 5%-6.5% hydrogen peroxide • Bleaching gels applied in stock trays- 10% carbamide peroxide
strips • Crest Whitestrips 6% hydrogen peroxide • Crest Whitestrips Premium 10% hydrogen peroxide • Wear 30 minutes at a time once or twice a day • Only cover 6 anterior teeth
Paint-on bleaching pastes • Viscous liquids • Towel dry teeth • Liquid solidifies in 30 seconds to a minute. Keep mouth open until material dries • 30 minutes • Apply twice a day to achieve maximum benefit • Crest Night Effects, Colgate Simple White Night
Stock trays • Heated in boiling water and adapted to teeth • “Boil and bite” • Ill fitting tray • Usually 10% carbamide peroxide
DDS prescribed home bleaching • Mostly 10% to 22% carbamide peroxide at a pH near neutral in a viscous gel. • Made up of urea and hydrogen peroxide • Mixed into a gel of propylene glycol or glycerin or both • Some products have potassium nitrate to reduce tooth sensitivity. • Custom formed tray • 30 min to overnight
What are we using in clinic • Opalescence 15% Carbamide peroxide • We also have • 3M White & Brite 22% and 16% Carbamide peroxide
Fluoride varnishes • Enamel Pro Varnish-5% sodium fluoride • 3M Vanish XT- 2 part system-paste and liquid, needs to be cured, dry tooth, depending on reason for varnish may need to etch. • Ultradent--Flor-Opal Varnish; 5% sodium fluoride, mix at least 5 times. • Patients with sensitive teeth. Usually class V • Paint on surface/tooth that is sensitive
Color guide • Vitapan classical • B1 is “whitest” • A1-A4 reddish-brownish • B1-B4 reddish-yellowish • C1-C4 greyish shades • D2-D4 reddish grey
Sealant application • Surface Cleaned • ISOLATE • Etch-be careful to only apply etch to the tooth surface to be sealed • 15-20 seconds • Rinse and dry • ISOLATE • Sealant applied • Cure- 20 seconds
Dental hygienists can assist in the prevention of disease with the placement of sealants. Which of the following reasons accounts for the greatest number of sealant failures? • Water contamination • Improper set time • Acid not properly rinsed • Tooth not properly etched • Clinician inaccuracy
A patient’s tongue has just contaminated the occlusal surface that you had just etched for a sealant. What should be the next step • Rinse the tooth thoroughly to get rid of saliva contamination, then dry thoroughly and apply sealant. • Saliva is not a contaminant so proceed with the next step of drying and then applying the sealant • Begin over again by re-etching the tooth for the same amount of time, thorooughly dry the tooth, and apply sealant • Re-etch the tooth for a shorter amount of time, thoroughly dry the tooth, and apply sealant • Dismiss the patient and reappoint for another day.
What purpose does acid etching serve in the application of pit and fissure sealants and composite resins? • It kills bacteria • It puts a glaze over the tooth • It increases the surface area available for sealant/composite bonding • It provides activation molecules to start the chemical reaction.