The search for more effective options in the treatment of tooth staining is nothing new. Over the centuries, there has been an ongoing interest in seeking solutions for making teeth white. The Romans used to wash their teeth with Portuguese urine. During the 14th century, having your teeth bleached was the most-requested treatment after tooth extraction and was carried out through combined use of metal files and nitric acid. In the late 19th century a combination of H2O2, ether and electricity was used. Later, the same ingredients, but with heat rather than electricity. HCl or hydrochloric acid was introduced for teeth whitening in 1916, and in 1966 combined with H2O2. In 1970 it was established that H2O2 is the most effective stain removal agent.

One has to distinguish extrinsic discolorations from intrinsic discolorations. Extrinsic discolorations are superficial and caused by tobacco, wine, coffee, tea and some herbs. They can be easily removed by the use of cleaning pastes and polishing.

Intrinsic discolorations represent stains inside the structure of the tooth (enamel, dentine) and can cause a yellow, brown or grey appearance of the teeth. Reasons for intrinsic discolorations are fluorosis, the use of tetracyclines (antibiotics) at young
ages, enamel and dentine malformations or a damaged pulp as sometimes encountered after injury or root canal treatment. This kind of discoloration cannot be removed by conventional cleaning procedures. They are the main target of bleaching techniques.

How does Bleaching work?
Principally bleaching is an oxidation process A special bleaching gel containing a H202 is administered on the surface of the respective teeth and activated by laser light. . When the bleaching agent H202 dissolves, it releases free radicals which split large pigmented molecules responsible for the actual discoloration into smaller light-reflecting molecules. The more reflection there is the lighter the teeth appear.

What different kinds of Bleaching methods are there?
Two different ways of bleaching can be distinguished: Home Bleaching and In-Office Bleaching.

During Home Bleaching specially adapted splints are used to apply a low-dose H202- gel (approx. 3%) to the patient's teeth for several hours a day or over night. The actual bleaching routine is done by the patient over a period of 3 - 4 weeks. Yet the exaggerated and prolonged use by the patient can lead to harmful side effects such as irritation of the gingiva and damage to the enamel.

In-Office Bleaching is a short time treatment performed by the dentist who uses a high percentage H202-gel sometimes in combination with an activator such as the plasma or halogen lamp in order to speed up the bleaching process. These techniques still need a considerable amount of bleaching sessions to obtain the desired outcome. Only moderate discolorations can be treated.

What is Laserbleaching?
The latest, "in-office bleaching'' method which is in use since 1996 is Laserbleaching providing fast, predictable and long-lasting results. In the course of the procedure the bleaching gel containing high percentage H202 an a special absorber which prevents any adverse heat effects to the pulp is activated by laser irradiation and the actual bleaching process is thereby accelerated.

The bleaching procedure takes place under medical supervision and satisfying
results can be achieved in a very short period of time (approx. 1 hour). Only severe
staining needs more than one in office treatment session with a laser. Even the very severe discolorations caused by antibiotics (tetracyclines) can be treated by laserbleaching.

Intrinsic discolorations can cause a yellow, brown, grey or blue-grey appearance of the teeth, eventually with banding. The first is the easiest to bleach, the last the hardest one. Home bleaching can only deal with the first, yellow one, and it takes a considerable amount of time. The persistent use of home bleach gel can cause side effects in the body.