Do you have a front tooth that has turned dark over the years? As we age, our teeth naturally become more yellow, and in some instances more grayish due to the natural wearing of enamel. There are certain situations where a tooth can become dark very quickly, its cause being trauma or a root canal.
In a healthy tooth with a healthy pulp (the nerve), blood is cycled in and out. In a tooth that has lost the vitality of the nerve, blood is no longer able to be cycled in and out and so the expired cells become to accumulate leading to the dark color.
In the past, many would immediately restore these rather unaesthetic presentations with a conservative veneer or a crown. In many situations, dependent on the amount of healthy tooth structure available, these are still the preferred methods of treatment for root canaled or traumatized teeth. In situations where the teeth are preserved, the root canal treatment is done conservatively, then the treatment options to address color issues can be even more conservative.
In this situation, we have elected to whiten the tooth from within. The process is as easy as two or three visits. The first visit is an evaluation after the tooth has been seen by an endodontist (a root canal specialist). Once the tooth is determined healthy enough to proceed to bleaching or "restoring", can we begin the process. For internal bleaching, we will make a small access hole without the need for anesthetic so we can place a special type of bleaching material. Depending on how dark the tooth is, there may be a need to have multiple follow-up appointments to reapply the bleaching material inside the tooth.
Once the tooth color has become stable, we flush all of the bleaching material out, place a temporary and wait for 10 days before placing a final filling. The reason we need to wait between flushing out the bleaching material and placing a filling is to allow for all of the bleaching material to stop oxidizing, as this can interfere with the adhesion of the bonding system. If the bonding is unable to be at its maximum strength, we run the risk of decreasing the life of the restoration. The following is a video of our latest case that outlines the steps involved. Enjoy!