Our case of the month for July involves a treatment to whiten a discoloured lower front tooth. We will often come across darker teeth when they have undergone a root canal treatment due to the loss of the nerve and blood supply. Often the degradation of blood products from the pulp tissue within the dentinal tubules cause the tooth dentine to be gradually discolour and give that inherent grey/ dark appearance. This can be quite unsightly especially on a front tooth. For back teeth, in almost every case, we will need to place a crown once a tooth has been root filled to maintain function. This will also improve the colour as the ceramic cover the dark dentine. However, for front teeth, crowns are not always needed as the access for the treatment is on the inside of the tooth and when done under microscope, can be extremely minimal. So how do we whiten the tooth?
 

One of the main aesthetic challenges we face as dentists, is a dark discoloured front tooth. This usually results from after a root canal treatment which may be needed for a variety of reasons but is usually from trauma. The reasons for the discolouration do vary. This could be from remnants of the pulp tissue being left within the root canal system and then decomposing within the tooth permeating into the dentine. There can also be rupture of the blood vessels within the pulp allowing blood products to seep into the dentinal tubules and discolour the tooth as this degrades. Another common reason is not so well known. Studies have shown that another factor could be the result of not removing all of the root canal sealant material once the tooth has been treated. van der Burgt TP, Mullaney TP, Plasschaert AJ. Tooth discoloration induced by endodontic sealers. Oral Surg Oral Med Oral Pathol. 1986;61:84–9. [PubMed] [Google Scholar] [Ref list]

The chromophores resulting from the disintegration of root canal sealer remnants penetrate through the dentinal tubules into the coronal tooth structure gradually causing progressive discoloration. The key factor is that most root treated teeth do appear darker than non root treated teeth and when this is on a front tooth, it is a major aesthetic issue.
 

Most people want to have white teeth. After all, nothing is more embarrassing than smiling in front of someone or a camera with teeth as dark as charcoal. That's quite exaggerated, but you get the idea. If you don't believe that many people want white teeth, it s worth knowing that the teeth whitening industry generates over £10 billion a year. That's a lot of money spent on trying to get a set of teeth white.
 

Today is the first of July and summer is in full swing. Wimbledon is around the corner, the Lions have just beaten the All Blacks and it's party season. Why not freshen up your smile with tooth whitening? After all, a beaming smile shows confidence, health and beauty! Here are the options:
 

1. Philips ZOOM LED in surgery whitening. By far and away our best technique; this will provide instant results. After 90 minutes of treatment, you will have a visibly whiter smile which is easy to maintain. We provide a take home kit as part of the package. All for just £499, a steal.
2. Take home kit. If you would prefer to just use a take home kit, one hour of the day is all that is needed for 14 days. We use Philips ZOOM Daywhite 6% HP gel for the best results. Only £275 for a full kit,
3. Oral B White strips. For a simple, quick top up or stain removal, use these disposable strips for one hour of the day. Each pack contains 28 strips.

Everyone deserves white teeth; book your self in today.