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    How Opalescence Go can restore confidence in pediatric patients

    Exploring some whitening possibilities for the take-home option from Ultradent.

    Children and adolescents experience detrimental effects from severely unattractive teeth that can result from tooth discoloration of both deciduous and permanent teeth; visible caries and decay; and poor gingival health.

    Negative social interactions (i.e., bullying, teasing, embarrassment, etc.) because of tooth discoloration can leave lasting psychological impacts.1 An unaesthetic oral condition can also affect a child’s self-esteem and lead to a poorer quality of life.2 As recent generations are faced with increasing concern about body image, psychological and social adjustment become an important factor in pediatric evaluations.

    Category Cruncher: In-office whitening products

    However, addressing tooth discoloration issues in young patients has been challenging and problematic given patient age, cost factors and limited research as to the effects of whitening treatments on pediatric patients. With inadequate research and education, dentists are cautious about using whitening products on pediatric patients. Thus, children, adolescents and parents may begin using alternative methods to improve tooth color, leading to the potential for abuse.3 A comprehensive understanding of common pediatric tooth discolorations and treatment options is necessary to maximize the psychological, social and educational potential for tooth whitening for young patients.

    Tooth whitening and pediatric patients

    Whitening treatments provide the most conservative cosmetic option to treating stains and discolorations for pediatric patients, something that can help to greatly improve a young patient’s self-esteem and psychosocial interactions. However, little research regarding tooth whitening has been completed on adolescents and children. This has led to a general lack of professional understanding about what type of whitening treatment is appropriate for children and adolescents. According to the policy set by the American Academy of Pediatric Dentists (AAPD), they encourage judicious use of bleaching of vital and nonvital teeth.4 The AAPD also recommends for patients (and their parents) to consult their dentists about whether whitening treatment is ideal for their condition.

    Pre-op shade for a pediatric patient.Pre-op shade for a pediatric patient.Without established guidelines, selecting the type of whitening treatment for pediatric patients can be challenging. However, for children and adolescents experiencing social distress and a lack of self-esteem due to tooth discoloration, whitening provides an appropriate and conservative solution. The whitening studies that have focused on children and adolescents have found whitening treatments to be effective, with the only adverse effects being those commonly experienced with tooth whitening, such as hypersensitivity.5-10 Whitening gel has also been shown to improve gingival health, reducing inflammation and plaque formation, which also contributes to an enhanced smile appearance and, subsequently, greater confidence when smiling and socializing.11

    Post-op shade in a pediatric patient.Post-op shade in a pediatric patient.Challenges do exist for successful tooth whitening in pediatric patients. Irrespective of age or method (i.e., in-office, OTC, or at-home), research indicates that whitening treatments cause a high prevalence of side effects (i.e., tooth sensitivity, gingival irritation, etc.).5-7, 12 This can also influence patient compliance, as experiencing tooth sensitivity and/or gingival irritation during and after bleaching may be more traumatic an experience for children than adults.

    Dental perspectives: How Ultradent's Uveneer's can save time

    Additionally, determining the ideal concentration of bleaching agent is essential to ensure effective bleaching without damaging young healthy tissue. Research has determined that enamel permeability decreases with age. This makes pediatric patients more susceptible to whitening because more of the active ingredient interacts with the tooth tissues. Primary teeth also have relatively larger pulps and thinner dentin and enamel when compared to permanent teeth, leading to greater effects from whitening in children. Lower concentrations of whitening agent may be necessary for pediatric patients to provide effective results with minimal side effects on both deciduous and permanent teeth.

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