Dental and Medical Problems

Dent Med Probl
Index Copernicus (ICV 2020) – 128.41
MEiN – 70 pts
CiteScore (2021) – 2.0
JCI – 0.5
Average rejection rate (2021) – 81.35%
ISSN 1644-387X (print)
ISSN 2300-9020 (online)
Periodicity – quarterly

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Dental and Medical Problems

2010, vol. 47, nr 3, July-September, p. 373–378

Publication type: review article

Language: Polish

Wybielanie zębów z żywą miazgą a ryzyko objawów ubocznych na podstawie piśmiennictwa

Side Effects of Bleaching of Vital Teeth – a Review of Literature

Joanna Siniawska1,, Maria Gawriołek1,, Janina Stopa1,

1 Klinika Stomatologii Zachowawczej i Periodontologii Uniwersytetu Medycznego im. Karola Marcinkowskiego w Poznaniu

Streszczenie

Istotne zwiększenie zainteresowania pacjentów wybielaniem zębów jest związane z kulturą wyznaczającą ważne miejsce wyglądowi człowieka. Dobre wyniki można uzyskać różnymi metodami nieinwazyjnymi w przypadku zębów z żywą miazgą, za pomocą wybielających środków chemicznych, takich jak stężony w różnym stopniu nadtlenek wodoru (HP) lub jego prekursor – nadtlenek karbamidu (CP). Celem niniejszego opracowania jest przedstawienie zagadnień związanych z bezpieczeństwem procedur wybielających stosowanych przez lekarza lub pod jego nadzorem, i ryzykiem wystąpienia objawów ubocznych zarówno wczesnych, jak i późnych. Stężone środki wybielające mogą spowodować przykre, dolegliwe, ale i poważne oparzenia tkanek miękkich, gdy preparat wybielający będzie miał styczność z nimi. Może ponadto wystąpić miejscowy stan zapalny, rozległy obrzęk, uszkodzenie naczyń, a nawet rozległa martwica naskórka. W piśmiennictwie z ostatnich lat znajdują się doniesienia przedstawiające mniej udokumentowane dotąd powikłania związane z procesem wybielania. Jakkolwiek nie jest jeszcze znane w pełni znaczenie opisanych w piśmiennictwie zmian związanych z wybielaniem zębów, należy stosować wybielanie pod szczególną kontrolą lekarską. W wywiadzie należy zwrócić uwagę na to, czy pacjent(ka) nie dokonywał podobnych zabiegów często w przeszłości. Powtarzanie zabiegów wydaje się związane ze znacznie większym ryzykiem powodowania trwałych, nieodwracalnych i znacznych uszkodzeń, które mogą doprowadzić do pogorszenia jakości uzębienia.

Abstract

The substantial increase in patients’ interest in teeth whitening is related to today’s culture in which physical appearance plays a very important role. Good effects in teeth with vital pulp can be achieved by various non-invasive methods with the help of whitening chemical agents, such as hydrogen peroxide (HP) of different concentration levels or its precursor – carbamide peroxide (CP). The aim of this paper is to present the issues connected to the safety of the whitening procedures conducted or supervised by dentists and the risk of side effects, both early and late ones. Concentrated whitening agents may cause unpleasant, painful as well as serious burns of soft tissues contacting with the whitened area. Moreover, local inflammation, extensive oedema, vessel damage or even wide-ranging epidermal necrosis may occur. The literature of the last few years contains reports presenting less documented complications related to the whitening process. However, the role of the changes resulting from teeth whitening described in the literature is not very well-known yet; therefore, whitening should be performed under careful medical supervision. During the medical interview a special attention must be paid to the frequency of similar procedures carried out on the patient in the past, since their recurrence seems to be related with a significantly higher risk of causing permanent, irreversible and considerable damages of teeth which may lead to deterioration in dentition quality.

Słowa kluczowe

wybielanie zębów, objawy uboczne, nadtlenek wodoru, nadtlenek karbamidu

Key words

tooth bleaching, side effects, hydrogen peroxide, carbamide peroxide

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