HJAR Jan/Feb 2023

50 JAN / FEB 2023 I  HEALTHCARE JOURNAL OF ARKANSAS ORAL HEALTH not harm or damage teeth irreversibly. This process has been improved over the years, and if used correctly, can produce remark- able results. In the 1990s, over-the-counter (OTC) bleaching solutions came on the market. There are a couple of techniques utilized, and both involve having the chemical in contact with the tooth surface. In the den- tal office, the process involves a blue LED light being placed on the teeth that are in contact with the bleaching chemical. This process accelerates the whitening effect, and patients then use bleaching trays at home, which are made from impressions of their teeth in order to obtain a customized fit. The chemical is placed in the bleaching tray, and after a certain number of hours, depending on the chemical, the teeth are whitened. If patients are not compliant with their dentist’s instructions or the OTC instructions, teeth can become very sensitive. The bleach goes through the microscopic enamel rods and can reach the nerve of the tooth, making it very sensitive to hot or cold liquids and foods. As people began bleaching and over-bleach- ing, sensitivity issues were noted. 3 DIALOGUE COLUMN ORAL HEALTH DENTAL trends such as teeth whitening, brushing with activated charcoal, wearing oral jewelry, and DIY fillings have not only made headlines, but are also associated with being trendy, hip, or making a statement. With any new trend or alternative option, there should be sound evidence that these trends are not harmful, especially when it involves oral health. Teeth whitening has been around for cen- turies. Even 4,000 years ago, white teeth were a mark of beauty and a sign of wealth.1 The Egyptians created a paste that included pum- ice stone, which was ground and mixed in wine vinegar. This was applied to the teeth to whiten their dentition. The Romans used ammonia that they extracted from urine as a bleaching agent. 1 It’s hard to imagine wanting white teeth that desperately, but it is docu- mented history. Fast forward to modern times — whiten- ing teeth in dental offices began in the 1980s. The main ingredients for whitening teeth are carbamide peroxide and hydrogen peroxide. 2 The key to whitening or bleaching teeth is to use a concentration that is safe, produces the desired results, and uses a method that does Other risks include tooth surface roughen- ing, softening of the enamel, increased po- tential for demineralization, burning tissue when overfilling the trays, and unacceptable color change when the tooth surface is next to a dental bonding. 4 Increased frequency of bleaching can lead to teeth being sensitive all the time and becoming so sensitive the tooth needs root canal treatment. Although this oc- currence is rare, patients have been known to be impatient and believe bleaching for three consecutive 24-hour days versus 8 hours per day for a week “speeds up” the process. Overall, the bleaching process is very safe if instructions are followed carefully andmoni- tored by a licensed healthcare professional. Activated charcoal as a whitening agent has gottenmuch interest in the past few years. Generally, a whitening toothpaste contains one of two important ingredients, either carbamide peroxide or hydrogen peroxide, and an abrasive agent. The abrasive agent removes the extrinsic stain, then the peroxide can enter the enamel rods and get into the tooth surface and whiten the intrinsic por- tion of the tooth. Toothpastes that include the activated charcoal ingredient have been DENTALTRENDS: The Impact on Oral Health Everyone would like a pretty smile, but not everyone has one. In today’s society, emphasis is placed on appearance, and the public equates looking attractive to being healthy. But is this a true comparison? Dental aesthetics has not escaped the analogy of presenting healthy and being easy on the eyes, and dental trends have caught notice in many different groups of people and in various cultures.