1. Two types of stains: 1. Extrinsic stains (can become
intrinsic): can be removed by hand/ultrasonic scaling, coronal/air
polishing
2. Intrinsic stains: whitening products may or may not lightening
the color depending on special stain and severity; may require
cosmetic restorations (veneers)
2. List possible causes of extrinsic stains: 1. Poor oral
hygiene: yellow, brown, green, black
2. Coffee, tea, red wine, colored cola drinks, foods: brown to black
3. Tobacco products and betel leaf chewing: yellow-brown to
black
4. Antimicrobial rinse (chlorhexidine): brown
3. List possible causes of intrinsic stains: 1. Medications
during tooth development
2. Tetracycline, minocycline: brown, gray, black bands
3. Fluoride: white, brown spots or bands
, 4. Explain how whitening works: Enamel is composed of 97%
of minerals Microscopic spaces between enamel rods
accumulate stain over time; stain may also penetrate to the
dentin
Peroxide or other whitening materials passes through the spaces
in the enamel and reaches the dentin, where it releases oxygen
free radicals that oxidize the stains and lighten the color of the
dentin
* We whitening the dentin, not enamel*
5. The process of whitening can be accelerated by: Low-
intensity heat or high-intensity light (composite curing light, laser,
or a high-intensity plasma arc light
* LED (better) or UV light
6. List currently available whitening materials: 1. Hydrogen
peroxide (fast): liquid, varnish, or gel in concentration from 5% to
40%