Sometimes teeth can become internally discoloured due to a trauma, repeated dental procedure, or a root canal treatment. This colouring can vary from light grey in appearance to black. This can seriously affect a patient’s self-confidence, especially when the teeth are visible in the smile zone. Traditional teeth whitening methods, such as Laser whitening or home teeth whitening systems, are not effective on root filled teeth. Sometimes, a dentist may suggest porcelain veneers or crowns to hide the deep tooth discolouration. The problem with crowns and some porcelain veneers is that extensive irreversible tooth enamel reduction is necessary which can be costly. However, now there is internal tooth whitening and inside/outside tooth whitening techniques available to tackle this problem effectively.
During the assessment visit, the Specialist Endodontist will check the discoloured tooth. This is to make sure it is a good candidate for internal whitening. To establish this we will usually take an x-ray.
Using the dental microscope we remove some filling and root filling material via the back of the tooth to create an access area for the whitening gel. The tooth will still look normal from the front. We then either place whitening gel directly over the root canal space (Internal tooth whitening) or create a special whitening tray that has access to the inside of the tooth (Inside/Outside whitening).
After a week of internal or inside/outside whitening, we then reassess the tooth. Once the desired results are achieved, the access cavity is sealed using a white filling.
Usually, this procedure will last for many years. Top-ups may be necessary from time to time. This could be every few years.
These kinds of whitening treatments (internal whitening and inside/outside whitening) do not always work. However, in the right hands, they are usually very successful treatments. It is always advisable to attempt an internal or inside/outside whitening procedure first before opting for more invasive treatments like dental veneers or crowns. The whitening treatment allows the tooth enamel to remain in place.