Bleaching of discolored teeth.

Bleaching is a viable treatment alternative to attempt esthetic improvement of discolored teeth. Natural tooth structure as opposed to a veneer or crown margin is considerably superior in tissue response. Caution has to be exercised in selecting cases and advising patients of the possibilities from bleaching and that bleaching may not be entirely successful or lasting. It still should be considered as a treatment of first choice. If applied properly and in carefully selected cases the results can be very rewarding for the dentist and especially the patient. A knowledge of the agents used and biological limits must be kept in mind when bleaching teeth to prevent potential disastrous complications. It is especially important to keep the bleaching time to the shortest effective time possible with vital pulps. Bleaching when successful provides a superior margin and a less expensive alternative than crowns. Bleaching should generally be considered before crown preparation because if bleaching is unsuccessful crowns can always be fabricated. This is true for younger individuals with tetracycline stained teeth because crowns may need to be remade several years after their initial placement due to further eruption of teeth and further recession of the gingival tissues.