This is a teeth whitening method, where the nerve has been removed. As mentioned earlier, teeth with a removed nerve change colour over time, due to the actual removal and some components in the pastes used for root canal treatment. This type of whitening is carried out in the dental office by a dentist and is absolutely painless.

A part of the filling, which has been placed after extraction of the nerve, is removed. Since internal bleaching is mostly done on front teeth (incisors and canines), the filling is removed from the side of the tongue or palate. The entrance of the root canal is opened in order to reach to the paste used for filling the root canal. Then, a thin layer of a special cement (glass ionomer cement) is applied on the paste, which hinders penetration of the bleach to the root. The bleach, used in this case, is hydrogen peroxide of high concentration. A cotton pellet, soaked with the hydrogen peroxide, is applied in the crown of the tooth and a temporary restoration is immediately placed. The tooth is left for several days and the patient is able to notice how the colour improves themselves.

When the desired colour is achieved, the cotton pellet is removed and the tooth is sealed with a pad and photopolymer filling of the same colour. For highly discoloured teeth, a sufficiently good effect cannot be achieved with only one cotton pellet, and a new one is required. In most cases internal bleaching is combined with external bleaching. If the desired colour is not achieved, veneers or porcelain crowns could be used.

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