There are 2 techniques for ‘bleaching’ : in the dentist’s chair or at home. In the first case a gel is applied to the visible parts of the teeth which are then exposed to a strong light source for about an hour. This has the advantage of giving an immediate result but it is a bit tiring and the effect is less durable than the second process. In this case impressions (moulds) are taken and individual acrylic trays prepared. The patient fills the trays, which fit over the teeth, with the whitening gel and wear them for several hours (most people leave them in overnight). The result lasts longer, the patient can decide when the desirable shade is achieved (usually after 5 or 6 days) and there is usually some gel remaining which can be used at a later date to give a ‘tweak’.
Traditionally straightening misaligned teeth was achieved using metal brackets and bands fixed to the teeth and joined by a wire adjusted to move each tooth in the required direction. In recent years, with the help of computer 3D imagery, a whole new approach to orthodontics has evolved. The initial case study starts with X-rays and impressions of the jaws. This information is analysed by a computer program; a proposal for the final result is shown to the patient and once approved the program will calculate the necessary steps for the treatment. As with the bleaching this involves a series of acrylic trays (in this case of slightly more rigid material) except that they are worn all the time (only removed for eating and cleaning). Typically these trays are changed every 2 weeks and an average treatment will take a year.
Bruxism is the unconscious habit of grinding or clenching teeth; it will be the subject of a future article.

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