Nonvital Teeth Whitening Options

When a nerve in the tooth dies, the tooth needs endodontic treatment (root canal). The tooth that has been endodontically treated can, however, slowly darken over time. The color change can range from light gray to dark black. This color change is not cosmetically pleasing.

For the back teeth, molars, and premolars, this color change may not be objectionable. The tooth might not be visible when you speak or smile. Usually, a back tooth will be protected and covered with a ceramic or porcelain to metal crown. The crown color is made to match your natural tooth color.

Front teeth, or teeth easily seen when you talk or smile, benefit the most from nonvital tooth whitening. Just as with back teeth, when a medium- to large-sized filling is present, it is probably better to protect the tooth with a crown. However, many times the front teeth that have had root canal therapy have smaller- sized restorations. When these teeth turn a darker than normal color, a cosmetic problem results. The nonvital whitening procedure is the most conservative and least expensive method to attempt to change the unwanted color to a more acceptable appearance.

The procedure involves gaining access to the original preparation made for the root canal and removing part of the filling and any other debris that remains. A small portion of the existing root canal filling is removed to allow a new sealer material to be placed over the remaining root canal filling to protect it from the whitening solution. Depending on your particular situation, the tooth may then be whitened internally, externally, or both at the same visit. As a rule, the longer a tooth has been dark, the longer it will take to whiten.

There are three methods available to whiten the endodontically treated tooth: power whitening, walking whitening, or patient-applied whitening.

Power whitening involves the application of a whitening solution to the outer surface and internally (where the filling has been partially removed). Most patients show great improvement after only one treatment.

Walking whitening involves placing the whitening solution into the opening in the tooth and temporarily sealing it in place. It will remain there for about 1 week. At that time, the color of the tooth is reevaluated and the need for another application of the whitening solution is determined.

The patient-applied process will require that you place the whitening solution into the access opened in your tooth. It will be held in place by a cotton pellet. You will remove the cotton and solution after about 1 hour. You will repeat this process daily until the tooth has reached the desired shade.

Some teeth may not be at all responsive and will need porcelain veneers or full crowns to be made attractive again. The degree of whitening for any tooth is impossible to predict. It is possible that after some time, the tooth may start to turn dark again, and the whitening process may need to be repeated.

There is a fee associated with the initial access opening of the tooth and cleaning and sealing of the internal portions of the teeth.

In many cases the improvement of the appearance of the darkened tooth is quite noticeable. It is certainly the simplest and most cost-effective manner of correcting this type of problem.

We will discuss your particular needs and make the appropriate treatment recommendations.

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