“Walking bleach,” or endodontic whitening, provides a whitening solution for the many patients with one or more non-vital teeth. Non-vital teeth often appear darker than the rest of a patient’s smile due to internal bleeding caused by trauma, the presence of necrotic debris, or pigmentation as a result of previously used endodontic treatment materials. Thus, unlike most whitening cases where discoloration is caused by external staining to vital teeth (usually due to smoking, eating, and/or drinking habits,) as the pre-fix “endo” suggests, endodontic whitening, or walking bleach, is used when discoloration comes from the inside out.
Although different than traditional whitening, endodontic whitening remains a relatively simple procedure—most often completed in four steps. First, the clinician opens the pulp cavity of the patient’s non-vital tooth, removing any previously placed restoration materials as well as the cervical barrier, as they may obstruct the whitening process. Next, the clinician places the endodontic whitening material, such as Opalescence® Endo—a specially formulated 35% hydrogen peroxide whitening gel—into the pulp chamber and closes it with a temporary cement, leaving the whitening product to perform its function. After three to five days time, clinician will then assess the color of the patient’s tooth to determine if it has reached the desired shade. Then, the endodontic or “walking bleach” is removed, and the procedure is complete. If the patient or clinician believes a lighter shade can be achieved, the procedure may be repeated.
Opalesecence Endo Before and After Case
Here are some of the questions most commonly asked by clinicians in regards to “walking bleach.”
Question: What is the correct depth of application of the bleach within the pulp cavity?
Answer: Opalescence Endo should always be applied above the bone crest and below the clinical crown of the tooth, leaving a 2.0mm protective margin.
Question: Due to shade regression over time, should I aim to whiten the non-vital tooth to a slightly lighter shade than desired?
Answer: Yes. It is recommended that the clinician leaves the bleach in the tooth until a slightly lighter than the target shade is achieved, as the tooth shade often regresses slightly upon removal of the bleach.