Bleaching and enamel microabrasion in the smile esthetics: a case report

The color change of teeth is frequent in the dental office and has important role in smile harmony. Objective: To discuss through case report the dental bleaching technique associated with enamel microabrasion to remove localized white spots on the maxillary incisors and canines. Case report: Patient, female, aged 18 years, attended the Clinic of the University of Ribeirão Preto complaining about the negative aesthetics of her smile due to the presence of white spots on teeth #13, #12, #11, #21, #22 and #23. After detailed anamnesis and clinical examination, the spots were diagnosed as enamel demineralization caused by cariogenic challenge occurred during the use of orthodontic brackets. Dental bleaching technique with 38% hydrogen peroxide was applied followed by enamel microabrasion with 6.6% hydrochloric acid and silicon carbide paste. After absolute isolation, 1 mm thick paste was applied on enamel stain with the aid of resin composite polishing abrasive rubber. Each application was followed by copious washing and analysis of the stain removal with wet enamel surface. In total, six applications of 10 seconds each were used. Finally, enamel polishing was executed with felt discs and diamond paste, and topical application of fluoride. Conclusion: It was concluded that bleaching associated with enamel microabrasion technique is a safe, simple, and effective option for solving the esthetics of teeth with white spots.