There are a number of reasons teeth lose their luster. Smoking is perhaps one of the most common, followed by food and beverages that stain our teeth, like wine and coffee. Aside from these external factors, however, a tooth can undergo staining from within the tooth itself. Typically this is due to a structural defect within the tooth, a dying tooth, or because blood and other bodily fluids penetrated the tooth during prior root canal treatment. Regardless of the cause, there are still opportunities to restore such a tooth to match the color of its adjacent teeth, by bleaching the tooth from the inside-out – a process known as “internal” tooth bleaching. 

What is internal tooth bleaching?

Internal tooth bleaching is much different than bleaching (or whitening) the outside of the tooth, mainly because (as the name suggests) the bleaching takes place from within the tooth. Despite the general ease and affordability of the procedure, many aren’t even aware of the possibility to bleach teeth in such a manner, causing them to go years with stained teeth in their “smile-zone.” Studies show the procedure is safe, and has good long-term results.

How does it work?

There are different processes for internal bleaching, depending on whether the tooth in question is stained because of prior root canal treatment, or because it’s in need of root canal treatment. If a tooth requires a root canal, your doctor would conduct surgery on the tooth in the typical fashion, excavating the tooth’s pulpal chamber of dead or dying tissues, and preparing it for a crown or temporary filling. So, in this instance, prior to applying the temporary filling, you doctor would first deposit a bleaching agent to alter the tooth’s color from the inside-out. Typically, this solution is allowed to remain within the tooth for a period of up to two weeks to obtain maximum results, after which you’ll return to the office for an exam to see how things progressed.

The bleaching process differs dramatically if the tooth is discolored because of a prior root canal treatment. In these cases, the process generally only requires the drilling of a small access hole to the tooth by which the doctor can insert a cotton pellet soaked with the bleaching agent. In this scenario, the pellet would also remain within the tooth for some time. Additionally, a patient may be sent home with bleaching trays to further encourage thorough whitening.
 
If you’re interested in internal tooth bleaching, ask your doctor, or have them refer you to an endodontist who specializes in this type of work. If you possess a generally healthy mouth, you may be a good candidate for this type of bleaching.