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Bleaching and bonding for the older patient Martin GD Kelleher Serpil Djemal Ahmed S Al-Khayatt Arijit J Ray-Chaudhuri Peter FA Briggs Richard WJ Porter Dental Update 2025 38:5, 294-303.
Authors
Martin GDKelleher
MSc, FDS RCPS, FDS RCS (Ed), FDS RCS (Eng)
Consultant in Restorative Dentistry, King's College London Dental Institute and St George's Hospital, Tooting, London
Older people who remain reasonably well may wish to maintain or enhance their dental and oral appearance, preferably at minimal biologic and financial costs. Bleaching and bonding represents a very good treatment option and a sensible strategy for this group. Bleaching addresses the discoloration, while direct composite bonding can improve the shape of worn, or otherwise unaesthetic, teeth without damaging the structure or health of the residual tooth tissue. This pragmatic treatment is well tolerated by older patients. The visual and functional improvements are greatly appreciated by this group, partly because of the non-destructive and affordable nature of the benefits.
Clinical Relevance: Bleaching and bonding represents a proven, sensible, pragmatic, affordable and practical approach to managing the aesthetic problems of older patients, and the benefits are achievable without destroying their residual sound tooth tissue.
Article
Chronologic age affects different people in a huge variety of ways, including their perception of their self image. There are enormous variations in the expectations of older people. Many are physically well and want to maintain, or enhance, their dental and oral appearance, preferably at a minimal biologic cost. For this group bleaching and bonding represents very good biologic and financial value. The accumulation of various stains over many years often results in yellowing or browning of the teeth. This can be regarded, by some patients, as being an unacceptably ageing feature of their smile. Many well-groomed older people regard these stains and discolorations as being capable of being interpreted by others, such as their young grandchildren, as reflecting poor maintenance cleaning on their part.
Wear of teeth is a normal physiologic aspect of ageing but, if pathologic, can result in shortened, worn teeth where the visible internal dentine shows. This visibly exposed dentine can become stained, often significantly, by normal dietary chromophores, for example tea, coffee, red wine, curry, or worse, by cigarettes, cigar or pipe smoking. These shortened teeth can look dark and the combination of dark colour and shortened shape is unacceptable to many patients.
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