Endodontic Care
Internal Bleaching
Internal bleaching is a procedure used to address discolouration in a tooth that has had root canal treatment. Rather than working on the tooth's outer surface, a bleaching agent is placed inside the tooth to address the source of the colour change from within.
What is internal bleaching?
Internal bleaching is a procedure performed on teeth that have already undergone root canal treatment and have subsequently darkened. Unlike conventional tooth whitening, which is applied to the outside surfaces of the teeth, internal bleaching involves placing a bleaching agent inside the pulp chamber of the tooth to address intrinsic discolouration that originates from within the tooth structure.
The procedure makes use of the access opening that was created during the original root canal treatment, so no additional drilling into the tooth structure is typically required.
Why does a tooth darken after root canal treatment?
Teeth that have had root canal treatment may darken over time for several reasons. Remnants of pulp tissue left in the pulp chamber can break down and release pigment compounds into the surrounding dentine. Blood breakdown products from the initial injury or treatment can also stain the tooth structure from within. In some cases, certain dental materials used during root canal treatment can contribute to discolouration over time.
This type of discolouration originates inside the tooth, which is why conventional external whitening typically has little effect on these teeth, the colour change is coming from within the dentine and cannot be adequately reached from the outside.
How the procedure works
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Access and preparation
The access opening from the original root canal is reopened. A barrier material is placed over the root canal filling to protect the root from the bleaching agent.
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Placement of bleaching agent
A bleaching agent is sealed inside the pulp chamber and the tooth is temporarily sealed with a provisional restoration.
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Review and repeat if needed
At a follow-up appointment, we assess the degree of colour change. The process may be repeated over several visits, depending on the extent of the discolouration and the response of the tooth.
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Final restoration
Once a satisfactory colour change has been achieved, the bleaching agent is removed and the tooth is permanently sealed, typically with composite resin.
What to expect regarding results
Internal bleaching can reduce intrinsic discolouration to varying degrees. The extent of colour change depends on the nature and severity of the discolouration, how long the tooth has been darkened, and individual tooth characteristics. Some teeth respond more readily than others.
In cases where bleaching achieves only partial improvement, or where the tooth does not respond adequately to bleaching, alternative approaches, such as composite bonding or a veneer, can be used to address the remaining colour difference from the outside.
Who is a candidate?
Internal bleaching is appropriate for patients who have a tooth that has darkened following root canal treatment, where the tooth is otherwise structurally sound and the root canal is intact and well-sealed. It is not suitable for teeth with structural compromise, active infection, or inadequate root canal treatment.
A clinical assessment and x-rays are required to confirm suitability before proceeding. If internal bleaching is not appropriate in your case, we will discuss the alternatives available to you.
If internal bleaching is not sufficient
If internal bleaching does not achieve adequate colour change, or is not suitable in a particular case, there are other options that may be considered:
- Composite bonding applied to the front surface of the tooth to mask residual discolouration
- A porcelain veneer, which covers the visible surface of the tooth with a thin layer of ceramic
The most appropriate option depends on the degree of discolouration, the overall condition of the tooth, and the patient's preferences. We discuss all available options at the consultation.
About our endodontic services
Endodontic services at Wildwood Dental Clinic are provided by our general dentist team. Our dentists are not licensed specialists in endodontics.
Have questions about internal bleaching?
Call 306.374.7272 or book a consultation.