Bleaching Agents, Styptics and Mouthwash

Goodmorning
Theja Lakshmi K.B

II nd year BDS
R.no:42
CONTENTS:-
> Bleaching agents

> Styptics
> Mouthwashes
BLEACHING AGENTS
> These are agents used to remove stains from

teeth or to improve their whiteness.
> Most of them act by oxidising the stain/ yellowish

coating on the enamel, but few reducing agents also
have stain removing action.
1) OXYGEN RELEASING AGENTS:
> release oxygen which reacts with organic

pigment to decolourise it and loosen it from tooth
surface.
> It is then washed off to expose the white enamel.

1] HYDROGEN PEROXIDE
- Primary oxygenation agent.
- The dilute(3%) mouthwash is occasionally used as

an antiseptic/ antiplaque agent.
- The concentrated solution(20-30%) in water

(perhydrol) or ether may be applied carefully to the
stained teeth and wiped off for cosmetic whitening.
- Burning sensation, erythema,inflammation and
sloughing may occur if it comes in contact with
gingival/oral mucosa.
2] CARBAMIDE PEROXIDE
- Equimolar complex of hydrogen peroxide with

urea which acts as a carrier and releases
hydrogen peroxide on reacting with water.
- Some tooth whiteners contain 10% carbamide

peroxide.
3] SODIUM PEROXIDE
- Water soluble, releases oxygen In solution and

may be used for bleaching teeth.
4] SODIUM PERBORATE
- Insoluble, but slowly releases oxygen on coming

in contact with water.
- It present In some tooth powders.
2) CHLORINE RELEASING AGENTS:
- Bleaching powder (chlorinated lime) slowly releases chlorine

which acts as an oxidizing agent and decolourises many dyes.
- Addition of acetic acid to bleaching powder immediately before
application accelerates its decomposition and hastens stain
removal.
- Excessive use of any oxidizing bleaching agent can damage
the tooth enamel and even affect dentine.
- Tooth sensitivity and weakening of crown may result.
- The oral microbial flora may also be disturbed.
3) REDUCING AGENTS:
- Sodium thiosulfate is reducing agent which is used

for removing certain stains, e.g.iodine stain.
- Sequential application of an oxidizing agent

followed by a reducing agent may be needed for
silver stain.
4) SILICA
- It is a nonabrasive adsorbent which is included

in some whitening toothpastes and tooth powders.
-Use of laser for whitening the teeth is increasing.

2] STYPTICS:-
- Styptics are local haemostatics that are used on bleeding
sites like tooth socket and wounds.
They are:--
> Adrenaline
> Thrombin
> Fibrin
> Gelatin foam
> Thromboplastin
> Astringents
1. Adrenaline:Sterile cotton soaked in solution of
adrenaline is commonly used in tooth sockets and as
nasal packs for epistaxis.
Adrenaline arrests bleeding by vasoconstriction.
2. Thrombin: powder is dusted over the bleeding

surface following skin grafting. It is obtained from
bovine plasma.
3. Fibrin: obtained from human plasma is available as sheets.
It is used for covering or packing bleeding surfaces.
4. Gelatin foam: is porous spongy gelatin used with
thrombin to control bleeding from wounds. It gets completely
absorbed in 4 to 6 weeks and can be left in place after suturing of
the wound.
5. Thromboplastin: powder is used in surgery as a styptic.
6. Astringents: like tannic acid are used on bleeding gums.

Coagulants Used Systemically are:-
• Vitamin K
• Fibrinogen
• Specific deficient factor-factors, II, VII, VIII, IX,X
• Ethamsylate
Vitamin K
> is a fat-soluble vitamin essential for the
biosynthesis of clotting factors. There are three
compounds:
• Vitamin K1- present in food from plant source

• Vitamin K2- produced in the gut by bacteria.
• Vitamin K3- a synthetic compound used
therapeutically.
Actions
- essential for the biosynthesis of clotting factors-
prothrombin and factors VII, IX and X by the liver.
Human requirement
Not clearly known- recommended intake in
adults is 50-70 mg/ day
Deficiency—
- results from liver diseases, malabsorption, long-
term antibiotic therapy and rarely by dietary
deficiency.
- manifested as bleeding tendencies.
- Adverse reactions are seen on parenteral

administration of vitamin K-allergy
3] MOUTHWASHES:-
- solutions containing active ingredients for
cleansing and deodorising the oral cavity.
- 15-30 ml of the diluted solution is used for gargling
and rinsing the mouth.
- contain astringents, antiseptics and/or obtundents,
flavouring and sweetening agents.
- Prolonged use of concentrated solutions result in
staining.
Types of Mouthwashes
1. Antiseptic and astringent mouthwash- for

soreness under dentures. They harden the mucous
membrane.
2. Obtundent mouthwash--for sensitive oral lesions.
3. Detergent mouthwash---for cleansing and

deodourising action.
Uses
1. Soreness under dentures

2. Sensitive oral lesions.
3. Postoperative and other bedridden
patients for deodourising the oral cavity and
to maintain oral hygiene.
-mouthwashes are refreshing.
4. In halitosis.
5. Stomatitis.
6. Surgical impaction-after removal of
impacted tooth.
,Chlorhexidine (CHLORHEX REXIDINE) and
Povidine iodine (BETADINE) are some commonly
used mouthwashes.
Thankyouuu
!!

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Goodmorning

Theja Lakshmi K.B

> Bleaching agents

> These are agents used to remove stains from

> Most of them act by oxidising the stain/ yellowish

> release oxygen which reacts with organic

> It is then washed off to expose the white enamel.

- Primary oxygenation agent.

- The dilute(3%) mouthwash is occasionally used as

- The concentrated solution(20-30%) in water

- Equimolar complex of hydrogen peroxide with

- Some tooth whiteners contain 10% carbamide

- Water soluble, releases oxygen In solution and

- Insoluble, but slowly releases oxygen on coming

- Bleaching powder (chlorinated lime) slowly releases chlorine

- Sodium thiosulfate is reducing agent which is used

- Sequential application of an oxidizing agent

- It is a nonabrasive adsorbent which is included

-Use of laser for whitening the teeth is increasing.

2. Thrombin: powder is dusted over the bleeding

5. Thromboplastin: powder is used in surgery as a styptic.

6. Astringents: like tannic acid are used on bleeding gums.

• Vitamin K1- present in food from plant source

- manifested as bleeding tendencies.

- Adverse reactions are seen on parenteral

1. Antiseptic and astringent mouthwash- for

2. Obtundent mouthwash--for sensitive oral lesions.

3. Detergent mouthwash---for cleansing and

1. Soreness under dentures

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