rXmarksthespot

10+ Year Member
Dec 18, 2008
9
0
Status
Pharmacy Student
Some office whitening procedures include acid etching. Does the etching dissolve the enamel rods/prisms? If it does then do they grow back?
 

UCSF2012

Tooth Rehab Student
10+ Year Member
Nov 28, 2007
864
7
Status
Rehab Sci Student
Some office whitening procedures include acid etching. Does the etching dissolve the enamel rods/prisms? If it does then do they grow back?
Acid etching "dissolves" a VERY minute layer off the top. Fortunately, the enamel layer's relatively thick over most areas of the tooth. No, it doesn't grow back, because the ameloblasts are long gone. Enamel's a one time deal.
 
Last edited:

rXmarksthespot

10+ Year Member
Dec 18, 2008
9
0
Status
Pharmacy Student
I had a pt who had the procedure done. Her teeth still felt rough 5 days after when I saw her. I of course didn't have an answer, but got interested and started looking around. I couldn't find anything that would link to that except the etching. I'm sure that her and her doc have it figured out by now but I was still curious. - Thanks for the info :)
 
About the Ads

aphistis

Moderator Emeritus
10+ Year Member
15+ Year Member
Feb 15, 2003
8,392
36
Indianapolis
Status
Attending Physician, Dentist
Acid etching "dissolves" a VERY minute layer off the top. Fortunately, the enamel layer's relatively thick over most areas of the tooth. No, it doesn't grow back, because the ameloblasts are long gone. Enamel's a one time deal.
This isn't quite right. Ameloblasts are a one-time thing, yes, but remineralization is a dynamic, continous process. Enamel is dissolved by bacterial acids every time you put sugar in your mouth, but given enough time, the enamel remineralizes from salivary minerals to repair the damage. Dentists commonly see incipient carious lesions that have remineralized to intact enamel.
 

rXmarksthespot

10+ Year Member
Dec 18, 2008
9
0
Status
Pharmacy Student
So does that mean that the rough feel of her teeth will naturally go away in time as the enamel remineralizes?
 

UCSF2012

Tooth Rehab Student
10+ Year Member
Nov 28, 2007
864
7
Status
Rehab Sci Student
This isn't quite right. Ameloblasts are a one-time thing, yes, but remineralization is a dynamic, continous process. Enamel is dissolved by bacterial acids every time you put sugar in your mouth, but given enough time, the enamel remineralizes from salivary minerals to repair the damage. Dentists commonly see incipient carious lesions that have remineralized to intact enamel.
I know where you're coming from, I would have to disagree on the details. Yes, enamel can be remineralized, but less so at the superficial-most region where the enamel rods were dissolved by acid. There's a difference between bacterial acid and 35% phosphoric acid dissolving a matrix. Remineralization requires a framework of existing matrix. The 35% version takes away much more of the framework to remineralize, and you're left with trying to remineralize air. Of course, these pores created by etching aren't gigantic. The diameter appears to be roughly the diameter of one enamel rod or so. We're talking an insignificant amount.
 
Last edited:

UCSF2012

Tooth Rehab Student
10+ Year Member
Nov 28, 2007
864
7
Status
Rehab Sci Student
So does that mean that the rough feel of her teeth will naturally go away in time as the enamel remineralizes?
This is on the electron microscope level, so I'm not sure her tongue can feel it.
 

rXmarksthespot

10+ Year Member
Dec 18, 2008
9
0
Status
Pharmacy Student
Well maybe I'm on the wrong path then. I'm still curious to find out why a patient's teeth would feel rough for 5 days maybe longer after a whitening procedure.
 

UCSF2012

Tooth Rehab Student
10+ Year Member
Nov 28, 2007
864
7
Status
Rehab Sci Student
I had a pt who had the procedure done. Her teeth still felt rough 5 days after when I saw her. I of course didn't have an answer, but got interested and started looking around. I couldn't find anything that would link to that except the etching. I'm sure that her and her doc have it figured out by now but I was still curious. - Thanks for the info :)
Sounds more like the dentist used something abrasive against her teeth. Something to sand down material.
 

rXmarksthespot

10+ Year Member
Dec 18, 2008
9
0
Status
Pharmacy Student
The only info that I have to go on is what she told me of course. She did not metion any sanding etc. She said that they cleaned her teeth, etched them, then did the gel and zoom light thing. Sorry that's all I have to go on.

But no matter what her teeth should not feel rough for a long period of time after this procedure... right?
 

UCSF2012

Tooth Rehab Student
10+ Year Member
Nov 28, 2007
864
7
Status
Rehab Sci Student
The only info that I have to go on is what she told me of course. She did not metion any sanding etc. She said that they cleaned her teeth, etched them, then did the gel and zoom light thing. Sorry that's all I have to go on.

But no matter what her teeth should not feel rough for a long period of time after this procedure... right?
Yea, that first step sounds like the culprit. When cleaning the teeth, you can you a somewhat abrasive agent or a polishing cup thingy, which can be somewhat coarse.
 

dheav005

keepin' it movin'
10+ Year Member
7+ Year Member
May 27, 2005
297
5
Norfolk
Status
Dentist
did she have some sort of intrinsic staining?

Ultradent makes a product called Opalustre that uses hypochloric acid and silicon carbide particles to remove a thin layer of the enamel. I have used it before to remove fluorosis stains with good results. It is fairly corrisive though; you can definitely feel the roughness of the enamel with your explorer (and, I would imagine, your tongue, though I dont make a habit of sticking my tongue in patient's mouths).

It could potentially leave a roughened surface for several days, especially if the provider did not use a fluoride varnish or something similar immediately afterwards. Also, it can be used selectively PRN-style, so that fits in with the OP's description.
 

rXmarksthespot

10+ Year Member
Dec 18, 2008
9
0
Status
Pharmacy Student
did she have some sort of intrinsic staining?

Ultradent makes a product called Opalustre that uses hypochloric acid and silicon carbide particles to remove a thin layer of the enamel. I have used it before to remove fluorosis stains with good results. It is fairly corrisive though; you can definitely feel the roughness of the enamel with your explorer (and, I would imagine, your tongue, though I dont make a habit of sticking my tongue in patient's mouths).

It could potentially leave a roughened surface for several days, especially if the provider did not use a fluoride varnish or something similar immediately afterwards. Also, it can be used selectively PRN-style, so that fits in with the OP's description.
Not sure about that... I never noticed anything. I will have to get more info from her the next time I see her.
 
About the Ads