The White Board

Whitening Partial Denture Case Study

By Michelle Mirsky, D.D.S.

Dr. Michelle Mirsky

Case
Patient presents with missing 1-3, 13-16, 17-20, 32, 30-29 and wearing maxillary and mandibular removable partial dentures. There are circumferential clasps on #21 and 29 She is having these RPD's remade and does not want to match the shade of A3.5 of her existing teeth.

Issue
What is the best treatment for a patient that wants to use an in-office whitening system to bleach, but has less than a full dentition? There are not enough teeth to have any significant occlusion to hold the retractors in place. The patient cannot wear trays for the same reason. Trays would have distal extensions on the ridges and the tray material would be very uncomfortable. Compliance and cost are significant factors to consider when doing take home bleaching.

Solution
The best approach is to offer chairside bleaching with a light activated whitening lamp where you can control all of the issues above. The gingival 1/3 of #29 and 21 will be the compromise in this bleaching case.

Treatment
Be sure to have the patient wear the removable partial dentures during the procedure. This will help keep the retractors in place and the teeth separated enough to apply the bleach. The light needs to reach both maxillary and mandibular arches. The outcome is very predictable and successful.

Michelle Mirsky, D.D.S. is a general dentist who has had a private practice in Manhattan for 30 years. She graduated from Columbia University College of Dental Medicine in 1977. She is currently the Assistant Clinical Professor at the Columbia University College of Dental Medicine and the Group Leader for the Senior Clinic. Dr. Mirsky is a member of the New York County Dental Society, American Dental Education Association, American Dental Association, American Academy of Cosmetic Dentists, New York Academy of Dentistry and the New York Academy of Sciences.


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