ABSTRACT
Ask the patient whether he or she is happy with the colour of the teeth at the initial evaluation appointment. Often the patient will express a desire to have lighter teeth. With this information bleaching can be added into the correct sequence of restorative treatment. It is not appropriate to do bleaching treatment during the definitive stage of restorative treatment. It is better to plan for bleaching at the beginning of a treatment plan. Immediately prior to cementing a definitive porcelain crown, the patient may say: 'I really wish I could have all the teeth lighter, but I suppose there is nothing you can do about it'. These days there is something that can be done about it. In this case, it should be explained to the patient that bleaching treatment can be undertaken and a provisional crown can be fitted. The porcelain would have to be stripped from the existing crown and new porcelain placed. If the definitive crown was a strengthened all-porcelain crown such as the Procera or Inceram, it may have to be entirely remade. Another option is for the definitive restoration to be fixed with provisional cement while bleaching treatment is undertaken and the teeth lightened. It is always best to wait a month after bleaching to let the shade 'settle' prior to selecting the new shade of the tooth. Careful pre-planning would prevent a costly crisis from occurring.
