National Dental Assisting Examining Board (NDAEB) Practice Exam

When is tooth whitening or vital bleaching not indicated for a dental patient?

1. When the patient has sensitive teeth

2. When the patient presents with severe tetracycline and fluorosis stains

3. When the patient has gum disease

4. When the patient is undergoing orthodontic treatment

The correct answer is: When the patient presents with severe tetracycline and fluorosis stains

Tooth whitening or vital bleaching is generally not indicated for patients presenting with severe tetracycline and fluorosis stains because these types of discoloration are often resistant to standard whitening procedures. Tetracycline staining results from the use of antibiotics during tooth development, leading to intrinsic stains that may not effectively respond to bleaching agents. Similarly, fluorosis occurs due to excessive fluoride exposure during tooth development, resulting in white or brown spots that are also intrinsic in nature. In these cases, alternative treatment options, such as veneers or crowns, may be more suitable for achieving desired aesthetic results. While tooth whitening can pose risks or limited effectiveness in the presence of sensitive teeth, gum disease, or during orthodontic treatment, these conditions do not universally contraindicate the procedure. Sensitive teeth may benefit from specific formulations or desensitizing agents prior to treatment. Active gum disease might require periodontal treatment first, but whitening can eventually be performed after addressing the underlying issues. Orthodontic patients may need to wait until after treatment is complete to ensure even results, but again, this doesn’t completely rule out the procedure. Therefore, the presence of severe intrinsic stains like those from tetracycline or fluorosis specifically limits the effectiveness of traditional whitening methods and indicates a need for alternative treatments