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DAY WHITE 2
™~
The active ingredient in the gel that causes the whitening is
carbamide peroxide. This ingredient breaks down into hydrogen peroxide,
which acts as an oxygenating agent causing oxygen to enter the enamel
and dentin (the outers layer of your teeth) to break up deposits lodged
in your tooth structure.
This whitening acts only on the molecules that
carry the discoloration and its affects will depend on the strength and
duration it is in contact with your teeth.
The strength of this active
agent is limited by safety concerns. Your tooth structure remains
unchanged, only the tooth surface is made lighter. Porcelain
restorations and white fillings will not usually whiten.
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Three weeks before you
start:
 | Brush you teeth twice a day with a
desensitizing toothpaste that
contains potassium nitrate and fluoride to decrease tooth
sensitivity while you whiten.
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| Make sure any gum tissue cuts or
scratches are healed. |
| Before and after pictures will be
taken. |
| View Whitening video. |
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| Brush and floss your teeth before putting in your bleaching trays
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| Apply a small thin line
of gel or a drop in each tooth indentation for a total
of 10-12 drops into each of the tooth
imprints in the tray.
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| DO NOT OVERFILL THE TRAY
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| Insert the tray into your mouth and seat the tray firmly against
your teeth, be sure not to push all the gel out
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| Wipe the excess material from your gum with your finger or dry
toothbrush
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| Try to wear the trays about 2-3 hours per day or for convenience
sake you can wear the trays over night (the gel loses 80% of its
activity after 2 hours of being in your mouth)
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| Rinse your mouth after removing the trays and brush away any
remaining gel
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| Clean the tray with a toothbrush and warm water, hot water will
damage the tray; dry carefully and store in the tray holder in a cool,
dry place
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| Fill your tray with professional strength
fluoride and wear for about 2-5 minutes following the
whitening. Make sure you remove all the fluoride and avoid
swallowing any of the fluoride
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| AVOID EATING, DRINKING OR SMOKING while the whitening tray is in
place
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| Don’t use any household or other whitening products to whiten your
teeth
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| Keep out of reach of children
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| Keep away from direct sunlight
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| Maximum results are achieved when the process is continued for 14
nights
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| AVOID citrus fruits and other acidic foods while in process of
bleaching. They can contribute to sensitivity by changing the acidity
of your saliva and could cause damage to the outer tooth surfaces or
slow down the whitening process
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| AVOID tobacco, coffee, dark colas and red wines because these
substances may restain your teeth
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| You should AVOID stain-causing beverages such as coffee, tea, coke
for several days after the procedure, because your teeth may more
readily absorb stain at this time.
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| Try using a straw.
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| Utilize automated
toothbrushes and whitening toothpastes. |
| After 2-4 weeks your teeth are probably bleached as much as possible
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| The area of the tooth closest to the gums may take longer to whiten
than the biting edge and will continue to remain the darkest part of
the tooth
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| Renew the whitening as needed (every 3-6 months), by re-applying the
gel in the tray and wearing the tray with the get for 2-3 hours for
two to three applications
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| Daily brushing,
flossing.
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| Regular dental cleanings will keep your
teeth whiter, maintain gum tissue health, keep staining to a minimum
and determine need for whitening touch-ups.! |
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10% of patients might experience some discomfort to their teeth,
gums, lips, or throat and increased sensitivity to cold, heat, or
pressure during the whitening process.
This sensitivity is short lived
and usually ends a day or two after the treatment is completed. If any
of these symptoms occur and are more than mild, and you have persistent
discomfort, discontinue the treatment until you can contact Dr. Peterson
at 436-3491. These symptoms usually reside 1-2 days after interrupting
the treatment.
If this uncommon cause of sensitivity develops he can
adjust your treatment regimen to help you attain the best results while
ensuring your safety.
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Sensitivity can develop in 15-20% or more
of patients just from wearing the tray alone!
If you do develop sensitive teeth try these things:
| Determine if the sensitivity is in the
teeth or the gums. The symptoms are temporary and
will subside in 1-3 days following termination of use of
the whitening gel. |
| Check to make sure you are not
overloading the tray with gel. Follow the dosage
markings on the syringe. |
| Use a soft-bristle toothbrush
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| Special toothpaste (i.e. Sensodyne)
for sensitive teeth.
You may also try an application of potassium
nitrate or fluoride
for 10-30 minutes prior to or after whitening, or
alternating night with whitening material, is more than
90% effective in reducing sensitivity. |
| Fluoride rinse or gel for sensitive teeth. A
sensitivity protection toothpaste will usually take a couple of weeks to
ease the discomfort. Ask us for potassium nitrate and fluoride to put
in the tray after your "bleaching".
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| Use short-term
treatments (20-60 minutes) in
order to control these problems. |
| Brushing the teeth with
baking soda using a wet toothbrush for 30-60 seconds may
help decrease tooth sensitivity. |
| Some times breaking up the amount of
time whitening is done into smaller, longer spaced segments, will
alleviate the sensitivity problem. Try taking a break for a day or
two. |
| Try taking ibuprofen
for acute sensitivity. However, only take this
medication if you have do NOT adverse reactions to this
medication and it does not interact with any medications
you are currently taking. |
| If you have a jolt or
sharp pain you could have recessed gums, enamel
fractures, a chipped tooth or leaking
margins. This is why an exam is performed
before whitening is started in order deal with these
problems first so you will be able to whitening your
teeth with fewer complications. |
| As of this time there seems to be no
apparent long term problems with tooth whitening |
| Apply
a ribbon of Sensodyne or Crest Sensitive toothpaste
(alone) into their bleaching tray for either 30 minutes
before or for 30 minutes after bleaching.
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If restorations are planned for the anterior (front) part of your
mouth it is advisable to accomplish the whitening first, then match the
new restorations to the now bleached teeth. You will need to plan to
wait three weeks or longer after whitening before starting these
restorative procedures.
The whitening process may cause some temporary dehydration
of the teeth. This dehydration may appear as white
spots or striations on the teeth. These spots will disappear
within 1-2 weeks after completion of the whitening process. Because
a tooth is translucent, and because of light reflection the
same tooth can look a different color under a different
light. This is why is is difficult to tell patients exactly
how many shade changes they may reach with the whitening
procedure. Teeth all respond differently. But
remember this general rule to match the whites of your eyes
for the most natural look. #
| Contraindications/limitations
of home bleaching: |
Comments |
| Extensive composite
(white) & porcelain restorations |
Restorations will NOT
bleach and you need to be informed about the
cost of replacement |
| Pre-existing sensitivity |
2/3 of these people
will experience some sensitivity for 1-4 days;
usually reversible upon termination of bleaching |
| Severe gray/blue banded
tetracycline
staining |
Guarded prognosis, may
reduce amount of
"masking: required for future |
| Discoloration in
gingival third or exposed yellow |
Guarded prognosis for
whitening |
| Pregnant or
lactating |
No know adverse effects
but avoid use as a precautionary measure |
| TMJ |
Consider bleaching one
arch and monitor comfort |
| Translucent teeth |
May appear darker after
bleaching |
| Amalgam
restoration in front teeth |
Replace amalgams to
avoid "greening effect" |
| Noncompliance or unrealistic
expectation |
Determine realistic
whitening results**** |
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Usually we cannot predict the effectiveness of whitening for each
individual patient. The degree of whitening is variable because each
person’s reaction to the procedure is individual.
But your own long
term results will depend on if you smoke, drink coffee/tea/red wine and
if you have good dental health habits.
Depending on your oral health
habits you may need "touch-up’ treatments at regular intervals
You can periodic re-treat at home to maintain the desired color and
shade. To help keep your teeth white, don’t forget to see us twice a
year!
For a permanent change, you should consider the placement of
Veneers.
***An Update on Tooth
Whitening, Woman Dentist Journal, pg 10-22, Jan/Feb 2003
#Nightguard Vital Bleaching; Dr. Haywood; Dental Products
Report pg 82-86,96; Oct 2002.
February 06, 2008
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