Inside Dentistry
October 2014
Volume 10, Issue 10

A Complex Whitening Protocol Is Not Always Better

High performance is possible with a simplified whitening technique

Jaimeé Morgan, DDS

Many methods have been proposed and adopted by the profession when it comes to whitening teeth via bleaching. The myriad protocols have included light enhancing, heat activation, etching before whitening, pressure enriching/heightening, special primers painted on teeth to allow better penetration of the whitening agents, and others. In the quest for improving results, the profession as a whole tends to be mesmerized at times and often misled into believing that newer is better, and that more complex procedures will give results never before seen.

Engaged Staff, Interested Patients

Enthusiasm wanes and boredom sets in, which means the sparkle and excitement that once accompanied the explanation of how tooth whitening worked, and why the patient should embark on this journey, may now be presented with a ho-hum yawn. Regular staff meetings to ramp up the interest of the dental team usually take care of the lackluster approach. Stating the facts about the incredible simplicity and effectiveness of whitening should bring the level of excitement back to the office.

Whitening teeth by way of bleaching is one of the simpler, more predictable services that can be provided to patients. Instead of rejecting the notion that this procedure can be done easily, predictably, safely, and inexpensively, with bare minimum additional equipment, a new appreciation for its simplicity should be embraced.

Case Presentation

A post-orthodontic, 14-year-old female patient reported to the office desiring to have her smile enhanced with whitening. Lip balm was placed on patient’s lips to provide more comfort while cheek retractors were placed. After cheek retractors were securely placed to move cheeks and lips away from teeth to be whitened, a combination tongue retractor and bite block was placed (Isoblock™, Ultradent Products, Inc.). Teeth were pumiced and thoroughly rinsed and dried prior to placement of gingival barrier (Opal Dam®, Ultradent Products, Inc.). A chemically activated 40% hydrogen peroxide whitening agent was placed on the upper teeth (Opalescence® Boost, Ultradent Products, Inc.). The first application of Opalescence Boost was removed using surgical suction, and then a second application was placed. After removal of the second application of Opalescence Boost using surgical suction, the teeth were thoroughly rinsed and dried. A microbrasion polishing agent (Opalustre®, Ultradent Products, Inc.) was used to enhance reflectance to the whitened teeth. After rinsing the polishing paste from the teeth, the gingival barrier was removed and one final rinse was provided. A neutral sodium fluoride rinse was given to the patient before leaving the office, as is recommended after microbrasion polishing.

Whitening success was evident, and no lights, heat, pre-bleaching primers, or pressure devices were needed.

Key Takeways

• Activated 40% hydrogen peroxide gel is conveniently delivered via syringe for precise application

• Two 20-minute applications, for a total of 40 minutes of treatment time

• Syringe-to-syringe mixing activates product just prior to application, so no light is required

• 6.6% hydrochloric acid chemical and mechanical abrasion slurry with silicon carbide micro-particles

• Provides chemical white and brown superficial stain removal, as well as minimally invasive treatment of fluorosis

For more information, contact:
Ultradent Products, Inc.

About the Author
Jaimeé Morgan, DDS, has a private practice in Midvale, Utah.

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