General Tooth Lightening Information

What is the In-Office Lightening that is done in an hour? The process done in the one visit in the office is a great jumpstart to quicken the lightening process. Impressions are taken of your upper and lower teeth so that take home trays can be made for your maintenance applications. A plastic retractor is placed in your mouth to keep your lips, cheeks and tongue away from your teeth during the procedure. A special coating is applied to your gums and is hardened to a candy-coated consistency. The teeth are dried and the solution is applied to all your teeth. It remains on your teeth for 10 minutes, is wiped off, and reapplied up to 2-3 more times before the process is complete. The candy-coating on the gums is removed, as well as the retractor and you are sent home with trays. Be aware that the in-office accomplishes 2/3-3/4 of the total lightening. If you choose, you may use the trays at home to heighten the effects. It is recommended that you wait 48 hours before using the trays and then fill them with a small ribbon of gel and wear 15% overnight or 35% for 30 minutes, wipe out the gel, and then wear the trays for 5 minutes filled with Sensodyne ProNamel. You may use the trays for 3-7 days until you see the results you want. Keep in mind that the solution will continue to lighten up to 48 hours after the last application. This process will also require maintenance from time to time, at your discretion. The maintenance protocol is to wear the trays, as directed, with the gel and then 5 minutes with Sensodyne ProNamel for 3 consecutive days.

Do the Crest White Strips work? Yes, to some degree. The active ingredient in Crest White Strips is carbamide peroxide. The Crest Strips have the lowest percentage of solution and takes the longest to achieve an optimal level of whitening. There is a strip that covers the upper teeth and one that covers the lower teeth. The top half of each strip is on the front side of the teeth and then it reaches around to the backside of the teeth. You may wear both strips at the same time. The strips are placed over the teeth and usually cover from molar to molar, depending on the number and size of your teeth. Teeth have curves and could have spaces between them or be crowded and thus the strips may not be able to touch all the tooth surfaces. The solution, which is on the inside of the strip, must be in contact with the tooth surface to be effective. Crest White Strips are inexpensive, but may not reach the desired endpoint. It will require more frequent maintenance.

What is the difference between all the lightening treatments? Speed and cost are the deciding factors. The in-office has a faster onset and costs the most. This is ideal for people who have a big event coming up soon or just don’t want to wait days before they see results. Our office recommends the take home trays for the majority of people because the cost is reasonable and it only takes 14 days to achieve the full results. We offer 15% and 35% solutions. Keep in mind that the solution will continue to lighten up to 48 hours after the last application. All these methods will accomplish the same level of lightening, in time, and all will need periodic maintenance.

15% HOME TOOTH WHIGHTENING INSTRUCTIONS

1. Uncap the Opalescence syringe and expel a thin ribbon of solution along the bottom of each tray. Recap the syringe to prevent further oxidation. Place the upper tray on the upper teeth and the lower tray on the lower teeth. The trays are not interchangeable. If some of the solution is expelled from the trays and gets on your gums, wipe the solution off with a tissue. Do not press against the fronts of your teeth while placing the trays so you do not squeeze out too much solution from the tray.

2. Wear the trays filled with Opalescence solution overnight, or for 6 hours daily.

3. To help reduce possible tooth sensitivity, after the application, wipe out the trays with a tissue and dot the bottom of the tray with small dots of Sensodyne ProNamel. Wear each tray for 5 minutes.

4. Wipe out the trays with a tissue. Rinse the trays with warm water and clean the crevices of the trays with a Q-tip to remove as much used solution as possible.

5. Store the trays upside down in the storage case provided for you. Be sure the trays are dry before your next application.

6. Any leftover gel may be stored in the refrigerator. Remove them the day before you start your next application so the gel is not cold on your teeth. Keep all gel out of the heat and sunlight. Do not keep them in your car. Do not freeze.

7. Once you start the process, continue fro the next 14 days. Please keep the appointment you made to check the results after the 14th day.

You will want to do periodic follow-up applications to maintain your results. Maintenance is done the same way as described above except only done for 2-3 days.

Please call our office for any further assistance.

Frequently asked questions about 15% Home Whitening

1. Can I wear the tray while I sleep? Yes, it is recommended to wear the trays overnight to get the best benefit. The trays may also be worn during the day for six hours, continuously.

2. Can I wear the tray longer than the recommended 6 hours? Yes, it is not necessary to

awaken after only six hours of sleep. Just remove the trays when you get up.

3. Can I lighten for more than 14 days? Yes, but the teeth reach their maximum change by the 14th day. There is no added benefit to wearing it longer unless you have tetracycline stains, in which case, you wear the trays for a year.

4. Can I lighten my teeth when pregnant? No.

5. Can I eat or drink while I wear the trays? No.

6. Are there any foods or drinks I should avoid? Yes, you want to avoid anything that stains your dishware or cups. Avoid all tobacco products, dark liquids (coffee, tea, colas, soy sauce, red wine, grape juice, Kool-Ade), dark foods (blueberries, tamarind, cocoa, powdered yellow cheese products, orange Metamucil), acidic foods (oranges, lemons, limes, tomatoes, pineapple, marinara sauce). Be aware that these products counteract the lightening effect. If you aren’t sure about a food or drink, please call our office.

7. Can I drink coffee through a straw? No, it is not recommended. Try drinking white tea.

If you absolutely have to have it you must be aware that coffee counteracts the lightening effect.

8. I am seeing lines and spots on my teeth. What should I do? This is a normal occurrence. The lightening is a process that takes 14 days and what you see are areas of your teeth that have lightened more quickly. Within days after the process is complete all will be blended.

9. My gum looks white. What should I do? Stop wearing the trays and apply some Vitamin E oil on the area. The whiteness is caused by overfilling the trays and getting the gel on the gums. Vitamin E oil is available at the grocery store or pharmacist in gelcap or bottled. To get the oil out of the gelcap, hold it gently and pierce it with a needle and squeeze the oil and apply with your finger. If you use the bottled oil, put a drop on a Q-tip and apply where needed. When the whiteness is gone, in a day or two, you can resume the process. Be careful not to fill the trays with too much gel.

10. My teeth look darker at the gumline and on my canines. This is normal. Teeth are usually lighter at the edges and darken as you get closer to the gumline. Canines are naturally ! shade darker than incisors.

11. Will I need to redo this process? Yes, to maintain your new shade. It is at your discretion how frequently you want to maintain your new shade. Your diet (dark foods and liquids) and habits (smoking) will have an effect on how long your new shade lasts. You will be able to tell when it’s time. You will notice your teeth are looking yellow or dingy. The maintenance protocol is wear trays overnight with Opalescence and then 5 minutes with Sensodyme ProNamel for 3 days.

12. How do I get more lightening gel and Sensodyne ProNamel? Our office always keeps Opalescence in stock. You may purchase more at any dental visit or call us at 919-682-5327, to be sure the office is open, and stop in and buy more. Sensodyne ProNamel may be purchased where all toothpaste is carried or you may get a tube at your next hygiene visit.

13. If I have any gel left over, what do I do? After the process is completed, if you have any solution left to use for future maintenance, you may store any leftover gel in the refrigerator. Keep the gel out of heat and sunlight. Do not leave it in your car. Do not freeze.

14. What do I do if my teeth get sensitive? Stop wearing the trays until the sensitivity stops, usually in a day or two. This is a transient sensation for some people and can range from a mild sensitivity to a sharp zing. When you are ready to resume the process, wear the trays for 5 minutes with Sensodyne ProNamel, wipe out the tray and apply the whitening gel and wear for 30 minutes, wipe out the tray and apply Sensodyne ProNamel and wear it for 5 minutes. Continue this method until complete. If sensitivity returns, stop the process until sensitivity ceases and wear the trays every other day in the above manner. For continued sensitivity, stop until the sensitivity subsides and then wear the trays every third day in the above manner. Separate each gel application by 2 days of no treatment until the 14th day of application.

15. Will my existing dental work change color? No. The lightening gel only works on natural tooth structure. Some old amalgam (silver) restorations may leave a dark purple color in the tray. This is caused by the oxidation of the material and is normal.

35% HOME TOOTH WHIGHTENING INSTRUCTIONS

1. Uncap the Opalescence syringe and expel a thin ribbon of solution along the bottom of each tray. Recap the syringe to prevent further oxidation. Place the upper tray on the upper teeth and the lower tray on the lower teeth. The trays are not interchangeable. If some of the solution is expelled from the trays and gets on your gums, wipe the solution off with a tissue. Do not press against the fronts of your teeth while placing the trays so you do not squeeze out too much solution from the tray.

2. Wear the trays filled with Opalescence solution for 30 minute application.

3. To help reduce possible tooth sensitivity, after each application, wipe out the trays with a tissue and dot the bottom of the tray with small dots of Sensodyne ProNamel. Wear each tray for 5 minutes.

4. Wipe out the trays with a tissue. Rinse the trays with warm water and clean the crevices of the trays with a Q-tip to remove as much used solution as possible.

5. Store the trays upside down in the storage case provided for you. Be sure the trays are dry before your next application.

6. Any leftover gel may be stored in the refrigerator. Remove them the day before you start your next application so the gel is not cold on your teeth. Keep all gel out of the heat and sunlight. Do not keep them in your car. Do not freeze.

7. Once you start the process, continue fro the next 10 days. Please keep the appointment you made to check the results after the 10th day.

You will want to do periodic follow-up applications to maintain your results. Maintenance is done the same way as described above except only done for 2-3 days.

Please call our office for any further assistance.

Frequently asked questions about 35% Home Whitening

1. Can I wear the tray while I sleep? Yes, but the gel is only effective for the first 30 minutes. There is no added benefit to wearing it longer.

2. Can I wear the tray longer than the recommended 30 minutes? Yes, but there is no

added benefit since the gel is only effective for the first 30 minutes.

3. Can I lighten for more than 14 days? Yes, but the teeth reach their maximum change by the 14th day. There is no added benefit to wearing it longer unless you have tetracycline stains, in which case, you wear the trays for a year.

4. Can I lighten my teeth when pregnant? No.

5. Can I eat or drink while I wear the trays? No.

6. Are there any foods or drinks I should avoid? Yes, you want to avoid anything that stains your dishware or cups. Avoid all tobacco products, dark liquids (coffee, tea, colas, soy sauce, red wine, grape juice, Kool-Ade), dark foods (blueberries, tamarind, cocoa, powdered yellow cheese products, orange Metamucil), acidic foods (oranges, lemons, limes, tomatoes, pineapple, marinara sauce). Be aware that these products counteract the lightening effect. If you aren’t sure about a food or drink, please call our office.

7. Can I drink coffee through a straw? No, it is not recommended. Try drinking white tea.

If you absolutely have to have it you must be aware that coffee counteracts the lightening effect.

8. I am seeing lines and spots on my teeth. What should I do? This is a normal occurrence. The lightening is a process that takes 14 days and what you see are areas of your teeth that have lightened more quickly. Within days after the process is complete all will be blended.

9. My gum looks white. What should I do? Stop wearing the trays and apply some Vitamin E oil on the area. The whiteness is caused by overfilling the trays and getting the gel on the gums. Vitamin E oil is available at the grocery store or pharmacist in gelcap or bottled. To get the oil out of the gelcap, hold it gently and pierce it with a needle and squeeze the oil and apply with your finger. If you use the bottled oil, put a drop on a Q-tip and apply where needed. When the whiteness is gone, in a day or two, you can resume the process. Be careful not to fill the trays with too much gel.

10. My teeth look darker at the gumline and on my canines. This is normal. Teeth are usually lighter at the edges and darken as you get closer to the gumline. Canines are naturally ! shade darker than incisors.

11. Will I need to redo this process? Yes, to maintain your new shade. It is at your discretion how frequently you want to maintain your new shade. Your diet (dark foods and liquids) and habits (smoking) will have an effect on how long your new shade lasts. You will be able to tell when it’s time. You will notice your teeth are looking yellow or dingy. The maintenance protocol is wear trays twice for 30 minutes with Opalescence and then 5 minutes with Sensodyme ProNamel for 3 days.

12. How do I get more lightening gel and Sensodyne ProNamel? Our office always keeps Opalescence in stock. You may purchase more at any dental visit or call us at 919-682-5327, to be sure the office is open, and stop in and buy more. Sensodyne ProNamel may be purchased where all toothpaste is carried or you may get a tube at your next hygiene visit.

13. If I have any gel left over, what do I do? After the process is completed, if you have any solution left to use for future maintenance, you may store any leftover gel in the refrigerator. Keep the gel out of heat and sunlight. Do not leave it in your car. Do not freeze.

14. What do I do if my teeth get sensitive? Stop wearing the trays until the sensitivity stops, usually in a day or two. This is a transient sensation for some people and can range from a mild sensitivity to a sharp zing. When you are ready to resume the process, wear the trays for 5 minutes with Sensodyne ProNamel, wipe out the tray and apply the whitening gel and wear for 30 minutes, wipe out the tray and apply Sensodyne ProNamel and wear it for 5 minutes. Continue this method until complete. If sensitivity returns, stop the process until sensitivity ceases and wear the trays every other day in the above manner. For continued sensitivity, stop until the sensitivity subsides and then wear the trays every third day in the above manner. Separate each gel application by 2 days of no treatment until the 14th day of application.

15. Will my existing dental work change color? No. The lightening gel only works on natural tooth structure. Some old amalgam (silver) restorations may leave a dark purple color in the tray. This is caused by the oxidation of the material and is normal.

Whitening (Bleaching) Teeth in the Dental Office

Whitening live teeth that are discolored is an effective procedure, but you should know some important information before deciding to have this procedure accomplished on your teeth:1. Whitening is the most conservative and least expensive procedure available to whiten live, stained teeth. 2. Whitening teeth at home is an alternative to in-office whitening, and should be considered.3. Whitening in the dental office requires one or more 60-minute appointments.4. Slight to moderate tooth discolorations can usually be removed successfully.5. Some teeth whiten easily, but others whiten less successfully. The only way to determine the whitening potential of your teeth is to accomplish the procedure and evaluate the results.6. Whitening in the dental office may be somewhat uncomfortable during the process and for a short time after the procedure.7. If discoloration is severe, crowns or veneers are usually the more acceptable treatment to lighten tooth color.8. Your whitened teeth will require retreatment occasionally to maintain the color to which they have lightened.9. Custom whitening trays are included with the procedure to follow up with maintenance treatments at home.

THE CLINICAL PROCEDURE:1. Once or more 60-minute appointments may be required. Each appointment is the same, and the appointments are at least 7 days apart.2. Anesthetic is not used.3. Plastic material is placed on your teeth to isolate the whitening solution from the gums.4. Whitening solution, which is concentrated hydrogen peroxide, is placed on the isolated teeth.5. The whitening solution will be applied 3-4 times during the appointment. The material is removed from the tooth and fresh solution is applied each time.6. The isolation plastic material is removed from the gums. Topical fluoride is applied and your appointment is complete.7. Custom take home trays are fabricated for use after in-office procedure for future maintenance.

AFTER THE PROCEDURE:1. Immediately after each whitening appointment, your teeth will be lighter than they will be 24 hours later due to dehydration of the tooth surface. Once the teeth rehydrate, the color will lessen slightly.2. Your teeth may be sensitive for a few days because of the hydrogen peroxide applications. This sensitivity will gradually disappear in the next few days. You can place the toothpaste, Sensodyne ProNamel< in the take home trays and wear them for 5 minutes daily to ease the sensitivity.3. You may require more than one in-office whitening procedure. After 48 hours, you may use your custom take home trays for 3 additional applications. Additional gel may be purchased at our office for future applications.