Mighty white

26 April, 2011 / Infocus

A female patient was referred to the practice, wishing to have her teeth whitened. She’d had her teeth whitened a couple of years ago but felt they had darkened since then.

The patient was fit and well with no relevant medical history and a regular attendee of her own general dental practitioner. She is a non-smoker and has moderate alcohol intake.

We discussed the various whitening options with the patient and an in-office whitening treatment was chosen.

Intra oral examination showed that the patient had some old, palatal resin restorations on the upper anterior teeth that were discoloured. There were generalised deposits of supra-gingival calculus present on the lower anterior teeth and some areas of recession. The patient was informed about the calculus deposits and also the areas of recession and advised to have hygiene treatment as it would compromise the overall result. She was also informed that she may need to change the old resin restorations after the whitening procedure as the whitening gel would not affect the resin restorations.

The patient wished to continue with the in-office whitening procedure. The procedure was explained to the patient and after-care instructions were explained as well. The patient was happy to proceed, and a consent form duly signed.

Before commencing the whitening procedure, a pre-operative shade was taken and also a digital photograph. The patient’s teeth pre-operative shade was A1.

The patient was given ZOOM protective eyewear and made comfortable on the dental chair. The room temperature was also made suitable. Patients can often feel cold when lying on the dental chair for long periods of time and a blanket is often offered to patients in such cases. Patients are also offered a movie to watch on Eye-Trek lenses to pass the time.

The ZOOM mouth retractor was placed in the patient’s mouth to retract the lips. This also allows the patient to relax and not worry about consistently keeping their mouth open throughout the procedure. It also ensures the Discus plasma light head is accurately positioned at all times.

Rope-like cotton rolls were placed in the upper and lower labial sulcus to keep the lips away from the teeth. In order to protect the gingivae from the whitening gel and light, the buccal sulcus was then packed with gauze squares to provide further protection. A face bib was then placed around the retractor, a liquid dam applied to all remaining gingivae and light cured. When light curing the liquid dam, the light cure was moved across the teeth to minimise heat transfer from the light cure to the teeth.

At this stage only the teeth were visible. The ZOOM whitening gel was applied to all the teeth that were visible. The end of the light head was then fitted into the mouth retractor. The patient was advised not to move her head as this would disengage the light. The patient had three 15-minute whitening sessions. After each 15-minute session, the whitening gel was removed with high volume suction and further fresh whitening gel was placed on the teeth.

The patient was comfortable during the procedure and only felt slight sensitivity during the last session. A desensitising gel was applied at the end of the three sessions and left on for five minutes. It was then removed with the high volume suction. All barriers were removed and the patient was allowed to rinse her mouth.

The patient was delighted with the results and couldn’t believe the difference in shade from start to finish. The post-operative shade was 020 and a post-op photograph was taken.

The patient was given post-op care instructions again – avoiding all coloured foods and drinks, including coloured toothpaste and mouthwashes. The patient was given desensitising toothpaste to use for the next couple of days. A courtesy call the next day was made to the patient and the patient was fine and couldn’t stop smiling.

At the Kalyani dental lounge, we are more than happy with the results of the ZOOM Advanced Power Whitening System. Everything that is required to carry out the procedure comes in one simple kit. It is easy to use and the results are fabulous. The average results are seven to eight shades lighter in less than an hour. All our patients are amazed at the end of their whitening procedure. It is good to see patients leaving with a happy and big, beautiful smile that provides them with greater confidence.

Products supplied by Discus Dental.

Laura Higgins qualified with a diploma in dental hygiene in December 2002 from Glasgow Dental School. She is a member of the British Society of Dental Hygiene and Therapy and currently works at the Kalyani Dental Lounge in Glasgow.

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