Professional tooth whitening as a perfect amendment to aesthetic treatment protocols

– User report by Dental Hygienist Tanja Falck –

Who would not want to have it: A radiant, bright smile, which underlines the individual personality and charisma? Nowadays, aesthetic dentistry has become increasingly important. The beautiful and attractive appearance is not the only reason, however. Healthy, white teeth play an important role for the self-confidence and social acceptance of the patients.

Modern tooth whitening solutions and overall aesthetic concepts have proven to be successful in achieving the desired spotless smiles. Nevertheless, the indications and requirements are as different as the range of existing treatment concepts. Application durations as well as the expenditure of time and money may vary significantly – especially when set in relation to the expected results. Therefore, the patients’ requirements and objectives should be exactly determined in detail prior to the start of a specific treatment protocol.

Recently a 31-year old woman presented herself in the practice with the wish to improve the overall aesthetics as well as the color of her teeth. Being a non-smoker and generally healthy, the patient has not visited a dental practice for several years. The initial situation showed substantial discolorations alongside all teeth. Clearly visible cavities in the anterior area of her teeth (11 and 21) as well as a secondary cavity at 22 MB interfered with the aesthetic appearance (Fig. 1 + 2). Luckily, the general periodontal condition was in a good state.

Fig. 1 + 2: Initial situation

As the patient was not prepared to heavily invest in a cost-intensive treatment, we decided to go ahead step by step. By the VITA shade system, we determined the initial tooth color, which turned out to be an A3. On the basis of all known clinical factors, we discussed different treatment options in detail and agreed upon a procedure, including professional tooth whitening, endodontic treatments as well as aesthetic composite fillings and crowns.

Before the start of the whitening treatment, I had to remove the colorations, stains, and calcifications from the tooth surfaces within a professional tooth cleaning session, using an ultrasound scaler and a powderjet device (Fig. 3).

Fig. 3: After the professional tooth cleaning    

The anterior teeth (11 and 21) with the visible fillings were endodontically treated by our dentist afterwards. Then we were ready to initiate the whitening treatment with OpalescenceTM PF tooth whitening gel with 16% carbamide peroxide (Ultradent Products) and specific custom trays. As the patient still needed additional aesthetic treatments, we went ahead with the whitening the lower teeth 35 – 45 and the upper teeth 15 – 12 and 22 – 25. Tooth 16 was missing. The initial treatment in our practice resulted into a D2 shade­. I showed the patient how to fill the whitening gel into the trays and handed-over the syringes for a further treatment at home.  

The patient continued the whitening treatment at home for five days, wearing the trays 2 hours daily. In the control session in our practice we noted a color change closely to D2 (Fig. 4 – 6).

Fig. 4 – 6: After five whitening days: Temporary crowns and first control in the practice

Fig. 4

Fig. 5

Fig. 6

Following, the patient left for her annual leave and continued the whitening treatment afterwards for five more days – again 2 hours daily. The second control in the practice showed a brilliant natural tooth color B1, with which the patient was extremely happy (Fig. 7).

Fig. 7: After 10 whitening days: Control in the practice

Then the temporary crowns were set.

At this occasion we also took additional pictures on the basis of which the dental technician could produce the crowns in the matching color.

The permanent crowns at 11 and 21 as well as a beautiful new composite filling at 22 MB were applied at a later stage, literally after the entire whitening procedure was completed (Fig. 8 + 9).

Fig. 8 + 9: Final results: Permanent crowns, new filling, tooth color B1

In order to keep the tooth color as white and radiant, I recommended the patient to pay attention to a good dental home care and to perform a professional tooth cleaning twice a year. Foods and drinks with dying effects should be avoided directly after the whitening treatment. If necessary, touch-ups can be done easily and quickly at a later stage, for example with Opalescence GoTM (6% hydrogen peroxide) in convenient prefilled UltraFitTM trays.

This overall concept represents a great way to realize radiant smiles and beautiful aesthetic results without the need for huge monetary investments. The main reason is the choice of a professional home-whitening system like Opalescence PF. After the initial introduction in the practice, the patient can do the treatment independently at home, without taking-up expensive practice and chair time. Moreover, the formulation of Opalescence PF is very gentle and effective.

I personally have been working with Opalescence PF for 12 years now. In our practice the whitening gel has even been present many years longer. Opalescence PF is available in two formulations (10% and 16%) and offers an easy handling for both, users and patients. The gel contains the PF formula (potassium nitrate and fluoride) for gentle, but effective treatments. Besides Opalescence PF, a full range of Opalescence products is available for cosmetic and medical whitening treatments.

We have made many great and convincing experiences with Opalescence and really enjoy working with it. Our patients appreciate the flexibility and efficiency of the Opalescence system, combined with an interesting cost performance ratio. They always have the choice, whether they want to go for treatments with individual custom trays or with prefilled UltraFit trays. After all these years, it is still a pleasure to see the happiness of our patients after the whitening treatments and how their lives can change in a positive way due to the newly gained bright, white smiles!  

Dentist: Christel Bruun-Eriksen

Dental Hygienist: Tanja Falck


About Author

Tanja Falck works as dental hygienist in a private dental practice in the Northern part of Norway. Her focus lies on prophylaxis treatments, professional oral hygiene sessions as well as the prophylaxis of periodontal diseases. Additionally, Tanja concentrates on holistic concepts in terms of professional tooth whitening.

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