I. This material is caustic. Use appropriate protection.

A. Protect the patient with:
1. Eyewear
2. Protect soft tissue with rubber dam and ligation
3. SUBSTITUTE FOR 2 - Paint-on dam (optional)
*NOTE: Clean teeth (as in II below) PRIOR to applying

B. Protect staff with:
1. Gloves
2. Eyewear
3. Gowns

II. Clean the teeth

A. Pumice or prophy paste

B. Wash and dry

C. EXCEPTION - see I.A.3. above

III. #9 Enhancer

A. Dispense 1/2cc 35% bleaching gel into dappen dish

B. Add four (4) drops of #9 Enhancer

C. With a plastic instrument, gently mix for ten seconds

IV. Bleach the teeth

A. Apply to teeth with disposable brush for a six-minute application. Rinse and re-apply. Five to ten applications constitute an in-office treatment.

B. Use disposable brush to cover

1. Labial
2. 2/3 Incisal - lingual surfaces
3. EXCEPTION - With paint-on dam, cover facial surfaces only
4. NOTE - no need to etch prior to bleaching

V. Remove bleach

A. Suction - use small surgical tip

B. Alternate - Wipe incisally with dry 2x2

C. Rinse

VI. Remove soft tissue protection

VII. (Optional) Polish (fluoride prophy paste)

VIII. Recall

A. Four to five days post treatment

B. Evaluate for potential additional treatment

I. Check endodontics -

A. Radiograph

B. Do not bleach if negative signs or symptoms

II. Protect soft tissue

III. Open the tooth

A. Clean

B. Remove discolored dentin

C. Reduce gutta-percha two 2-3 mm below gingival margin

D. Remove internal restorations that prevent bleach from saturating

IV. Clean the tooth (OPTIONAL - Chlorhexidine soap with or without pumice)

V. Seal gutta-percha and subgingival tooth structure

A. Light-cured glass ionomer, or

B. Bonded composite (White)

VI. Bleach the tooth (internal and external)

A. Gel bleaching

1. Fill chamber/cover entire external surface
2. Change gel every 4 minutes (5 - 10 applications = 1 treatment: 20 to 40 minutes total)
3. Temporize
4. May need second appointment

B. "Walking" Bleach procedure (internal)

1. Place bleach (either paste from sodium perborate and Superoxal, OR 35% Seal-Syringe Delivered Gel)
2. Seal tooth with composite (ALLOY preferable)

C. Combined - you may perform both procedures in one visit

VII. Restore the access opening

A. Remove the temporary

B. Etch inside of chamber

C. Apply dental adhesive

D. Fill the opening

E. Polish

VIII. Re-appoint patient - one week with gel, 2-5 days with walking bleach technique

NOTE: SHELF LIFE ON THIS PRODUCT IS NINE MONTHS FROM DATE OF DELIVERY