About Bleaching
44% Instructions
There are two approaches to in-office use of our 44% carbamide peroxide: Stent (upper arch only) and Paint On.
44% Carbamide Peroxide Power Bleach - Stent Technique
Life-Like Cosmetic Solutions 44% power bleach has been formulated to be most effective when used in a stent for the UPPER ARCH -- providing that proper safety precautions are taken. Our power bleach is an ideal material for use in situations where a patient has particularly heavy staining, needs a psychological boost to help him or her to follow through on the total bleaching program, or needs an immediate reduction in staining as a prelude to at-home bleaching. As with all power bleaches, in order to assure longevity in effect (18 months or more before fadeback), it is best to have the patient do a full course of at-home bleaching after treatment with the 44%.
DIRECTIONS:
Upper arch: Form stent on the vacuum-former. This will be the same stent the patient takes home with them for at-home bleaching. While the stent is still on the model, trace around the gingival margin with a ball point pen, then remove the stent and carefully scallop 1/2 mm shy of the markings. Take special care to trim the stent to stay off of the soft tissue. Remember to take a "before" picture of the patient.
- Express evenly about 1/4 cc of material into the labial reservoirs of the teeth to be treated.
- OPTIONAL: Evenly disperse four drops of #9 Enhancer over the 44% bleaching material in the stent.
- Place the stent. A small amount of material may foam out. Wipe excess from the gums with a dry 2x2. Wait about 30 seconds and wipe mucosa again with a slightly moist 2x2. Place a dry 2x2 in labial vestibule to further prevent gel from contacting soft tissue. Leave passively in patient's mouth (in dental chair or waiting room) for up to 30 minutes.
NOTE: Recent literature suggests that use of etching agents such as Nitric Acid or Po4 provides no real benefit to the bleaching process.
NOTE: SHELF LIFE OF THIS PRODUCT IS ONE YEAR FROM DATE OF DELIVERY - KEEP REFRIGERATED
44% Carbamide Peroxide Power Bleach - Paint On Technique
In certain cases it may be decided that a combination of in-office and at-home treatment will be the best course of action. We have already described the use of 44% Carbamide Peroxide applied in a stent in the office. Here is another option for in-office treatment:
- Examine patient, decide treatment plan, offer teeth cleaning, take "before" pictures, take impressions, form models, build in labial reservoir, vacuum form mouth tray with .040 clear and soft tray material (.080 if heavy biter or bruxer), treat one arch at a time as is typically done with at-home treatment.
- Polish the teeth to be treated.
- OPTIONAL: Protect soft tissue with paint-on dam or rubber dam and ligation.
- Put about 1/2cc of 44% bleaching material in dappen dish.
- OPTIONAL: #9 Enhancer: Add four (4) drops #9 Enhancer to dappen dish. Mix for ten (10) seconds.
- OPTIONAL: Place dappen dish in curing oven or microwave. Activate oven from a cold start. Heat bleaching material to about 130 to 140 degrees Fahrenheit (56 to 60 degrees Centigrade).
- Remove dappen dish. Immediately paint bleaching material on (facial area of stent) and 1/2 incisal lingual of teeth to be treated.
- Let set in place on teeth for five minutes in sequence. Spray off with water spray.
- Repeat procedure five more times, if desired.
OPTIONAL
- Follow through with at-home treatment with 10%, 15%, or 20% Carbamide Peroxide, syringe-delivered gel. Dispense one syringe (5.5 cc) to patient -- approximately one week's supply.
- Have patient put 1/2cc of material in tray and leave in for one hour treatment time, two times each day.
- Set recall appointment for one week from date of in-office treatment.
- Examine patient again. Decide whether or not to continue at-home treatment. Take "after" pictures if appropriate.