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Newsletter – 1st Quarter 2002

This Issue:

  • Reference Guide Introduction
  • At-Home Whitening 2002 – Whitening has come a long way
  • In-Office Whitening – Accelerated with NO Lights and NO Heat
  • Stent Fabrication – A Step-By-Step Illustrated Guide
  • Sensitivity Chart – Symptoms, Causes, & Solutions
  • Oral Health – The Next Step in At-Home Treatment


Welcome to the second annual Whitener “Reference Guide” that you and your whitening staff can use all year long. It’s a handy guide with step-by-step instructions, charts, and useful, practical tips – things that make whitening easier, and more effective for your practice and your patients.If you have not received your hardcopy version of the Whitener Reference Guide, give us a call now and we’ll send one – 800-543-3545.

Whitening has come a long way in the last decade. Here are some guidelines and tips to help you and your patients receive the benefit of the state-of-art of whitening for 2002.

30% Carbamide Peroxide – T here has been a steady progression from 10% carbamide peroxide to higher concentrations. Thirty percent has now been available for over two years and has proven itself – safe, fast, low sensitivity, and excellent patient compliance. Key clinicians such as William Strupp, DDS have embraced it as the only whitener they deploy. It is also the best way to distinguish your professional whitening far above new OTC whitening products.

Low Sensitivity with No KN03 – Short wear time, not chemicals such as potassium nitrate, are the best way to reduce sensitivity. Using 30% carbamide peroxide with its 20-30 minute treatments prevents dehydration and allows rapid rehydr ation. Potasium nitrate in whitening gel does not have time to take meaningful effect. Instead, use 30% carbamide peroxide to prevent sensitivity through short wear time and faster results.

Dual Arch Whitening – Wearing two stents on the upper and lower arch at once for more than 30 minutes invites TMJ issues. Using 30% carbamide peroxide keeps the treatments under 30 minutes, avoids p;TMJ problems, and allows the patient to whiten in half the time.

Patient Compliance – The longer the treatments and total number of days to whiten, the great decline in patient compliance. The short wear time and fast whitening with low sensitivity using 30% is the way to achieve successful whitening cases and happier patients.

Routine Whitening – Another key to patient compliance is the ability to make whitening as routine as possible. Encourage patients to whiten wh ile in the shower every morning. Short wear time is again the key.

At-Home Cleaning & Debriding – Carbamide peroxide has been used as a periodontal anticeptic longer than it has been used to whiten teeth. Eighty percent of all adults have some f orm of gum disease. Using 8% Carbamide Peroxide gel (Life-Like PerioFormula) with a tray that overlaps the gum line is an effective way to reduce this shocking statistic.

No Reservoirs – Reservoirs defeat van der Waal’s Forces and allow bleach to leave the tray. They are ineffective and take unnecessary lab time. In short, they waste busy time, have no benefit, and can cause problems – so skip them.

Tray Off Soft Tissue – Properly trimmed trays are a must with high concentrations. The trays should not overlap the gingival when whitening. Pay close attention to the trim and keep the edges smooth and off the soft tissue.

Patient Instruction – The patient should be shown how to load the tray with the proper dosage. Demonstrate how small the beads of bleach should be in each tooth indentation, and show the patient how the plunger should only move a total of 1/4cc. Let patients know what to expect. Inform the patient that uneven whitening is common, to stick with it, and that it will whiten and even out quickly.

More Information
Check out these links for further information about these subjects:
At-Home Products
30% Safe for At-Home Use

With NO Lights and NO Heat

Life-Like 35% H2O2 In-Office Kit with #9 Enhancer:

* Fast, effective, versatile – Vital & Non-Vital
* No Lights – No large initial investment
* You keep ALL your fee
* Avoid the risk of pulpal sensitivity/damage

Life-Like’s 35% H2O2 Kit includes the #9 Enhancer which substantially increases the rate of oxygen release and de creases the required exposure time. In virtually the same amount of procedural time, you can provide maximum in whitening and avoid the cost and risk to your patients of using heat generating lights or lamps. Call 800-543-3545 today and ask us how you can accelerate your in-office whitening.

More Information
Check out these links for further information about these subjects:
The Role of In-Office Whitening
44% Carbamide Peroxide Instructions
44% Carbamide Peroxide Syringe Delivered
44% Carbamide Peroxide Bottled Gel
35% Hydrogen Peroxide Gel Syringe Delivered
35% Liquid Hydrogen Peroxide – 1 Oz Bottle
No. 9 Bleaching Enhancer

By the Numbers . . . Step-by-Step


Document the patient’s initial tooth coloring. Take a photo that includes the shade guide and record the shade number to establish a baseline. This will provide both you and your patient with a good point of reference.
Fill the impression tray with impression material. The material should come to the top anterior of the impression tray. Use an impression material dispenser or mix as directed by the material’s directions.
Note: Do not use block-out or die-spacer to ensure a tighter seal. Instead, allow maximum whitening per unit dose, and minimize the swallowing of gel.
Take the impression — Push the impression tray over the teeth until the material is covering the full depth of the teeth. Hold it carefully without movement for 30-50 seconds to allow the material to set. Remove the tray carefully by leveraging it off the molars first. Rinse and wrap the impression in a damp paper towel. Let it set until it becomes firm.
Mix the stone and pour the cast — Moisten the impression with water and then shake it off. Carefully flow a small amount of stone into the tooth indentations using a dental spatula. Use a vibrator to work the bubbles out of the impression material and ensure bubble-free margins. Allow the stone to harden.
Prepare the model – Soak the model in water for easiest separation. Remove the stone model from the impression. Grind down the base of the model so the central incisors are pointing upward in a 90° angle from the floor of the vacuum machine.
Put the model onto the vacuum machine. Both arch models can fit, but you may choose to do just one at a time.
Select the EVA and insert the sheet into the vacuum machine — .040 is the standard — or use .080 for bruxers. Clamp the sheet down.

Engage the vacuum machine heater to heat the EVA. Allow the EVA to sag a minimum of 2 inches. The lower the sag, the thinner the tray. Lower the EVA onto the model until the EVA bracket is fully down into place.
Engage the suction for 15-20 seconds to ensure a good form. Push the heating element aside and, with moistened, gloved fingers, immediately apply labial lingual pressure three times from cuspid, lateral, central, lateral, and cuspid.

Allow the tray to sit on the vacuum machine for a few minutes to cool. Then remove model and stent.
Trim away the excess EVA.
Use a ballpoint pen to trace a solid line along the gingival margin as a guide for trimming.
Trim the tray with a pair of small curved crown and bridge scissors to insure that the tray will not overlap the soft tissue.
Optional: Flame the EVA lightly with a laboratory torch to remove any rough edges.
Run the stent under cold water using your fingers and fingernails to rub off the pen ink.
Once the tray is trimmed, check the fit by re-applying the tray to the model.
If a stent sags open and fails to close with a tight fit, you’ll be glad to know that there’s an easy fix:

* Hold the stent under hot tap water for 5-10 seconds to make the material pliable.
* Squeeze the stent between your thumb and second finger. Use your index finger to push the middle of the stent into place.
* Holding it in place, run cold tap water over the stent for 15-20 seconds.

More Information
Check out these links for further information about these subjects:
Support Material – EVA options and more
Leave Reservoirs Behind! – An informative article



More Information
Check out these links for further information about these subjects:
Sensitivity Myths
Clinician’s on Sensitivity & 30%
Sensitivity Causes
Sensitivity Testimonial
Sensitivity Management
Soft Tissue Management
The ABCs of Whitening Sensitivity – An informative article
The Next Step in At-Home
Brushing, flossing, whitening – most patients currently understand the importance of these basic at-home oral health care practices. But there are additional options and steps patients can take to achieve better oral health that you can help them attain:
It is so easy to allow patients to pass through appointments as “watches” and continue to stay a part of the over 80% adult population who has some form of untreated periodontal disease. PerioFormula, an 8% carbamide peroxide product, can help you change all that. It is applied using a stent that is trimmed to extend onto the gingiva by 2-3 mm. Patients wear the tray and gel for just 5 to 10 minutes a day. Carbamide peroxide has been shown to:

* Reverse gingivitis and incipient periodontitis
* Retard moderate to severe periodontitis
* Release H202 for sustained antiseptic and oxygen-cleansing action
* Eliminate supragingival aerobic bacteria
* Reduce subgingival anaerobic bacteria via hydrostatic pressure from the debriding tray
* Remove unhealthy tissue as well as clean and soothe minor wounds and inflammations so that natural healing can occur
* Foam and flush out food particles most patients miss
* Guard against the risk of periodontal infections via plaque inhibition
* Significantly reduce halitosis
* Promote periodontal health without antibiotics
* Reduces plaque formation and gingival inflammation

Tongue Scraper
Approximately 80% to 90% of all bad breath comes from the putrified waste of bacteria in the mouth. The nooks and crannies of the tongue, which are the primary source of bad breath, act as a breading ground for bacteria. The Life-Like Tongue Cleaner:

* Provide your patients a way to better manage the overall bacterial count in their mouths.
* Acts like a squeegee to remove the coating of plaque and bacteria on the tongue.
* Is more effective at reducing halitosis than even brushing.
* Reduces plaque formation on the teeth.
* Unlike a toothbrush, avoids causing the gagging reflex.
* Offers your patients a cleaner palate to better taste, enjoy, and appreciate food.

Less than 20% of adults admit to flossing daily, and only 2% admit to it between every meal. Food between the teeth results in plaque formation and feeds the bacteria that causes gum disease and bad breath. It doesn’t make sense that millions of people allow their oral health to lapse each day when there is such a simple, practical, and effective way for busy people to remove food from between their teeth after every meal. The Life-Like Tripick Toothpicks feature:

* Unique triangular shape is designed to remove innerproximal food and plaque.
* Glides smoothly between teeth without splintering.
* Plastic construction is supple yet strong.
* Reusable strength.
* Compact case goes anywhere.

More Information
Check out these links for further information about these subjects:
An Update on At-Home Cleaning & Debriding
An Antiseptic Tool for Gum Disease Management
The Role of At-Home Cleaning & Debriding in your Practice
Tongue Cleaner – The Toothbrush should not stand alone

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