Laser whitening step-by-step
WHITER TEETH AREN’T JUST FOR MOVIE STARS AND POLITICIANS
It seems that everyone is in search of a brighter and more engaging smile. According to Statistic Brain Research Institute, “the tooth whitening industry rakes in over $11 billion annually.” Obviously, there is serious interest in this form of self-improvement.
By Heidi Christopher, RDH
1 GETTING READY
• Measure and record the shade of the patient’s teeth using a Vita shade guide
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• Clean teeth surfaces using a pumice that does not contain glycerin. Try to remove any dental plaque and superficial stains, being careful not to abrade the soft tissue.
• Apply Vaseline to the patient’s lips and insert check retractors. Use cotton rolls for increased protection and comfort.
2 APPLY LIQUID DAM
• Rinse and air dry the teeth and gingival tissue.
Be sure to extend the material at least half a millimeter
onto the enamel, and cover any exposed root surfaces. |
• Initiate the flow of the liquid dam by discharging a small amount onto a mixing pad or other surface.
• Starting at one end of the arch, apply the liquid dam to the gingiva to build a strip about 2 mm wide by 1−1.5 mm thick. At embrasures, express the liquid dam through the opening, filling the space completely.
• Protect one extra tooth at each end of the arch beyond those that will be whitened.
• Cure the liquid dam in sections with a standard curing light for 5−10 seconds per arch.
3 MIX WHITENING GEL
• Remove caps from both the activator and base gel syringes. Connect the two syringes together by twisting one onto the other until fully tightened.
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• Push the mixed gel into the gel base barrel, then unscrew the syringes from each other.
• Screw on a brush applicator tip.
4 APPLY GEL
• Divide the upper and lower arches into four treatment sites. – Q1 Upper right quadrant (4−8) – Q2 Upper left quadrant (9−13) – Q3 Lower left quadrant (20−24) – Q4 Lower right quadrant (25−29)
• Dry the teeth by wiping them with gauze or a cotton roll.
• Evenly apply a thin layer (approx. 1 mm) of the mixed LaserWhite20 gel over all four quadrants.
• Use only half of the gel in this application, saving the remaining gel for the second application.
• Make sure that the gel does not contact the patient’s gingiva, tongue, or lips.
• Check patient for sensitivity or discomfort. If sensitivity continues, use the desensitizer included in the kit.*
• Do not proceed if sensitivity continues.
5 LASER APPLICATION
• Ensure everyone in the room is wearing the appropriate eye protection and press the Ready button on the EPIC.
• Place the whitening handpiece, with disposable clear cap attached, about 1mm from Q1 without contacting the gel.
Allow gel to remain on teeth for a minimum of five
minutes after last laser cycle |
• Activate the laser by pressing down on the foot pedal and hold the handpiece in place for the duration of laser delivery of 200 J, about 30 seconds.
• Repeat for Q2, Q3 and Q4.
• Repeat for all quadrants one more time (each quadrant will receive two doses).
• Remove gel using a surgical suction tip. Flush lightly with an air and water spray to remove any residual gel, if necessary.
*Desensitizer not available in Canada.
6 SECOND APPLICATION
• Replace brushed applicator tip with new tip and reapply LaserWhite20 gel using above steps, using remaining half of gel.
• Repeat laser application steps above. Each quadrant will now have four doses of laser energy.
• Allow gel to sit five minutes after last laser cycle and remove.
7 FINAL STEPS
• Rinse teeth thoroughly with water from syringe.
• Remove liquid dam by sliding the tip of an explorer or forceps between the gingiva and the barrier, carefully lifting it away.
• Use an explorer or floss to remove any residual liquid dam from interproximal spaces and rinse again.
• Perform a final polish with a fine grade paste to give luster and shine to the teeth.
• Apply a moist cotton gauze over the gums and teeth and wait a few minutes to rehydrate the tissue and enamel.
• Measure and record the shade using a Vita Shade Guide Brightness Scale. Compare initial shades with final shades and discuss with patient.
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