A WIDE RANGE OF BLEACHING OPTIONS
I have been using Ultradent's Opalescence whitening gels for about 16 years. I use Opalescence for at-home bleaching. With its sticky, glue-like viscosity and 8-to 10-hour active time, I can recommend overnight wear for fast results. For in-office procedures, I use 40% hydrogen peroxide Opalescence Boost that goes from syringe to tooth without mixing pads or extra instruments.
I offer whitening as a complimentary service to all my patients. In fact, I built my practice on this marketing method. I find that Opalescence--because of its viscosity and sustained-release activity--gives us the best bang for our buck, and it gives our patients the best results for their efforts. I have patients place a conservative ribbon of Opalescence (10% in most cases) in their custom trays and wear it overnight for 7 to 10 nights. I see them again at the end of this regimen to see how successful the whitening has been. Because I bleach only the upper arch first, patients are well aware of the success. I then give them the lower tray and 3 to 4 more syringes of Opalescence to bleach the lower arch 7 to 10 nights. When you offer a whitening service like this, you need a product that works fast without causing sensitivity, and that's exactly what Opalescence does.
For patients going through orthodontic treatment, I use Ultradent's Opalescence Trèswhite Ortho prefilled bleaching trays. This system allows them to whiten while brackets are still in place; it even bleaches behind brackets. Patients love it because they can whiten while they are straightening. For ortho patients struggling with oral hygiene issues, I prescribe FlorOpal prefilled trays and recommend patients add 10% Opalescence bleach into these trays so they can wear them for hours. Neutral sodium fluoride in conjunction with carbamide peroxide helps decrease plaque formation, inflammation, and incidence of decay.
For bleaching nonvital teeth, I use an inside/outside technique where patients use their own custom trays. After injecting Opalescence 10% to 20% into the access opening of the nonvital tooth (the canals should be well sealed), patients fill the tray with Opalescence 10% to 20% and wear it overnight. Because nonvital teeth usually take much longer to whiten than vital teeth, I feel comfortable with an extended regimen (up to 12 months) of overnight bleaching. Vital teeth reach their whitening potential, and patients continue to bleach so the nonvital tooth can catch up. With Opalescence products, there is neutral sodium fluoride and potassium nitrate that helps make enamel harder and more resistant to decay.
It's not unusual for patients to have white spots on their teeth. When they come in for in-office bleaching with Opalescence Boost, I usually finish the appointment with an Opalustre polishing. It gives teeth a beautiful shine and can conservatively remove superficial white or brown spots. I follow up with a neutral sodium fluoride application (a rinse or FlorOpal prefilled tray). One patient had orange teeth with white striations. She had already been told she could not bleach her teeth. We started with in-office whitening using Opalescence Boost, finished that appointment with Opalustre, and I sent her home with custom trays and Opalescence 10% to use overnight every night. It took some time, but the outcome was beautiful.