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Bleaching Instructions & Consent Form

Significant Whitening can be achieved in many cases, but there is no definite way to predict how light your teeth will get.  Candidates with Yellow or Yellow/Brown teeth tend to whiten better and quicker than people with Gray or Gray/Brown teeth.  Teeth discolored by antibiotics, decalcification (white spots), root canal therapy, or trauma do not always respond as quickly or predictably, and may require additional treatment.  On the other hand, if your teeth are already a light shade of white--your whitening results could be minimal.  The level of whiteness varies with each individual; therefore, you may or may not achieve a higher degree of whitening.




Whitening of the teeth is a gradual process and may not be noticeable immediately.  Also, through the normal staining process of a day-to-day eating and drinking, you may experience a slight regression of shade.  This will depend on the frequency of your use of:  TOBACCO, COFFEE, TEA, RED WINE, BLUEBERRIES


It is essential to maintain a good oral hygiene program; including brushing and flossing. 


Touch-up of bleaching/whitening may be required in 6 months, yearly intervals, depending on your diet and hygiene.  Additional tubes of bleaching gel can be purchased for a nominal fee at our office.




Teeth Whitening have some risks and limitations.  Complications that can occur in Professional Teeth Whitening are generally infrequent and are usually minor in nature.


  1. Tooth Sensitivity:  You may experience some teeth sensitivity.  The sensitivity is usually mild if your teeth are not normally sensitive.  Our office recommends the use of sensitive toothpaste before and during teeth whitening procedure to reduce sensitivity during bleaching.  If your teeth are normally sensitive, you can experience EXTREME sensitivity.  We cannot eliminate this risk.  In some cases, we may suggest taking an Ibuprofen 400 mg before beginning the procedure.  Please let us know if you experience any discomfort during the procedure.  If your teeth become or stay sensitive following the procedure, Tylenol, Ibuprofen or Advil will usually be effective in helping you feel comfortable.  This sensitivity generally goes away in 12-24 hours.  If this persists for more than 24 hours, please contact our office.


  1. Gum and soft tissue irritation:  Temporary inflammation of the gums and other soft tissues of the mouth can occur during the procedure.  This is generally the result of the whitening gel coming in contact with these tissues.  Protective materials are placed in the mouth to prevent this, but despite our efforts, it can still occur.  Usually, this will go away within 1-2 hours following the procedure.  The irritation is generally short in duration and is very mild.  If discomfort persists for more than 24 hours, please contact our office.


  1. Fillings and other Dental Restorations:  Tooth colored fillings (composite), Composite Veneer/Bonding, Porcelain Crowns, and/ or Porcelain Veneers will not whiten at all.  We may be able to remove certain stains (tobacco) from the surface of the restorations.  All Dental restorations that show when you smile may need to be replaced at your expense.  Please be sure to discuss this with the Dentist prior to beginning treatment.    Metal fillings may leave a small amount of grey discolouration in the bleaching gel upon removal of the tray and is of no concern.




  1. Follow all Directions:  Please take time to read all written instructions, and listen carefully to all oral instructions.  You are welcome and encouraged to ask us any questions you may have.

  2. Communications:  If you do not understand something communicated to you during the consultation, exam, in any printed material given to you, or after the procedure, please feel free to ask us.

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