GAP Australasian-Dentist-May June 2019

Category 46 AustrAlAsiAn Dentist tooth whitening is very common practice in dentistry today, made famous by celebrities in the 1980’s and initially thought to have been discovered by accident by a group of dentists using peroxide to treat gum disease (Kurthy, 2016). the uK tooth whitening industry is believed to be worth over £40m as more consumers seek the white healthy smiles endorsed by many celebrities. (national smile Month, 2018) Further market research shows that 99.2% of us believe our smiles are an important social benefit. (Hexa research, 2017) Furthermore, a study found 48% of adults believe that a person’s smile is the most memorable thing they remember when first meeting them. (salemi, 2013) Haywood (2003) suggests that the efficacy of whitening is greatly improved when the peroxide level is around 6% Hydrogen Peroxide and custom made dental trays are made to hold the gel close to the teeth for a period of around 2 hours. Carey (2014) supports this positive approach and states “Home- based bleaching (following manufacturer’s instructions) results in less tooth sensitivity than in-office bleaching. the optimal regime to obtain persistence of Stop making your own whitening trays! lInICal It is never advisable to manufacture your own whitening trays – it is impossible to recreate the quality obtainable from a dedicated laboratory team. u Boutique’s trays are rigid enough to contain the gel, but flexible enough to offer maximum comfort. u The gingival margins are carved to ensure a tight seal, which prevents the leakage of gel and ingress of saliva. u A positive former is used, rather than a suck-down technqiue for better adaption of the tray material to the model. u A ‘hot-dot’ on ech tooth serves as a dosing tool. Simply fill this dimple with gel, no more, and the kit will last for several weeks to give optimum results. D entists often feel they are saving time and money by making their own whitening trays in-house. Whilst it may save on lab fees, these typically yield poor results which means that you end up paying for it later down the line. there are certain features of a laboratory made tray that you simply cannot reproduce if making the trays yourself. At Boutique we aim to provide our customers with the most up to date materials, techniques and information based on current clinical evidence. uK based, lab technician, Matt everatt, and Dr David Bretton, recently completed a literature review on the design of whitening trays which yielded some interesting results! the findings of this review prompted us to improve the design of our current whitening trays in order to manufacture to a very high quality, and ensure amazing results, every time. the specific design features of our ‘Mark ii ultra-seal’ trays are as follows: u semi-rigid eVA bleaching tray specific material u Hybrid pressure and vacuum formed process u Dosing dots u non-scalloped margins u sealed gingival margins the combination of the semi-rigid material, and the unique pressure and vacuum forming process, not only ensures we have the best adapted trays, but a more uniform tray thickness, which translates to better stability. the technique used by s4s also produces a beautifully clear, glass-like finish on the trays. non-scalloped, straight cut margins are the biggest change in our Mark ii trays, and the modification that we feel will have the biggest impact on clinical outcomes. the literature indicates that superior results are achieved with a straight cut margin on the tray, as opposed to scalloping. Further details will be released once the review has been published. sealed gingival margins are also an important design feature of our trays. the preparation of the margins is paramount to ensure a good marginal seal, which means less saliva ingress, and less gel wash-out, which in turn means more active gel is in contact with the tooth surface, leading to better results and less sensitivity. the combination of all these factors will take our tray design, and whitening results, to new heights. the fantastic synergy between Boutique Whitening and our laboratory partners means continuing innovation and the pursuit of excellence, to the ultimate benefit of our valued customers. Watch this space! the ‘Dosing Dots’ are a tool to aid the patient in administering the correct quantity of gel. By only filling the dot, the patient can be sure that they are not over filling the trays which can lead to sensitivity caused by excess gel in contact with soft tissues. it also means that the gel lasts longer to give better results. A Literature Review of Bleaching Tray Design and Efficacy Authors: Matthew Everatt and David Bretton, May 2018