Whiteness HP AutoMixx is a 35% hydrogen peroxide bleaching get for vital teeth. It exclusive for in-office use, always with isolation for the protection of intraoral tissues. The bleacher comes in a double-body syringe containing the peroxide and the thickener in distinct compartments. By means of a self-mixing tip, the phases are mixed as they come out of the syringe, so that the product is ready for direct application on the teeth avoiding manual mixing.
• 1 double-body syringe with 5g of bleaching gel
• 5 self-mixing applicator tips
• 1 syringe with 2g of gingival barrier (Top dam)
• 3 applicator tips
• 1 bottle with 2g of peroxide neutralizing solution (Neutralize)
• 1 Instructions for Use
Characteristics and Advantages
Single application per session: the product may be kept up to 50 minutes in contact with the teeth with no need to change the gel, since the pH is remains neutral and stable during the whole session.
Practicality: the phases are mixed via a self-mixing tip and the product is released ready for application, with no need for manual manipulation.
Cost reduction: the remaining content can be stored and used later;
No light source required: it is not necessary to use accelerating light sources (LED systems, high power laser and others).
No color alteration: the product has bluish-green color and undergoes no color alteration during the process facilitating visual control.
Contains calcium: aiming to keep the enamel integrity during the bleaching process, a soluble calcium source was added to the formulation of the product. Studies show that calcium significantly improves the enamel micro hardness decay (an effect always observed during the bleaching process).
With heat blocker: in cases when the professional desires to use some sort of light source, the heat blocker avoids that the heat generated by these sources reach the pulp, preventing hypersensitivity.
Gel with adequate and pleasant viscosity.
Yield: the syringe yields up to 4 complete applications (smile line).
• Bleaching of vital teeth exclusively in office. It can be used with or without light source.
• Vital teeth darkened due to age.
• Vital teeth naturally darkened or yellowish.
• Vital teeth that were darkened or stained due to pigmented substances contained in products such as coffee, tobacco, tea, etc.
• Light and mild stains due to fluorosis
• Vital teeth with light degree of stain due to tetracycline
Note: It is important to note that the literature shows that in-office bleaching may result in less bleaching intensity and occasionally less color stability over time compared to the at-home technique, since in the later the contact time between the bleacher and the teeth is longer and more frequent. Literature data shows that the combined technique (in-office and at-home) has been effective in more resistant cases. For these reason, a very good interaction between the professional and the patient is necessary in relation to clarifications on expected results based on clinical pictures and the color scale. It is important also that the professional explains to the patient that his/her teeth have a saturation grade, and in some cases the bleaching results may be not the one the patient sees as ideal. Regarding hypersensitivity, it is important to note that the in-office bleaching technique, due to higher peroxide concentration, may present a higher degree of sensitivity compared to the ones used in the at-home technique (less peroxide concentration).
Step by Step
Proceed with the prophylaxis of the teeth leaving the dental surface to be bleached free from biofilm. Take the color of the patient’s teeth by means of a shade guide and/or photograph before beginning the treatment.
After taking the colors, proceed to the insertion of the lip retractor (Arcflex, FGM) to facilitate access and manipulation of the buccal cavity. Then, apply Desensibilize KF 2% (FGM) for 10 minutes on the teeth to be bleached before starting.
Remove the desensitizing gel with water spray and dry up the gingival tissue. Make the relative isolation with Top dam (FGM) (light-curing gingival protector) covering the marginal gum and the papillae with a layer that is 3 to 5 mm wide and no thicker than 1 mm. The barrier should cover approximately 0.5 to 1 mm of the tooth surface. Use a clinical mirror observing from incisal to cervical if there is uncovered gingival tissue. If so, make the necessary correction. This stage is crucial to avoid contact of the peroxide with the gum. After application, light cure the Top dam (FGM) resin with 20 to 30 seconds of light curing for each group of 3 teeth. The gingival protector that is formed is rigid and insoluble, preventing occasional irritation by aggressive products.
With the self-mixing tip adequately coupled to the double-body syringe press the plunger gently until the phases (peroxide and thickener) are slowly mixed in the tip. A small amount of gel should be discarded in a disposable container before applying the product to the teeth. That will guarantee that the product applied on the teeth is correctly homogenized.
Apply the gel directly on the teeth to be bleached, normally from one 1st or 2nd pre-molar to the other. Cover the vestibular face of the teeth with the thinnest possible layer of gel, using the self-mixing tip itself to spread the product. The gel layer may be extended to the small area of the incisal/occlusal surface of the teeth. In case you want to use the light source, begin its use right after applying the gel. For each equipment, there is a specific time protocol for light exposure. Follow the instructions of the manufacturer for the duration of the light application, however, respect the protocol for the duration of the light exposure on the teeth as well.
After the application, the gel should be left in contact with the teeth for up to 50 minutes, period in which the professional should move the gel with an exploring probe or disposable micro applicator (e.g.: Cavibrush, FGM) to remove air bubbles and renew the contact of the gel with the teeth. There is no need to apply a new gel layer during the session.
At the end of the session, suck the gel with a fine suction tip and wash thoroughly. The removal of the gingival barrier may be carried out with an exploring probe or a similar instrument.
The polishing of the teeth with felt disks (e.g.: Diamond Flex, FGM) and polishing paste (e.g.: Diamond Excel, FGM) is recommended.
Office appointments should be scheduled with intervals of 7 days, allowing for the effective evaluation of the color of the teeth. If necessary, more bleaching sessions may be scheduled according to the steps described above. Generally, for good results, the suggestion is for 2 or 3 sessions for in-office bleaching.
To prevent occasional dental hypersensitivity during or after the treatment, Desensibilize KF2% (FGM) (5% potassium nitrate and 2% sodium fluoride) can be applied before the bleaching treatment, in a prophylactic way. The option of applying the desensitizer after the bleaching session is valid too, but may not show the same efficacy in some cases. In both cases (before or after the gel application), Desensibilize KF2% (FGM) may be applied on the teeth for 10 minutes. In cases of severe post session hypersensitivity, Desensibilize 0.2% (FGM) (for at-home use) can be applied by the patient for 10 minutes daily in a dental tray, until the symptoms disappear.
Monitor patients throughout the whole process in relation to hypersensitivity and possible soft tissue areas irritated by the peroxide. Fissures in the enamel or dentine exposure can lead to acute and intense pain. In those cases, it is recommended to interrupt the process and search for corrective treatment before resuming bleaching.
If the results obtained with the bleaching procedure do not fulfill patients’ expectations and patients do not show hypersensitivity or any other contraindication, the re-application of the product may be done in two more sessions, with a total of three sessions. In the need of one more session, a minimum interval of 7 days between sessions should be considered.
The double-body syringe already has the right proportion of each phase and the mixing is done inside the tip. The gel gets out of the tip ready for use.
We recommend to dispose a small quantity of the gel in a recipient previously the intra-oral application. This assures you that the applied product is adequately homogeneous.
One syringe in average yields 8 applications per arcade or 4 bleaching sessions (smile line). It is important that the gel is well spread and the applied film is as thin as possible.
If adequately closed and stored (as recommended in the instructions manual) can be stored up to its expiration date.
Whiteness HP AutoMixx typical application duration is 50 minutes.
The new formulation with a more stable pH allows for a alteration protocol for the application of the product, eliminating gel replacement during the session. Older versions of bleachers for in-office use used to have loss of activity of the catalyzers over time, with alteration of the pH to acid, which required the replacement of the bleacher during the session. With Whiteness HP AutoMixx one single longer application is made per session.
Two or three sessions with one week interval between sessions for a better stabilization of the bleaching are recommended.
The combination of the in-office and at-home techniques is an excellent alternative for those patients that have severely darkened teeth as well as for dental bleaching stability. The dentist can start bleaching with Whiteness HP AutoMixx and complement the treatment with the at-home bleaching products (Whiteness Perfect or White Class, FGM). After the first session in the office the patient can start the at-home technique.
Information for the Professional
• When necessary, double body syringes containing product can be stored. For that, maintain the lid tightly closed.
• Store the product at a location with temperatures between 5°C and 25°C / 41°F and 77°F for better conservation.
• Do not freeze the product.
• Protect it from direct sunlight.
• Do not use the product if it has expired. For disposable, check your country’s legislation.
• Keep out of the reach of children.
• This product has contraindications. Please refer to the instruction manual.
• The product is for exclusive in-office use and should be manipulated only by dentists.
• The health of the oral cavity should be evaluated before the treatment. Fissures in the enamel, infiltrations in restorations, exposed dentin and other factors that can compromise the bleaching treatment should be solved before its beginning.
• The product is contraindicated for patients who could not solve the problems above.
• The product is not recommended for bleaching teeth with amelogenesis and dentinogenesis imperfecta, severe fluorosis, intense staining by Tetracycline and other enamel and dentin anomalies, which may put the vitality of the teeth at risk.
• The product is not recommended for use under anesthesia. It is important to monitor the sensitivity felt by the patient during the bleaching process. In extreme cases when there are imperfections or failures in the tooth structure in such a way that the peroxide can get to the dental pulp in large amounts, there is a risk of pulp necrosis.
• The product is not recommended for breast-feeding or pregnant women and patients under 15 years of age.
• The product is not recommended for patients who have undergone recent gingival surgery or patients with inflammation of the gingival tissue or who may be allergic to the components of the product.
• The product is not recommended for use with high-power or other lasers that result in high temperatures on the dental surface. The temperature of the dental pulp should not surpass 42oC (108oF) to avoid irreversible damage to its vitality.
• Acid etching of the dental enamel before bleaching is neither necessary nor recommended.
• While manipulating the product, professionals as well as their assistants should wear protective gloves and goggles compatible with the equipment they are using. Patients should also wear protective goggles and other necessary protection to avoid accidental contact of the product with skin or clothes.
• Whiteness HP AutoMixx is a bleaching product with high oxidizing power and, when in contact with live tissue, can cause white staining and temporary irritation of the affected area (usually disappearing within 2 hours at most without any aftereffect). Avoid prolonged contact of the product with live tissue.
• In case of accidental contact with the skin or live intraoral tissues, neutralize the peroxide affected area covering it with a few drops of the neutralizing solution and washing it immediately.
• The bleacher is presented in a syringe with a double body which contains both phases in different chambers: the peroxide and the thickener. When removing the cap of the syringe, one should be careful not to push the plunger to avoid dripping of the content.
• The content of the syringe (peroxide + thickener) may be under pressure and/or may have leaked due to adverse storage conditions. Before opening the package, protect your hands and eyes and check for leakage inside the package. In case there has been a leakage, please, request product replacement.
• Proceed with the manipulation of the product far from the patient, over a sink or safe counter, without risk of contaminating other people.
• After utilizing the product, wash your hands and the materials contaminated by peroxide. When manipulating the product, always have prevention and safety in mind.
• Efficiently isolate the gingival tissue using the light-curing gingival protector Top dam (FGM) associated to the lip retractor Arcflex (FGM) or rubber dam. In all cases, it is crucial to avoid the contact of the peroxide with intraoral tissues.
• Patients should be warned to avoid ingesting acid foods and/or strongly pigmented foods for at least 24 hours after the bleaching treatment to prevent sensitivity and possible compromising of the process.
• Dental hypersensitivity may occur during or after bleaching. Because, in several scenarios, hypersensitivity is hard to predict, the use of the product Desensibilize KF 0.2% (FGM) is recommended for a prophylactic desensitizing procedure before bleaching. If hypersensitivity persists and it is not possible to continue the treatment, schedule a new appointment with a minimum interval of 7 days. Assess if there are no anomalies in the teeth that can be corrected to eliminate hypersensitivity.
• There may be cases of elevated dental hypersensitivity after the appointment (1 or 2 hours later). In those cases, the prescription of analgesics and application of Desensibilize KF 0.2% (FGM) with an individual dental tray for 10 minutes per day is recommended.
• The bleaching treatment may highlight areas of dental hypocalcification due to a more intense bleaching in those areas. In most cases, no additional care needs to be taken, and the stains disappear as soon as the bleaching process is ended and the tooth returns to its normal hydration. For more persistent cases, the treatment with fluoride in the affected area may help.