Whiteness HP Blue is a product that combines the technology of the best dental whiteners and the new trends of the world of dentistry in terms of safe and conservative techniques for in-office whitening.
Its major advantage is the presence of calcium in its formula to minimize the reduction in microhardness of the enamel due to the whitening. For the professional’s greater ease, the gel is applied one single time over the course of the session (40 minutes at the concentration of 35%).
The gel, obtained by mixing the phases, has an excellent consistency, highly visible homogeneous coloring, and can be applied directly from the syringe through a tip. Application directly from the syringe facilitates the process and provides time saving. For reasons of stability and catalytic potential, the product has the thickener phase separate from the peroxide phase, and they are mixed only at the time of use.
• 6 sets of syringes (1.2g per set, 7.2g of gel in total)
• 1 bottle with 2g of neutralizing solution for peroxide (Neutralize – FGM)
• 1 syringe of light-curing gingival protector (Top dam – FGM) with 2g and 6 applicator tips
• 6 syringe coupling devices
• 6 applicator tips
• Instructions for Use
• The right amount for one session
• Contains 1 set of syringes with 1.2g + Top dam with 1g
Characteristics and Advantages
• Contains calcium: does not interfere with the microhardness of the enamel.
• Self-catalyzed system: the exclusive formula of Whiteness HP Blue contains catalysts that make it much more active and efficient, dispensing with the use of external sources of acceleration.
• Excellent wettability: the main characteristic that a product needs to have in order for there to be a good transfer of the peroxide to the tooth structure is wettability, which the gel provides when deposited on the surface of the enamel. If there is not good wettability (inadequate consistency or affinity), the transfer of the peroxide is hindered and, consequently, the whitening result is hindered as well. Its new self-catalyzing formula with stable alkaline pH allowed for the product’s application protocol to be changed, eliminating the changes of gel during the same session. The older versions of in-office whiteners lose their catalyst activity over time and generally their pH moves into more acidic ranges, which brings the need to change the whitener during a single session. With Whiteness HP Blue, a single application is done for a longer period of time per session. With this new protocol, the whitening process has become simpler, faster, more productive, and safer.
• Pre-measured portions: the proportion between the thickener and peroxide phases comes pre-determined and packaged in syringes, which facilitates the process of preparing the gel and saves time. The total measured amount is easily enough to cover the smile line on both dental arches, without waste.
• Ease in mixing the phases: a syringe coupling system allows the two phases to be easily mixed, ensuring perfect homogeneity.
• Ease of application: the gel, obtained by mixing the phases, has an excellent consistency, highly visible homogeneous coloring, and can be applied directly from the syringe through a tip. Application directly from the syringe facilitates the process and provides time saving.
• Does not change color: the product does not change its color throughout the process making the visual control easier.
• Efficacy: the new catalyst composition allows for whitening efficiency with a 35% gel. Suggest application time: 40 minutes.
• Naturally dark or yellow vital teeth.
• Vital teeth darkened by age.
• Vital teeth that have been darkened or stained by
extrinsic substances, such as pigments in coffee, tobacco, tea, etc…
• In more challenging cases (severe darkening), it can be used in combination with the take-home technique.
NOTE: It is important to note that the worldwide literature demonstrates that in-office whitening may present a lesser intensity of whitening and potentially less shade stability (maintenance of the shade over time) than the take-home technique, because in the latter, the time of contact between the whitener and the dental structure is longer and more frequent. Data from the literature indicates that the combined technique offers quite satisfactory results in treating tough cases. For this reason, it is necessary for there to be a perfect professional/patient interaction with regard to clarifications about results, based on clinical photos and a shade guide. It is also important for the professional to clarify to the patient that their teeth have a degree of saturation, and that in many cases the patient will have their teeth whitened, but not to the ideal level he or she imagined. In relation to hypersensitivity, it should be noted that in-office whitening, since it has a higher concentration of peroxide, may present greater dental hypersensitivity during and/or after the procedure than lower-concentration peroxides like those for take-home use.
Step by Step
Whitening of vital teeth
Perform a good assessment of the oral cavity of the patient: the presence of caries, deficient restorations, fissures in the enamel, gingival recessions, gingivitis and other characteristics deemed important should be checked and treated before the procedure. Ensure your protection and that of the patient.
Position the lip retractor (Arcflex – FGM) to retract lips and cheeks.
Perform a prophylaxis with pumice and water.
Take the initial color of the teeth with a shade guide and photograph the initial case.
Apply the desensitizing gel (Desensibilize KF 2% – FGM) for 10 minutes to provide desensitization beforehand. Remove the excess gel with an vacuum tip, then wash and dry.
Perform relative isolation with light-curing gingival protector (Top dam – FGM) covering the edges of the gums and the papillas with a layer 3 to 5 mm wide and a maximum of 1 mm thick. The barrier should cover 0.5 to 1 mm of the tooth surface. Use a clinical mirror looking from the incisal to the cervical face and note if there is uncovered gingival tissue. If there is, correct it. This step is crucial in order to prevent contact of the peroxide with the gums. Use a lip retractor to facilitate the application of the barrier and also the whitener.
Cure Top dam by using 20 to 30 seconds of light curing for each group of 3 teeth. The gingival protector that forms is rigid and insoluble, preventing any irritation by aggressive products.
Prepare the gel: mix the two phases with the syringes connected, pushing the plungers 4 times on each side (total of 8 times), then push all the mixed content into one of the syringes, and it is ready for use.
1 – Make sure that both syringes are well attached;
2 – Mix the phases in a place away from the patient’s reach;
Place a tip on the syringe that still have the gel and apply a layer to the entire vestibular surface of the teeth to be whitened (including the interproximals) and extend a little onto the incisal and occlusal faces. The layer of gel should be between 0.5 and 1 mm thick. Consider only the smile line (generally from 2nd pre-molar to 2nd pre-molar of the other arch).
One syringe with 1.2g of gel yields enough for one simultaneous application on both arches.
Leave the gel on the dental surface for 40 minutes, with a single application of gel during the session. With the aid of a disposable micro applicator (Cavibrush – FGM), move the gel around on the teeth frequently (every 5 to 10 minutes) to release any oxygen bubbles generated and renew the contact of the gel with the tooth structure.
The application times for whiteners are suggestions and should be administered by the professional. Shorter times or interruption of the treatment may occur in cases of dental hypersensitivity.
At the end of the treatment, vacuum the gel with an endodontic or surgical cannula and rinse the teeth with plenty of water. Remove the gingival protector, detaching it with a probe.
Polish teeth with polishing paste (Diamond Excel – FGM) and felt disks
(Diamond or Diamond Flex – FGM).
1 – Monitor the patient throughout the whitening session regarding dental sensitivity and possible points of irritation from contact with peroxide. In any of the cases, interrupt the process and do a check and intervention (see comments in the section on Information for the professional);
2 – If the patient develops hypersensitivity that cannot be controlled, it is suggested that you interrupt the treatment and make sure there is no anomaly in the dental structure that could be causing the hypersensitivity (fissures, exposure of dentin, etc.). When the sensitivity is difficult to control or, for some reason, another whitening session is not possible or not recommended, whitening can be supplemented by using take-home whiteners (carbamide peroxide-based Whiteness Perfect 10%, for example);
3 – In cases where the two whitening sessions proposed do not result in a satisfactory level of whitening (cases of more severe staining), the treatment can be extended for two more sessions, provided that the patient does not present hypersensitivity. In this case, you must wait an interval of seven days between the sessions. For even more challenging cases, a combination of whiteners (in-office and take-home) may be indicated according to the parameters established by the professional;
4 – Satisfactory results may occur right from the first session. However, it is recommended that one more session is done for purposes of greater effectiveness of the treatment (2 sessions per patient);
5 – As with other whitening techniques, it is recommended to take the color of the teeth before treatment, give clarification to the patient on the real perspectives of their case (limitations in cases of tetracycline staining, grayish coloring, etc.), and warn about possible sensitivity and the need to change restorations. There are cases in which, due to particular characteristics of the teeth (characteristics of the enamel, pigmentation type, etc.), the desired level of whitening may not be possible to obtain.
6 – Once the whitener has been mixed, it must be used in the same session. The gel cannot be stored for use in another session after it has been mixed, because it will lose its effectiveness. If there is leftover gel during the session, it should be discarded (diluted with water and discarded in the sink, for example).
The proportion between the thickener and peroxide phases comes pre-determined and packaged in syringes, which facilitates the process of preparing the gel. The syringe coupling system allows the two phases to be easily mixed, ensuring perfect homogeneity.
Whiteness HP Blue has an application time of 40 minutes.
The new self-catalyzing formula with more stable pH allows for the product’s application protocol to be changed, eliminating the changes of gel during the same session. The older versions of in-office whiteners lose their catalyst activity over time and generally their pH moves into more acidic ranges, which produces the need to change the whitener during a single session. With Whiteness HP Blue, a single application is done for a longer time per session.
Two to three sessions can be done, with an interval of 1 week between them for better stabilization of the whitening.
The combination of the in-office technique with the take-home technique is an excellent alternative for patients who have quite dark teeth, and also for the stability of the dental whitening. The dentist can start the whitening with Whiteness HP Blue and complement with whiteners for take-home use (Whiteness Perfect or White Class – FGM). After the first in-office session, the patient can start the take-home technique.
Information for the Professional
• The product is exclusively for in-office and must be handled only by dentists.
• The health of the oral cavity must be evaluated prior to the treatment. Fissures in the enamel, infiltrations of any restorations, exposed dentin, and other factors which may compromise the whitening must be resolved before beginning the treatment. The product is contraindicated for patients with poor oral health.
• Fissures in the tooth enamel are quite common, but generally do not impede whitening, although there may be cases with acute pain caused by overly rapid infiltration of the peroxide into the dental structure through the fissures. Generally, this effect is characterized by acute pain in isolated elements. If the patient presents fissures in the enamel, keep a close watch for this possibility, since the depth of the fissures cannot be determined ahead of time. If very intense hypersensitivity occurs, apply Desensibilize KF 2% for 10 minutes. If this is still not effective, consider reducing the application time of the in-office whitener and complementing it with the take-home technique.
• The product is not recommended for whitening of teeth with imperfect amelogenesis and dentinogenesis, severe fluorosis, intense tetracycline stains, and other enamel and dentin anomalies that put the vitality of the tooth at risk.
• The product is not indicated for use with the patient under anesthesia. It is important to be able to monitor the sensitivity reported by the patient during the whitening. In extreme cases where there is some imperfection or failure in the dental structure such that the peroxide can reach the dental pulp in great quantity, pulp necrosis may occur.
• Whitening treatments are not recommended for pregnant or breastfeeding women or children under 15.
• The product is not recommended for people who have recently undergone gum surgery or have inflammation of the gingival tissue or people with allergic reactions to the product.
• Since it is a self-catalyzing product, it is not necessary to use accelerating light sources (LED system, high-power lasers, etc.).
• Acid etching of the dental enamel prior to the whitening is not necessary and not recommended.
• During manipulation of the product, both the professional and the assistant should wear gloves and protective eyewear compatible with the type of equipment that will be used. The patient should also wear protective eyewear and any other protection necessary to avoid accidental contact of the product with the skin and clothing.
• Whiteness HP Blue is a whitener with high oxidizing power, and when in contact with living tissue, may cause a white stain and temporary irritation of the affected region (which generally disappears within two hours, without recurrence).
• In case of accidental contact with the skin or living intraoral tissues, neutralize the peroxide by covering the region with a few drops of Neutralize solution and then rinse.
• The whitener consists of one phase called peroxide (phase 1) and another called thickener (phase 2), which must be mixed at the time of use. Care must be taken when manipulating the peroxide phase, because it contained hydrogen peroxide at a 50% concentration.
• The content of the syringes with peroxide may be under pressure and/or may have leaked due to adverse storage conditions. Before opening the package, protect your hands and eyes (dentist and assistant) and make sure there is no liquid which has leaked inside it. If there is leakage, request and exchange of the material.
• Proceed with manipulation of the product away from the patient, over a sink or safe space with no risk of contaminating other people.
• After using the product, wash your hands and the materials contaminated with peroxide thoroughly. Think of prevention and safety when handling the product.
• Do effective isolation of the gingival tissue by using the Top dam (FGM) gingival protector or rubber dam in association with the Arcflex lip retractor. In all cases, it is essential to avoid contact of the peroxide with the intraoral tissues.
• You should recommend to the patient to avoid consuming acidic and/or strongly colored foods for at least 24 hours after the whitening to prevent sensitivity and possible compromise of the whitening.
• Inform the patient about the possibilities of success and failure for the whitening to prevent the possibility of frustrating the patient’s expectations.
• After mixing the phases, insert the tip and make sure there is no resistance for release of the whitening gel before applying it on the patient’s teeth. If there is resistance, change the tip and test it on a surface (for example, mixing block).
• The product should be used as recommended in its protocol. It should not be injected under any circumstances.
• Some patients may experience dental sensitivity during or after whitening. If the patient has sensitivity during the treatment, interrupt the whitening session and treat the teeth with Desensibilize KF 2%. If the sensitivity persists and it is not possible to continue the whitening, schedule a new session with an interval of at least 7 days. Assess whether there is any anomaly in the teeth that may be corrected to eliminate this sensitivity.
• There are cases in which sensitivity appears only after the treatment (1 or 2 hours later). In these cases, if the sensitivity is high, it is recommended to prescribe an analgesic and, on occasion, an anti-inflammatory, depending on the need in each case.
• Whitening may highlight areas of pre-existing hypocalcification (hypoplasias) due to the different behavior of whitening (more intense) of these areas. In some cases, these stains disappear due to rehydration of the enamel after the whitening is concluded. Treatment of these areas with fluoride may also assist in making them disappear.
• Product for professional use only.
• Store the product at temperatures between 5 and 25°C for best preservation.
• Do not freeze the product.
• Protect from direct sun light.
• The validity period is 2 years from the date of manufacture.
• Do not use the product after its expiration date.
• For disposal of the product, follow the laws of your country.