Whitening. A comprehensive look at tooth whitening: The history. The science. The technology. From the world s leader in whitening.

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1 Whitening A comprehensive look at tooth whitening: The history. The science. The technology. From the world s leader in whitening.

2 How well do you understand whitening today

3 Worldwide, the demand for teeth whitening continues to grow. The science and technology of whitening have advanced considerably over the past decade, yet myths and misunderstandings about its safety and efficacy persist. Many dentists remain unclear about their whitening options and how best to treat their patients. They want to know:? Is whitening safe? How does light-activated whitening compare to other forms of treatment? What s the most effective chairside method of whitening? How do I determine which patients are good candidates for whitening? Should my practice offer both in-office and take-home whitening treatments? What kind of results can I expect to achieve? Your patients look to you to answer their questions about whitening and to make appropriate recommendations. As the world leader in whitening for 16 years and counting, Discus Dental is uniquely qualified to help you answer these important questions. We designed this brochure to ensure you re fully informed about the most advanced whitening options today; to address how the science and technology of whitening really work; and to look at how whitening has evolved over the past decade. You ll find out what our clinical studies have revealed regarding effectiveness and safety. And you ll come to appreciate the huge potential whitening has to dramatically increase both your patient satisfaction and your practice s revenue outlook. 1

4 History The Desire for a Whiter Smile Has Been Around for a Long Time. Even in ancient civilizations, white teeth were regarded as a sign of health and social status. Egyptians rubbed their teeth with a paste made of pumice and wine vinegar. Romans found that the ammonia in urine removed stains from teeth. In the 1700 s, barbers filed the surface of their customers teeth to make them whiter. Fortunately, today there are safer and far more pleasant ways to brighten smiles, and at the forefront of whitening technology is Discus Dental. First reported in-office whitening (Fitch & White) First marketing of a 10% CP take-home whitening gel First clinical study published on tray whitening by Haywood & Heymann s In-office whitening becomes an accepted procedure Dr. Klusmier uses gly-oxide in trays for orthodontic patients Dr. Munro uses a 10% CP solution in trays for periodontal treatments 20 take-home whiteners on the market 2

5 OTC products become popular Crest White Strips introduced NiteWhite introduced Zoom introduced Zoom2 introduced Zoom AP introduced BriteSmile introduced Discus Dental obtains exclusive licensing rights to add Amorphous Calcium Phosphate (ACP) to its whitening gels 3

6 Science The Science of Tooth Whitening Today How whitening works Teeth stains consist of molecules that interact with light in such a way that they appear colored. These molecules are called chromophores. Most chromophores are colored because they have one or more carbon-carbon double bonds. Peroxides (hydrogen and carbamide) break down into peroxide radicals. (See Step 1 diagram) Peroxide radicals are molecular fragments with no electronic charge, unlike ions, and have a single, unpaired electron. Radicals are extremely reactive and have a great affinity for double bonds. Peroxide radicals attack the double bonds of the chromophore, destroying the double bond. The double bonds can either be completely broken or be converted into a single bond. The net result is a molecule that is essentially colorless, thus making teeth appear whiter. (See Step 2 diagram) Step 1 Peroxides break down into Peroxide Radicals H 2 O 2 Peroxides (carbamide and hydrogen peroxide) Reactive unpaired electron break down into O OH OOH Peroxide Radicals (O, OH, OOH, and others) Step 2 Electron attacks and destroys the double bond Unpaired electron VERY reactive Chromophore double bond OH Electron attacks and destroys the double bond C C C C breaks down into C C C C OR C C C C 4

7 Understanding peroxide Hydrogen peroxide and carbamide peroxide are the active ingredients that whiten teeth. Both peroxides will ultimately break down into oxygen, water and peroxidefree radicals. These free radicals, which need something to attach to, are immediately attracted to double carbon bonds. These double carbon bonds (molecules) are the source of most color (i.e. stains) in the tooth. During the bleaching process, the double carbon bonds break into single carbon bonds, changing these colors in the tooth. The changed molecules become translucent making the teeth appear whiter. Hydrogen vs Carbamide Hydrogen peroxide (HP) breaks down completely within 60 minutes. Carbamide peroxide (CP) must first break down into hydrogen peroxide and urea, making it active for up to 6 hours, which allows for longer wear times. O SCB H 2 O 2 H 2 O O2 OH OH OOH O DCB DCB SCB SCB OOH SCB Hydrogen Peroxide Rapid breakdown to Free Radicals (O, OH, OOH) Free Radicals enter enamel & dentin and attach to double carbon bonds Double Carbon Bonds Stain molecules Absorb light Single Carbon Bonds Reflect light 5

8 In-office The Truth About Light-Activated Whitening Perhaps most misunderstood is the science of light-activated whitening. Clinical studies on Zoom show that no other whitening technique offers faster, more effective results. The Zoom gel works as a result of the photo-fenton reaction of peroxide and iron. The peroxide component reacts quickly with the iron to produce hydroxyl radicals a.k.a. stain terminators. The light reaction cyclically renews the iron, thereby continuing to produce hydroxyl radicals, significantly enhancing whitening results. Gel-alone treatments cannot consistently achieve the level of whitening that light-activated whitening does. Zoom: Remarkable results in one office visit. Clinical studies conducted using the Zoom System with patients starting at A3 or darker resulted in an average shade change of 8 shades in one office visit. What s more, 50% of those patients had an ending shade of B1 or better. A similar field test in 10 offices resulted in 60% of patients reaching ending shades of B1 or better. VitaPan Classic Shade Guide B1 A1 B2 D2 A2 C1 C2 D4 A3 D3 B3 A3.5 B4 C3 A4 C4 Studies have shown that contact time is an important factor in all whitening products. We believe that offering our Zoom AP system in three 15-minute session intervals allows for the amount of contact time necessary for optimal results, though our syringes contain enough to provide a fourth session if necessary. The simple fact is that the Zoom light is an activator for the gel. To measure results, we recommend using a VitaPan Classic Shade Guide, arranged in value order, or the Vita Bleached Guide 3D-Master which is already arranged correctly. This will give you a true measurement of the results you are able to obtain from the Zoom System. Additionally, the Zoom procedure works best on patients with yellow and brown staining. Those patients with gray shading from tetracycline or with fluorosis may experience less dramatic results. 6

9 Nothing surpasses the power of whitening with light. Photo Fenton Reaction STAGE 1 Zoom Gel contains Ferrous Gluconate which acts as a photo catalyst STAGE 2 Peroxide reacts with the iron to produce free radicals STAGE 3 Zoom Advanced Power light reacts with the resulting ion (Fe3+) through a Photo Fenton reaction. STAGE 4 Light cyclically renews the iron, so it continues to produce hydroxyl radicals, significantly enhancing whitening results. H 2 O 2 Fe 2+ OH- Fe 3+ Fe 2+ OH OH- Fe 3+ OH Fe 2+ & H 2 O 2 Fe 3+ & OH- & OH Fe 3+ & OH- & light Fe 2+ & OH The results are conclusive The Zoom System out-performs both gel-alone and other chairside whitening systems, making it the #1 lightactivated system in the world. The brightest, most powerful chairside lamp ever Nothing whitens faster or more effectively In clinical studies, patients with A3 or darker achieved an average improvement of 8 shades in 45 minutes* 50% of patients achieved an end shade of B1 or better* Comes with unsurpassed training and marketing support directly from Discus Dental Long-lasting results Zoom gets teeth whiter faster, and keeps them whiter longer using the latest light-activated whitening technology and industry-leading take-home whitening products. To keep teeth looking their best, we recommend flossing, brushing twice daily, and occasional maintenance or touchups with NiteWhite ACP or DayWhite ACP Take-Home Whitening Treatments. 45 minutes of whitening treatment Average Shade Change 8 4 Better Results * 33% whiter immediately after treatment than with gel alone 33% Zoom gel alone } Zoom gel with lamp Less Fadeback * 42% whiter 30 days after treatment than with gel alone 42% Zoom gel alone } Zoom gel with lamp *Data on file. 7

10 Take -home A Wide Range of Take-Home Treatments For some patients, take-home whitening treatments are preferable, primarily due to their lower cost. Determining which take-home product is right for a particular patient will depend on their lifestyle, their comfort with extended tray wear, how quickly they want to achieve whitening results, and their sensitivity level. Discus Dental offers NiteWhite ACP and DayWhite ACP take-home products in a variety of concentrations that enable you to treat each patient individually. Only Discus Dental Take-Home Treatments offer all these advantages: Patented Dual Syringes for New Levels of Stability By separating ingredients in our patented dual-barrel syringe, our bleaching gels are assured the best stability without requiring refrigeration. In addition, separating calcium and phosphate in each barrel maximises ACP s effectiveness. This proprietary syringe is available two sizes: Unit-dose (1 applications) Multi-dose (3 applications) Outstanding results that exceed patient expectations while addressing clinical concerns: NiteWhite ACP and DayWhite ACP do much more than effectively whiten smiles. They actually penetrate teeth to rebuild enamel and improve surface quality for a beautiful smile that stays white longer. All concentrations include amorphous calcium phosphate (ACP), potassium nitrate and (where available) fluoride. Variety of Wear Times for Better Compliance There are a variety of treatments to meet your patients lifestyle. NiteWhite ACP 10%, 16% and 22% are worn overnight for 7-14 days. For a shorter treatment, only NiteWhite Turbo ACP whitens teeth an average of 6 shades in 3 nights while DayWhite ACP has a twice-a-day wear protocol of days and it is available in 7.5% and 9.5% hydrogen peroxide. 10%, 16% and 22% carbamide peroxide worn overnight Our high-performance Turbo formula of 6% hydrogen peroxide with a patented activation matrix that extends the release of the hydrogen peroxide whitens an average of 6 shades in only 3 overnight applications With the same outstanding results and benefits of NiteWhite ACP, DayWhite ACP is designed for patients with tooth sensitivity or who may be uncomfortable with extended wear. DayWhite ACP requires treatment times of just 30 minutes, twice a day. Offered in three concentrations: 7.5% and 9.5% hydrogen peroxide and 38% carbamide peroxide, all worn minutes, twice a day 8

11 How to assess tooth sensitivity Before beginning a Zoom procedure or recommending take-home whitening products, it s important to assess overall oral health and to ask your patients if they have a history of dental sensitivity. If they do, remind them that the Zoom procedure may cause that sensitivity to flare up a bit, but that it is transient and can usually be treated. Also, before starting the whitening procedure, be sure to check for recession, dentin exposure, severe caries, cracks or abfractions, all of which should be discussed as possible sources of sensitivity. NiteWhite and DayWhite products all contain ACP, which helps to reduce sensitivity. Our products are the only whiteners on the market to contain ACP. Actually strengthens as it whitens Did you know... that NiteWhite ACP and DayWhite ACP are the only take-home whiteners that contain Amorphous Calcium Phosphate (ACP), which has been clinically proven to: Rebuild enamel by creating a new coating of hydroxyapatite over the tooth s surface 1,2,3,4 Reduce sensitivity by 30% 7,8 Restore luster by filling surface defects with the new layer of hydroxyapatite 5 Reduce fadeback often experienced 6 months post-treatment 5 ACP helps to protect and minimize sensitivity: ACP precipitates onto the tooth surface to form hydroxyapatite and within lumens of dentinal tubules to occlude ACP helps to remineralize teeth and rebuild enamel Adds shine and lustre to teeth Reduces fadeback HELPFUL TIP! To convert carbamide to hydrogen: divide by To convert hydrogen to carbamide: multiply by ACP clusters are applied to teeth during whitening treatment. Product Name Product Concentration Equivalent 10% CP 3.6% HP 16% CP 5.7% HP 22% CP 7.9% HP 6% HP 16% CP 7.5% HP 20% CP 9.5% HP 26% CP 38% CP 13.7% HP 2. With the ACP clusters filling the open dentinal tubules, sensitivity is reduced. 3. The new coating that ACP creates on the enamel fills surface defects, adding luster. Unique Delivery System Patented Dual-Barrel Syringes Means no refrigeration required! Stability and effectiveness are maximized by keeping the ingredients separate Available in 2 sizes: - multi-dose syringes 3 dual-arch applications - unit-dose syringes 1 dual-arch application Clinical Support 1 Amorphous Calcium Phosphate is patented technology exclusively licensed to Discus Dental, Inc. in this field of whitening by the ADA Foundation. 2 Flaitz C, Hicks J: Whitening Agents with ACP: Enamel Caries Formation and Progression. Journal of Dental Research 2006;Volume 85 Special Issue A, Abstract Tung, M.S., Eichmiller, F.C. Amorphous Calcium Phosphate for tooth mineralization. Compend Contin Educ Dent, Vol 25, No 9 Suppl 1, Sep 2004, pp Journal Code , Journal Subset MEDJSD, ISSN Corporate Author: American Dental Association Foundation. 4 M. Cherng, S. Takagi And L.C. Chow. Reduction in Dentin Permeability Using a Calcium Phosphate Slurry. Journal of Dental Research 83 (Special Issue A); IADR CD-ROM Abstract No. 0119, M. Markovic, B.O. Fowler And M.S. Tung. Preparation and Comprehensive Characterization of a Calcium Hydroxyapatite Reference Material. Journal of Research of the National Institute of Standards and Technology, Volume 109, Number 6, November-December Giniger M, Spaid M, Felix H, MacDonald J. A 180-Day Clinical Investigation of the Tooth Whitening Efficacy of a Bleaching Gel with Added Amorphous Calcium Phosphate. Journal of Clinical Dentistry, Volume XVI, No. 1, Giniger M, Spaid M, Felix H, MacDonald J, Ziemba S. Tooth Surface Enhancement By a 16% Carbamide Peroxide Take-Home Bleaching Gel Containing ACP. Journal of Dental Research 84 (Spec Issue A):1793, Giniger, MacDonald, Ziemba, Felix. The Clinical Performance of Professionally Dispensed Bleaching Gel with Added Amorphous Calcium Phosphate. Jada Vol. 136, March Geiger S, Matalon S, Blasbalg J, et al. The clinical effect of amorphous calcium phosphate (ACP) on root surface hypersensitivity. Oper Dent. 2003;28:

12 Patients Determining Which Patients are Good Candidates for Whitening 10 Many healthy patients may benefit from tooth whitening. However, treatment may not be as effective for some as it is for others. Yellow staining from aging, tobacco, dark cola, tea, coffee and red wine will achieve the greatest success with this procedure. Those patients with grey shading from tetracycline or other chemicals may experience less dramatic results, but should expect some improvement from either Zoom AP or a combination of Zoom AP and our take-home treatments, depending on patient preference. Ideal candidates for whitening: Patients with natural teeth Teeth that are stained from age, smoking, food Teeth with predominately brown or yellow staining Not every patient who wants whitening is necessarily an appropriate candidate, based on a number of health considerations. Whitening is contraindicated for: Pregnant and nursing mothers Those with AIDS or compromised immune systems Patients undergoing chemo and/or radiation therapy Patients with poor overall oral health Patients with immature dentition (usually under 13 years of age), though some patients aged 6-11 have been treated successfully Conditions less responsive to whitening include: Tetracycline stains Flourosis Stains Shades in the VITA C and D ranges Grey stains Bruxism Abfractions Worn incisal edges Misaligned teeth X-rays that reveal receded or calcified pulp chambers Before whitening Aging stains Smoking stains Genetic stains Tetracycline stains After whitening For those patients with severe stains, the use of the Zoom AP Chairside System in combination with take home products will provide the greatest results in the shortest period of time. It is recommended that all patients receive an oral prophylaxis prior to their tooth whitening appointment. As with any other whitening product, neither Zoom nor our takehome whitening products will lighten porcelain, composite or any other restorative material. Patients with bruxism or mal-opposed teeth are harder to bleach. Managing patient expectations is vital It s important to evaluate your patient s shade before beginning any whitening program. We recommend that you assess a patient s current shade using the VITAPAN Classic Shade Guide in value order (brightest to darkest). Patient responses to whitening will vary due to habits and tooth structure. It is the responsibility of the dentist or dental professional to determine if a patient is a viable candidate for tooth whitening through an oral exam, including a shade assessment. It is important to manage patient expectations based on the findings of the oral exam to help ensure ultimate patient satisfaction. We advise that you do not make predictions or promises to your patients regarding what level of whitening they are likely to experience. You can show them other patients before and after photos to give them an idea of how successful the treatments can be, but every patient is different and results will vary. Vita Shade Guide Listing by Value Light to Dark B1 A1 B2 D2 A2 C1 C2 D4 A3 D3 B3 A3.5 B4 C3 A4 C4

13 Only Discus gives you whitening choices for every patient. Every patient is different, that s why we offer a complete portfolio of whitening products so that you can treat each patient individually according to their needs, lifestyle, and preferences. No other company offers our range of whitening options. No other system surpasses Zoom for fast, safe and effective light-activated whitening. And no other company offers take-home options that contain ACP for reduced sensitivity, less fadeback, remineralization of teeth, and increased lustre. Considerations for recommending the right product: Dental history Oral health Has the patient whitened before? How long ago? Time considerations is your patient in a hurry for results? Would they prefer you do it all in-office Can the patient wear a tray for extended time periods? Is the patient a smoker or wine drinker? Perhaps a patient is getting married in the near future, or wants to look their best for a job interview. For immediate results the best choice may be a Zoom treatment. If time constraints are not an issue you may consider recommending NiteWhite ACP or DayWhite ACP, depending on how comfortable the patient is with wearing a tray for extended periods. You can also choose the concentration that s most appropriate for their needs, whitening goals and sensitivity levels. If a patient has stubborn stains that can t be optimally whitened with one in-office Zoom treatment, you can supliment their whitening with take-home products. Satisfied clients are the best marketing tool you have to build a successful dental practice. Treat all your patients... individually. Discus Dental, the world leader in whitening, lets you prescribe what s right for each individual patient. IN-OFFICE TAKE-HOME immediate results + maximum shades immediate results + accelerated maintenance night 4 8 hours/day NiteWhite ACP 16% for standard care day min. 2x/day DayWhite ACP 9.5% high-sensitivity supplement Zoom Dash Coming Soon NiteWhite ACP 10% for sensitive patients DayWhite ACP 7.5% Fluoridex Daily Defense Sensitivity Relief Toothpaste BriteSmile NiteWhite ACP 22% or Turbo Zoom! Weekender for extra-strength whitening packaged for portability DayWhite ACP 38% Coming Soon Relief ACP Oral Care Gel 11

14 Products Here are the products that have whitened nearly 2 million smiles worldwide More than 55,000 dentists around the world have discovered how Discus Dental whitening products have led to happier, more satisfied patients and a booming bottom line. Now it s your turn to put the safest, most effective treatments to work in your practice. Zoom in-office whitening We know that giving your patients the highest quality care and service is your highest priority. The Zoom In- Office Whitening System is clinically proven to whiten teeth an average of 8 shades in just one office visit, giving your patients the immediate results they want. Zoom gets teeth whiter, faster, and keeps them whiter longer using the latest light-activated whitening technology and industry-leading, take-home whitening products. Zoom is designed for practices that prefer complete ownership of the equipment, control of procedure kit inventory, and independent price setting to manage their desired profitability. Zoom In-Office Procedure Kits A comprehensive in-office whitening kit for exclusive use with Zoom lamps. Patients receive the added benefit of take-home maintenance in addition to sensitivity management and custom-fitted trays. Give your patients a white smile that lasts with Zoom, the world s leading whitening system. Zoom 25% Hydrogen Peroxide Chairside Procedure Kits for use with Zoom2 and Advanced Power lamps Contents: pack of 2 procedures with NiteWhite ACP 22% Carbamide Peroxide with DayWhite ACP 9.5% Hydrogen Peroxide with NiteWhite Turbo ACP 6% Hydrogen Peroxide Zoom In-Office Whitening Lamp The Zoom Advanced Power T Lamp provides results that last. Clinical studies prove that after 30 days, teeth remain 42% whiter after treatment with the lamp and Zoom gel than with gel alone*. Zoom (Original) 16% Hydrogen Peroxide Chairside Procedure Kit for use with Zoom2 and Advanced Power lamps Contents: pack of 1 procedure Zoom Chairside Procedure Kit with NiteWhite ACP Turbo 6% Hydrogen Peroxide Zoom Chairside Procedure Kit with DayWhite ACP 7.5% Hydrogen Peroxide 12 * Sabiha M. Bunek, DDS; John M. Powers, PhD; John W. Farah, DDS, Phd; Lori K. Brown, DDS; Santine E. Anderson, DDS; William T. Stevenson, DDS; Robert J. Stevenson, DDS. Effect of Zoom! Advanced Power Lamp on Whitening. Dental Advisor Research Report (Dental Consultants, Inc.), 2008

15 Take-home whitening Only Discus offers a full range of take-home whitening options that best suit your patient s individual needs, preferences, schedules and whitening goals. Whether they prefer night wear or day wear, require a full treatment, a maintenance treatment or touch-up or if they need results quickly, Discus has a product you can trust to deliver the results your patients want. Plus, our patented dual-barrel syringes provide stability without refrigeration. Only Discus Dental s NiteWhite ACP (overnight wear) and DayWhite ACP (day-wear) take-home whitening systems contain amorphous calcium phosphate (ACP), potassium nitrate and fluoride (where available) to provide unparalleled whitening while also rebuilding enamel, reducing fadeback, improving luster and dramatically reducing sensitivity. Multi-dose syringes Mini Kit 9 applications Contents: (3) 2.4 ml syringe patient DFU Standard Kit 18 applications Contents: (6) 2.4 ml syringe EVA tray case shade guide patient and dentist DFUs NiteWhite ACP 10% carbamide peroxide 16% carbamide peroxide 22% carbamide peroxide NiteWhite ACP 10% carbamide peroxide 16% carbamide peroxide 22% carbamide peroxide DayWhite ACP 7.5% hydrogen peroxide 9.5% hydrogen peroxide 38% carbamide peroxide DayWhite ACP 7.5% hydrogen peroxide 9.5% hydrogen peroxide NiteWhite ACP Turbo Gel Clinically proven to whiten an average of 6 shades in 3 nights! The 6% hydrogen peroxide gel is a special high performance formula with a surfactant technology that extends the release of the hydrogen peroxoide. Plus ACP, potassium nitrate and fluoride help to provide stronger, whiter teeth with improved luster and decreased sensitivity. Deluxe Kit 27 applications Contents: (9) 2.4 ml syringe EVA tray case shade guide patient and dentist DFUs Unit-dose syringes 8-Pack 8 applications Contents: (8) 1.3 ml syringe EVA tray case shade guide BreathRx toothpaste patient and dentist DFUs NiteWhite ACP 10% carbamide peroxide 16% carbamide peroxide 22% carbamide peroxide NiteWhite ACP 10% carbamide peroxide 16% carbamide peroxide 22% carbamide peroxide DayWhite ACP 7.5% hydrogen peroxide 9.5% hydrogen peroxide 38% carbamide peroxide DayWhite ACP 7.5% hydrogen peroxide 9.5% hydrogen peroxide 38% carbamide peroxide 1-Syringe Kit 6% hydrogen peroxide 4 applications Contents: (1) 2.4 ml syringe in a box, patient and dentist DFUs 2-Syringe Kit 6% hydrogen peroxide 8 applications Contents: (2) 2.4 ml syringes, EVA, tray case, shade guide, patient and dentist DFUs 3-Syringe Kit 6% hydrogen peroxide 12 applications Contents: (3) 2.4 ml syringes, EVA, tray case, shade guide, patient and dentist DFUs NiteWhite ACP Turbo Gel 3-Syringe Kit 40-Pack 40 applications Contents: (40) 1.3 ml syringe patient DFU NiteWhite ACP 10% carbamide peroxide 16% carbamide peroxide 22% carbamide peroxide DayWhite ACP 7.5% hydrogen peroxide 9.5% hydrogen peroxide 13

16 Accessories Zoom Protective Eyewear Zoom Protective Eyewear is specifically designed for use with the Zoom procedure. It utilizes polycarbonate lenses to block over 99% UVB and 99% UVA light. They fit easily over corrective eyewear and feature adjustable temples for a comfortable, secure fit. Zoom Protective Eyewear Contents: 1 pair Zoom Protective Eyewear IsoPrep Retractor The IsoPrep Retractor provided with the Zoom Kit is a universal size. Small IsoPrep Retractors are available separately for patients with small mouths or those who experience discomfort with the universal size. Best Practices Sensitivity Management Leading Zoom practices use a pre and post sensitivity protocol to ensure patient comfort. Fluoridex Daily Defense Sensitivity Relief Toothpaste Fluoridex Daily Defense Sensitivity Relief Toothpaste 2x/day, days prior to whitening Relief ACP Oral Care Gel Relief ACP Oral Care Gel in trays Use immediately after treatment or for extra sensitive patients instruct use just prior to treatment for minutes Order extra to have on hand for those extra sensitive patients. Product IsoPrep Retractor, size small Contents: pack of 3 Brännströms Hydrodynamic Theory of Pain Zoom Whitening Pen A convenient and new way for your patients to keep their smiles white! The easy to use, click-pen applicator brushes a 5.25% hydrogen peroxide formula directly onto the tooth. Just brush and go for quick touch-ups! It is assumed that stimuli to the dentin which cause pain do so by movement of the fluid within the tubules and the resulting displacement of nerve endings in the pulp. This is known as the hydrodynamic theory of dentinal pain perception. Zoom Whitening Pen Contents: 2 pens Zoom Whitening Pen Dentinal Tubules Nerve Fibers 14

17 Practice 4 Steps for Building Your Practice Now Nearly 55,000 dentists worldwide have seen significant growth in their practices due to the growing demand for whitening. Discus can do more than provide you with cutting-edge in-office and take-home whitening treatments. We ll be your partner in helping your practice grow, by providing in-office training and marketing support In-office marketing materials will educate and motivate your patients on their whitening options Use whitening as your opener to other cosmetic dental procedures using these rules: Inform your patients of their shade Diagnose their whitening potential Recommend the products that fit their needs and lifestyle Whiten the smiles of your staff it s a great way to get the message across Create Zoom and NiteWhite ACP/ DayWhite ACP portfolios of before and after photos of your patients. Nothing speaks to your patients more powerfully than dramatic after photos These numbers tell the story of what smart investments Zoom and NiteWhite ACP/DayWhite ACP are for your practice and how quickly that investment will be rewarded. Happier patients more likely to bring you referrals and repeat business and on-going increased revenue that help your practice thrive. Zoom: Fast whitening and a quick return on investment. Full Lamp Warranty included Keeps your practice competitive and on the cutting-edge 4 Zoom Procedures 10 Zoom Procedures 24 Zoom Procedures 2,000 5,000 12,000 (based on an average price of 500 per treatment) Discus Take-Home: On-going revenue and profits 4 Take-Home Procedures 10 Take-Home Procedures 24 Take-Home Procedures 1,000 2,500 6,000 (based on an average price of 250 per treatment) 15

18 FAQs Frequently Asked Questions Is tooth whitening safe? Yes. Extensive research and clinical studies indicate that whitening teeth under the supervision of a dentist is safe. In fact, many dentists consider whitening the safest cosmetic dental procedure available. Please consult candidate qualifications before performing a procedure. What causes tooth discoloration? There are many causes of tooth discoloration. The most common include aging and consumption of staining substances such as coffee, tea, colas, tobacco, red wine, etc. During tooth formation, consumption of tetracycline, certain antibiotics, or excessive fluoride may also cause tooth discoloration. Who may benefit from tooth whitening? Almost anyone may benefit from tooth whitening. However, treatment may not be as effective for some as it is for others. Yellow staining from aging, tobacco, dark cola, tea, coffee and red wine will achieve the greatest success with this procedure. Those patients with grey shading from tetracycline or other chemicals may experience less dramatic results, but should expect improvement from this brief procedure. For those patients with severe stains, the use of the Zoom Chairside System in combination with take home products will provide the greatest results in the shortest period of time. It is recommended that all patients receive an oral prophylaxis prior to their tooth whitening appointment. As with any other whitening product, Zoom will not lighten porcelain, composite or any other restorative material. Patients with bruxism or malopposed teeth are harder to bleach. It is the responsibility of the dental professional to determine if a patient is a viable candidate for this procedure through an oral exam, including a shade assessment. It is important to manage patient expectations based on the findings of the oral exam to ensure patient satisfaction. What causes tooth sensitivity? The most likely cause of sensitivity after a Zoom procedure comes from existing tooth sensitivity. Be sure to ask your patients if they have a history of dental sensitivity. If they do, remind them that the Zoom procedure may cause such sensitivity to flare up a bit, but that it is transient and can usually be treated. Also, before starting the Zoom procedure, be sure to check for recession, dentin exposure, severe caries, cracks or abfractions, all of which should be discussed as possible sources of sensitivity. It is recommended that sensitivity is discussed with patients before the procedure. What type of care is recommended for tooth sensitivity? You may want to treat existing issues before recommending a whitening treatment and disqualify any patient who is perio-involved, exhibits failing restorations or is otherwise in an unhealthy oral state. It is recommended to prescribe 5000 ppm Fluoridex Daily Defense Sensitivity Relief with 5% KNO3 for use 2x/ day, 14 days prior to any whitening treatment. It is also recommended for the patient to wear Relief ACP in trays minutes before and/or after the treatment. Relief ACP Oral Care Gel is a desensitizing gel that combines fluoride and KNO3. How long do the results last? Results are dependent on many factors: tooth structure, personal habits, physical health and oral hygiene. By following some simple post whitening care instructions, teeth that have been whitened with the Zoom system or the Nite White products will always remain lighter than they would have been without whitening. To keep teeth looking their best, we recommend flossing, brushing twice daily, and occasional maintenance or touchups with NiteWhite or DayWhite Take Home Whitening Systems. These are professional formula products designed to keep teeth their brightest. They are available only through a dental professional. 16

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