Track your patient’s home bleaching journey, the StyleItaliano way: a practical guide to achieving brighter smiles

A clinical case by our Community member Dr Tarek Hanbali

This article and its content are published under the Author’s responsibility as an expression of the Author’s own ideas and practice. Styleitaliano denies any responsibility about the visual and written content of this work.

With the highly rising demands for a charming white smile that came along with the increasing use of social media platforms, dental bleaching has emerged as the ideal solution to brighten the smile while fully conserving the natural teeth. In fact, it is the most conservative and effective approach to treating moderately discolored teeth.
Dental home bleaching gels are available in the market in different concentrations and types. The composition of the gel typically contains either hydrogen peroxide (HP) or carbamide peroxide (CP) as the active agent, and their application time differs based on the concentration used White Dental Beauty (Optident, Ilkley, UK) bleaching products are considered safe and highly effective both in terms of bleaching results and reduction of bleaching-associated tooth sensitivity due to its NOVON technology, which is a compound that provides enhanced whitening results over a shorter period of application time.
Nevertheless, one notable challenge associated with dental home bleaching lies in the perception of results among patients. Unlike in-office procedures that provide immediate and noticeable transformations, home bleaching occurs gradually over approximately two weeks. This gradual progression presents a unique obstacle, as patients might struggle to recognize the stark contrast in their teeth’s shade. The initial shade can be easily forgotten or underestimated by the patients immersed in the day-to-day progression of the treatment.
This potential oversight can be easily prevented with proper patient education and the use of the right equipment. Aside from using high-quality bleaching products, some key tools are essential to document and track the bleaching progress of the patients. Professional “before and after” images should be taken using a DSLR camera or using mobile phone with the help of auxiliary lighting, Smile Lite MDP2 (Smile Line, Switzerland), in addition to accurate shade measurements using Optishade colorimeter (Optishade, Smile Line, Switzerland) allowing both the dentist and the patient to have a clear “before and after” shade comparison and appreciate the whitening results.
Thus, this article aims to showcase the importance of using the right tools to properly bleach and track the bleaching progress of each patient, for a smooth and successful bleaching journey with satisfied patients.

style italiano styleitaliano white dental beauty teeth whitening gels
style italiano styleitaliano white dental beauty teeth whitening gels
style italiano styleitaliano home bleaching initial situation white dental beauty teeth whitening gels tooth whitening

Fig.1
A 21-year-old female patient visited the dental clinic asking for a brighter smile while conserving the beautiful natural appearance of her teeth. After discussing the treatment options, home bleaching treatment was selected.

style italiano styleitaliano optishade shade selection home bleaching treatment

Fig.2
Preoperative shade measurement was done using the Optishade colorimeter. Shade selection was made in the center of the middle third of the labial surface of the lateral incisor. Shade measurement can also be taken on the central incisors. After shade selection, a professional image was taken with an edge-to-edge positioning of the corresponding shade using the 3D master shade guide (VITA Zahnfabrik, Bad Sackingen, Germany).

style italiano styleitaliano home bleaching white dental beauty teeth whitening gels tooth whitening bleaching trays

Fig.3
Bleaching trays were prepared with a thickness of 1 mm and scalloping 1 mm from the margin to minimize the gel contact with the soft tissues and prevent irritation and discomfort.
16% CP gel from White dental Beauty was selected as the bleaching product. Instructions on how to apply the gel (1 drop for each tooth, 2 hours a day for 2 weeks), and strict dietary restrictions (heavily colored foods and drinks and smoking) were properly explained to the patient.

style italiano styleitaliano home bleaching optishade shades 2 weeks after bleaching

Fig.4
The patient came back 2 weeks after bleaching, and a new photo was taken with the shade guide corresponding to the old shade of her teeth. This way the patient can directly visualize the improvement in the teeth color. Additionally, new shade measurement was performed again using the Optishade colorimeter.

style italiano styleitaliano before and after home bleaching white dental beauty teeth whitening gels tooth whitening

Fig.5
The remarkable shade improvement can now be seen using the two tools of comparison. First, with the “before and after” pictures next to each other, edge to edge. Note that the patient was satisfied with the final result and didn’t want to have whiter teeth.

style italiano styleitaliano home bleaching optishade delta E comparison

Fig.6
Second, the remarkable shade improvement can be also seen, with the help of the delta E obtained on the Optishade application comparing the previous and new shades. The delta E calculated is very important to highlight the effectiveness of the treatment. It has been suggested that, when (∆E = 3.7), an acceptable level of visual perception was seen on a clinical level. In this case, a delta E of 8.82 was obtained showing the success of the procedure. An increase in the teeth lightness (L*) from 70.6 to 74.2, a reduction in the red-green component (a*) from 6.1 to 0.4, and in the yellow-red component (b*) from 26.6 to 12.7 were clearly noticed.

style italiano styleitaliano before and after home bleaching white dental beauty teeth whitening gels tooth whitening

Fig.7
This picture shows the shade improvement of the whole smile. The patient was very satisfied with the “before and after” pictures next to each other. Post-bleaching instructions were given to the patient to maintain the results for as long as possible.

Conclusions

The recipe for a successful treatment is never complete without patient satisfaction. That’s why it is extremely important to ensure that the patient himself is happy with the outcome of the treatment we offered to him. This can be made possible and guaranteed with the help of high-quality bleaching products offered by White Dental Beauty, great shade measuring tool of L*a*b* values by Optishade colorimeter, and professional photography equipment such as mobile dental photography with MDP2 (Smile Line, Switzerland) or DSLR camera to document the whole journey.

Bibliography

  1. Chemin K, Rezende M, Loguercio AD, Reis A, Kossatz S. Effectiveness of and Dental Sensitivity to At-home Bleaching With 4% and 10% Hydrogen Peroxide: A Randomized, Triple-blind Clinical Trial. Oper Dent. 2018 Jun;43(3):232–40.
  2. Basting RT, Amaral FLB, França FMG, Flório FM. Clinical comparative study of the effectiveness of and tooth sensitivity to 10% and 20% carbamide peroxide home-use and 35% and 38% hydrogen peroxide in-office bleaching materials containing desensitizing agents. Oper Dent. 2012;37(5):464–73.
  3. Alonso de la Peña V, López Ratón M. Randomized clinical trial on the efficacy and safety of four professional at-home tooth whitening gels. Oper Dent. 2014 Apr;39(2):136–43.
  4. Hardan L. Protocols for Mobile Dental Photography with Auxiliary Lighting. Quintessence Publishing Co; 2020.
  5. Hardan L, Bourgi R, Cuevas-Suárez CE, Lukomska-Szymanska M, Monjarás-Ávila AJ, Zarow M, et al. Novel Trends in Dental Color Match Using Different Shade Selection Methods: A Systematic Review and Meta-Analysis. Materials (Basel). 2022 Jan 8;15(2):468.

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