Frequently
Asked Questions
Q: When
is a Brilliance treatment contra-indicated?
A:
Patients with oral lesions should
not commence a Brilliance treatment.
Patients should be caries-free
and have healthy gums. Brilliance
is an esthetic treatment and should
only be undertaken when oral health
is well controlled. Most situations
in which bleaching is not advisable
can be overcome.
The presence of crowns on certain
teeth can be considered a contra-indication.
However, the patient can be advised
that these crowns will not whiten
and must be redone after the Brilliance
treatment. Composite restorations
present a similar situation.
A sufficient amount of motivation
is required to undertake a treatment
that will require between six
and eight weeks for lasting results.
Non co-operative patients or those
who don’t have a strong desire
for whiter teeth can be difficult
cases. The example that comes
to mind is someone who agreed
to whiten his/her teeth to please
a spouse.
Q:
Should smokers take special precautions
while whitening their teeth?
A:
Tooth whitening and smoking are
in opposition to one another -
smoking is a major cause of tooth
discoloration. It is our opinion
that one should not smoke for
the duration of the treatment
and one should not smoke at all.
Q:
Can a Brilliance treatment be
undertaken during pregnancy?
A:
There are no studies relating
bleaching and pregnancy. It would
be prudent to postpone treatment
until pregnancy is brought to
term since the peroxide could
cross over into the placenta.
Q:
What can be done to prevent soft
tissue irritation?
A:
Sensitivity is a signal that something
is wrong. The Brilliance tray
can be adjusted at control appointments
to ensure that it does not irritate
gingival tissues
Q:
If patients experience tooth hypersensitivity,
how can it be reduced?
A:
We recommend the use of stannous
fluoride whenever patients experience
tooth sensitivity. Stannous fluoride
can be applied at the end of each
Brilliance session. Patients can
apply a pea size quantity of stannous
fluoride gel to a toothbrush and
brush as with regular toothpaste.
Q:
What is the duration of a Brilliance
treatment and what factors affect
the duration?
A:
Brilliance treatment generally
begins with the upper arch, as
these teeth are more evident.
In most cases, a satisfactory
result is obtained after three
or four weeks. In certain cases,
we have observed better results
by extending the treatment up
to six weeks on the upper arch.
An important improvement is often
noted in the first week of treatment.
The lower arch generally whitens
at a faster rate (two to four
weeks) since the teeth are thinner
and smaller. Also, since the soft
tissue has already been exposed
to the gel, treatment can commence
with longer bleaching sessions.
Also, gravity assists in drawing
the gel to the gingival third
of the teeth on the lower arch.
Treatment duration depends largely
on the degree and nature of discoloration
as well as patient age. Younger
patients generally whiten more
quickly. Yellow-brown staining
generally whitens easily, while
grey-blue staining is more difficult.
Another factor is the patient’s
capacity and willingness to wear
the Brilliance tray.
Q:
Why is it preferable to bleach
only one arch at a time?
A:
Wearing two Brilliance trays simultaneously
increases interference with occlusion.
This interference can also destabilize
the Brilliance trays, reducing
their effectiveness and resulting
in soft tissue irritation.
Bleaching both arches together
results in the loss of a reference
point, which is an important source
of motivation for patients.
Q:
How long does it take to see results?
A:
For many patients, a color shift
can be noticed after the very
first Brilliance session. For
most patients, an appreciable
change has taken place by the
end of the first week.
Q:
Why does Brilliance use an 11%
carbamide peroxide concentration
as opposed to 16% carbamide peroxide?
A:
A clinical comparison of both
concentrations has shown that
a 16% concentration will whiten
teeth more quickly during the
first few days of treatment, however,
by the end of a two week treatment,
results are similar with either
11% or 16% carbamide peroxide.
The side effects of an 11% gel
are however much less than with
a 16% concentration.
Q:
Are there any advantages to using
a higher gel concentration?
A:
We don’t see the use for
these concentrations since patients
at a higher risk of experiencing
side effects (gingival irritation,
hypersensitivity, etc.) while
obtaining the same results.
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