Bleaching Information and Consent

Risks and Limitations:

1. Tooth sensitivity: During the bleaching process, many patients experience tooth sensitivity. This is usually milk if you teeth are not normally sensitive. With bleaching, this sensitivity will usually subside in 1-2 days. However, if your teeth are normally sensitive, please tell us before starting treatment.

2. Gums and soft tissue irritation: Temporary inflammation of your gums or any oral soft tissue may occur. With bleaching this is a minor problem and will resolve by itself in a few days.

3. Exposed Root Surfaces: These areas may be sensitive or become sensitive during bleaching. Therefore, be certain to make the dentist aware immediately of any sensitivity.

4. Fillings, Dental Restorations: Tooth colored restorations will not lighten evenly with your teeth.

5. Patient Cooperation: This may be the single most important factor affecting treatment. Lack of cooperation may adversely affect the quality of the results. We recommend you do not use any tobacco products, or eat any chocolate, picante sauce (or any tomato based product), coffee, cola, tea, red wine, blueberries, strawberries, beets or anything that will stain clothes.

Completion of Treatment:

1. Level of Lightening: Although the success rate is very high, there is no totally reliable way to produce how your teeth will lighten. Discuss this prior to signing this consent form. We cannot guarantee outcome, but we are partners with you and will work diligently to arrive to acceptable levels of whiteness.

2. Relapse: Following completion of bleaching, there may be a very gradual tendency of your teeth returning to a darker color. This depends on oral habits such as smoking, tea, and coffee usage, and eating certain staining foods. To prevent this restraining from occurring at all, you may choose to simply use a little gel once a month, or after your routine cleanings.