Overview: This article provides comprehensive instructions for the use, cleaning, and disposal of custom-made bleaching trays to ensure patient safety and optimal whitening results..
Understand Indications and Contraindications
Bleaching trays are custom dental devices designed to lighten natural tooth enamel.
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Indications
Used to aid in lightening natural enamel; may be designed with or without wells to contain bleaching material.
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Contraindications
Do not use for patients with tooth sensitivity, root exposure, active caries, or heavily restored teeth.
Evaluate Risks and Benefits
Dental professionals should advise patients of the potential outcomes of bleaching treatments.
Benefits: Potential to lighten enamel for most users.
Limitations: Treatments are less effective on crowns, veneers, and existing fillings. Deep stains from tetracycline or fluorosis may result in uneven whitening.
Risks: Temporary tooth sensitivity or soft tissue chemical burns may occur but typically resolve within a few days.
Apply Whitening Treatment
Follow these steps to ensure the bleaching trays are used correctly:
Clean Teeth: Brush and floss thoroughly before treatment. Use sensitivity toothpaste to reduce discomfort.
Load Trays: Place a pea-sized dot or thin ribbon of whitening gel in each tooth area of the tray, excluding the molars.
Seat Trays: Place the bleaching trays over the teeth. Do not eat or drink while wearing them.
Remove Excess: Wipe any gel that squeezes onto soft tissue immediately to avoid irritation.
Duration: Follow the specific whitening gel manufacturer’s instructions (typically 15 minutes twice daily or 45 minutes once daily).
- Should any whitening gel squeeze out of the tray onto the soft tissue, this should be wiped off as it may cause irritation. Should a large amount squeeze out of the trays make sure to use less next time.
- By the third day of whitening, your patient’s teeth may be slightly sensitive. Taking ibuprofen will help with discomfort.
- It is normal to experience stripping or streaking on the teeth. The color should even out a few days after use.
- Avoid smoking, coffee, red wines, and other staining food and drink while whitening and for 3 days after. Failing to do so could allow for unfavorable results.
- After using bleaching trays, rinse them thoroughly with water and allow them to dry before placing them in your case.
Adjust and Maintain Trays
If the bleaching trays are uncomfortable, minor adjustments can be made.
Trimming: Use sharp scissors to trim overextended or jagged edges for a better fit.
Post-Treatment Care: Rinse trays with water and allow them to dry before storing them in their case.
Clean Bleaching Trays
Dandy recommends cleaning the bleaching trays daily before and after every use.
Initial Rinse: Use warm water (not exceeding 45°C/113°F) and mild dish soap to remove saliva and residual gel.
Soap Selection: Use only soft, antibacterial, uncolored, and unscented liquid dish soap.
Debris Removal: Use a soft-bristle brush to clean the inside of the appliance periodically.
Final Rinse: Rinse thoroughly with cool water.
Avoid Damage: Do not use hot water, mouthwash, alcohol, or bleach, as these can warp or discolor the material.
Additional Information
- Patients should consult their healthcare provider if they experience a chemical burn.
- Patients may experience mouth or tooth sensitivity when first using the device, which typically resolves within a few days.
- Bleaching trays typically come with a limited warranty, which may vary depending on the manufacturer.
Dispose of Trays and Gel
Proper disposal ensures environmental safety and hygiene.
Tray Disposal: Clean trays with mild soap and water, then place them in the regular trash. Do not place trays in curbside recycling.
Gel Disposal: Dilute small amounts of leftover gel and pour them down a sink or toilet drain. For large quantities, contact local hazardous waste facilities.
ADA Codes
| Bleaching Trays | ||
| Whitening - external bleaching (over the surface of the tooth) per arch | D9972 | performed in the dental office under the supervision of your dentist |
| Whitening- external bleaching per tooth | D9973 | Application of whitening product to the exterior of a tooth - in-office |
| Whitening - internal bleaching (inside the tooth) per tooth | D9974 | Application of whitening product to the internal aspect of a tooth - in-office |
| Whitening - External bleaching for home application, per arch | D9975 | Includes materials and fabrication of custom trays |