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A new whitening approach

Philip Lewis reviews Dr Wyman Chan’s ‘innovative’ tooth-whitening course

This full-day course included both lectures and practical sessions with a live demonstration of the techniques on a patient. Each course is limited to a small number of delegates so that everyone can be given individual attention. Questions are encouraged and group discussion welcomed. The morning opened with a discussion of the aetiology of tooth discolouration including a classification of extrinsic and intrinsic staining. Only by understanding the type of stain, its cause and its anatomical position can practitioners formulate a reliable treatment plan. The importance of giving patients realistic expectations of the probable outcomes of whitening was emphasised as was the need to provide a proper consent form explaining both anticipated benefits and possible limitations. ‘Under-promise and over-deliver’ was the key; explanation before treatment will be seen as information whereas explanation afterwards may be perceived as an excuse! Moving on to shade taking, the importance of using natural daylight or lamps and devices producing light at 5500K was stressed. The place of spectrophotometers was considered and the importance of reliable photographic records emphasised. Most usefully, Dr Chan demonstrated a method of taking excellent clinical photographs with inexpensive ‘point and shoot’ pocket cameras. Not all clinicians own a dedicated SLR set with close-up lens and ring-flash but the method described results in perfectly adequate images for inclusion in the patient records. Lectures were supported by a comprehensive slide show. Legal speak

After a short break, the lecture moved on to a discussion of the current legal position concerning tooth whitening in the UK and then a comprehensive discussion about the products at our disposal including their chemistry, modes of action and physiological impact. While I admit attending a lecture on ionic exchange, carbon bonds and the action of free radicals would normally leave me cold, Dr Chan’s engaging and enthusiastic style made this section fascinating and a pleasure to watch. Most importantly, it impressed upon colleagues how necessary it is to have a working knowledge of the behaviour of both chemicals and teeth if treatments are to be safe and reliable. As we all know, there are several ways of whitening teeth but in all cases patient compliance is paramount. To ensure this, our treatments must be painless, easy to use, give rapid results and fit into our patients’ lifestyles. The drawbacks dental professionals encounter when providing tooth whitening often include: • Pain • Lack of compliance • Patient dissatisfaction with the result These drawbacks may be overcome by: • Approaching the procedure in a logical way

• Having a full understanding of the mode of action of the chemicals used

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