WHITENING CONSENT

Tooth-whitening may be done either in-office or with take-home trays.

Carbamide peroxide and other peroxide solutions used in bleaching are approved by the FDA as mouth antiseptics. Their use as bleaching agents has been effective, but unknown risks may exist. Acceptance of bleaching treatment means acceptance of these yet unknown risks. Pregnant women are advised to consult with their physician before starting treatment. While these materials appear to be safe, because their use is relatively new, unexpected problems can occur.

Tooth sensitivity or tingling is the most common side effect. Soft tissue irritation can also occur. If a patient experiences these or other adverse symptoms after the procedure, he/she should call the office immediately.

Patients should also understand that the amount of bleaching and its duration might vary. While most teeth lighten to the extent desired, some are more resistant. In some instances lightening is minimal or unapparent, and additional bleaching over time may be required to maintain the lightening originally obtained. Coffee, tea and other dark-colored beverages will stain teeth after treatment and are to be avoided for at least 24 hours after treatment.

I have read and understand the above description of possible consequences of in office whitening techniques. Being fully informed, I consent to and agree to the procedure.