PEDIATRIC UROLOGY PROSPECTIVE COMPARISON AND 1-YEAR FOLLOW-UP OFDEXTRANOMER/HYALURONIC ACID COPOLYMER INJECTIONFOR TREATMENT OF VESICOURETERAL REFLUX IN CHILDRENJ. OSWALD, M. RICCABONA, L. LUSUARDI, G. BARTSCH, AND C. RADMAYR ABSTRACT Objectives. To compare, in a prospective study, the efficacy of a single injection of polydimethylsiloxane (Macroplastique) or dextranomer/hyaluronic ac
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Microsoft word - bleaching.doc
There are three methods to whiten teeth: 1. In-Surgery Power Whitening
This is a tooth whitening procedure performed by the dentist using a hydrogen peroxide gel. The tissues are protected using a light cured dam. The session lasts approximately one hour. The in-surgery session gives immediate results. Even better and long lasting results can be achieved by combining this with a home whitening regimen. A Prodental At home deluxe kit is included with every in-surgery session. 2. At Home Whitening Kit
This treatment can be used to whiten teeth as a treatment by itself or after the power whitening to give increased results at home. A mouth guard is worn overnight with a small amount of whitening gel. After one to two weeks, the teeth gradually whiten. 3. Porcelain Laminate Veneers - veneers can be made to the colour you
desire - the result is a brightened, white smile. Points to note
1. Only tooth enamel will whiten, if you have any fillings or crowns visible when you smile these may need replacing at the end of treatment. 2. Teeth whiten at different rates, the main reasons being age, smoking and diet (e.g. red wine, coffee, cola, heavily staining foods). In our experience younger 3. Some people may experience sensitivity during bleaching treatments. However, 4. If you require change in tooth shape as well as colour then veneers may be more 2. Before & After
3. During Home Whitening, how long should I wear the trays for?
This depends on the amount of lightening that you desire and the original shade of the teeth. If your teeth are quite dark or very yellow/grey/tetracycline-stained, it will take longer to bleach the teeth. Tetracycline-stained teeth can take 6 months or up to 1 year to bleach. Some teeth can whiten after a few days. If you are not experiencing any sensitivity, you may wear the trays for at least 1-2 hours and even sleep with the trays in your mouth. It is very important to remove all the excess material around the gums or the palate prior to sleeping with the trays. 4. What do I do if I have sensitivity?
Sensitivity of teeth is the most common side effect of home bleaching. In fact, many patients suffer from sensitive teeth anyway; this occurs usually around the necks of the teeth where the gums have receded. If you are experiencing sensitivity, you should stop bleaching your teeth for a few days. You can resume after about 3-4 days. If the teeth become ultra-sensitive you can place a sensitive toothpaste into the bleaching trays for an hour a day, which will usually stop the sensitivity. Alternatively, you can rub the sensitising toothpaste into the gum margins with your finger 5 times per day for a few days. If you are at all concerned or, more than mild tooth sensitivity develops, cease treatment 5. What happens if the teeth do not bleach evenly?
If the teeth have white spots on them before bleaching, these spots will appear whiter during the first few days; however, the contrast between the spots and the rest of the tooth will be less and eventually the spots should become less noticeable. Sometimes, we can do a special procedure called microabrasion for you; where by the white spots can be more permanently removed. Ask us about this procedure if you are concerned about this. You may notice new white spots occurring on the teeth while you are undertaking the bleaching treatment, immediately after a bleaching session or in the morning if you have been wearing the trays for the whole night. These white spots were already present on the tooth before bleaching. As the teeth become lighter, they become more visible. Do not worry: as the whole tooth itself becomes lighter these spots will fade. Some teeth may appear banded with lighter/whiter areas. Again, these bandings are originally present on the tooth. When the tooth is dark, these bandings are not obvious. As the tooth becomes lighter, the lighter parts of the tooth will lighten first, followed by the darker banded area. After a week or so these should become less noticeable. 6. How will my teeth feel?
Normally the teeth feel very clean after the bleaching procedure. The bleaching materials also have an indirect effect on the gums in helping them to heal or improving health. (This is how the technique was invented: it was first used to heal gum irritation during 7. Will it work?
It is very rare, but sometimes the teeth do not lighten at all. If this happens and you are wearing the bleaching trays as recommended, you may need to try a different bleaching product or a slightly higher concentration of the bleaching material. We can do a few power-bleaching sessions for you while you relax in the chair. Discuss this with us. If you have white fillings in the front teeth that match the existing shade of your teeth before you bleach your teeth, they may not match the teeth afterwards. This is because your teeth can lighten, but the fillings do not. When the desired colour has been achieved, we can replace these fillings with a lighter shade of filling material to match the new shade of your teeth. Normally we will wait a week before changing the fillings. 8. How long does the bleaching last? Will I have to bleach my teeth
Normally the new white colour of your teeth keeps quite well. However, the effect is dependent on what has caused the teeth to discolour in the first place. If you drink lots of coffee, red wine or cola drinks, the effect may darken slightly. Some patients do a top-up treatment after 1-7 years; some patients do not need to. The dentist will ask you to stop using your trays after the desired shade of lightening has been achieved. This is to ensure that you do not over-bleach your teeth. 9. Does bleaching harm the teeth or gums?
Safety studies have shown that bleaching teeth using the dentist-prescribed home bleaching technique is perfectly safe on the teeth, cheeks, gums and tissues of the mouth. Bleaching the teeth with dentist-prescribed kits is equivalent to drinking one soda drink. The bleaching material has a neutral pH. There are problems with the bleaching kits that are purchased over the counter, without a dentist’s prescription. Although they are inexpensive, they normally contain an acid rinse that can damage the teeth or thin down the enamel of the teeth, which can be extremely harmful (There has been one case where a patient purchased the kit over the counter and bleached the teeth. The teeth went darker and the patient continued over-using the treatment. Unfortunately the acid rinse had worn the enamel away and the darker shade was exposed dentine.). It is not, however, advisable to bleach your teeth if you smoke. It is best to stop smoking for at least three weeks before commencing the bleaching procedure. Smoking causes the teeth to darken anyway and the effects will be diminished. The technique of bleaching teeth is not for everybody. There are some situations where bleaching teeth is contraindicated (such as where the front teeth are already crowned, or there are large fillings on the front teeth, or the teeth are already excessively worn and there is tooth surface loss.) The ideal situation is where there is not much wrong with the teeth except for the colour, which has become more yellow with age. 10. Home Bleaching treatment options:
1. Over night wear: All night long, whilst you sleep. Minimum wear time is 4 hours, although longer wear-time is beneficial. 2. Day time wear: 2-4 hours per application, once or twice a day. This option is 3. For patients with tooth sensitivity, limit wear-time to only 1-2 hours per day. It’s essential you follow the instructions given by us and by the manufacturers in wearing the trays and applying the bleaching agent. 2. Place a small amount of gel in each toot compartment in the tray. Use approximately one quarter of a syringe per tray. 4. Remove excess gel with finger or dry toothbrush. When inserting the tray, be careful not to push all the gel out, but be sure that the tray is completely seated. 5. After whitening, remove and rinse the trays with cold water. If necessary, use a toothbrush to remove any residue gel. Store the trays in a cool, dry place. Rinse Do's & Don'ts
Don’t use the treatment whilst pregnant or lactating. Don't eat, drink or smoke whilst wearing your custom made trays. Do store any remaining whitening gel in a cool, dry place for later use once the Do avoid citrus foods and juices, only if they cause tooth sensitivity, as these items change the acidity of your saliva and may cause irritation. Do continue good oral hygiene throughout the treatment. The products we use at ProDental are: At Home Whitening
Effective January 1, 2013 2013 EMPIRE PLAN FLEXIBLE FORMULARY Administered by UnitedHealthcare The following is a list of the most commonly prescribed generic and brand-name drugs included on the 2013 Empire Plan Flexible Formulary. This is not a complete list of all prescription drugs on the flexible formulary or covered under The Empire Plan. This list and excluded medication