Performs Vital Tooth Whitening Using Trays
Cosmetic, but not casual
Vital tooth whitening uses a tray-delivered peroxide gel on vital teeth. The exam tests candidacy, tray fabrication, instructions, and management of side effects.
Concepts to know
- Candidacy: the patient should have sound teeth and healthy gingiva, and expectations should be managed. Whitening does not change the color of restorations, so existing crowns and fillings may stand out afterward.
- Tray fabrication: take an accurate impression, pour a model, and fabricate a custom tray with a scalloped margin. Custom trays retain gel and protect the gingiva better than stock trays.
- Gel and instructions: place a small amount of gel per tooth, seat the tray, wipe excess, and follow the product's wear time. Overfilling irritates tissue and wastes material.
- Side effects: transient tooth sensitivity and gingival irritation are common; manage with desensitizing products, shorter wear times, and reduced frequency.
- Documentation: record baseline shade and obtain informed consent.
Traps
Questions often ask why a custom tray is preferred; the answer is fit, retention, and gingival protection. Another trap is the claim that whitening works on porcelain or composite; it does not. Also watch for questions implying that sensitivity means stopping permanently; it usually means adjusting the protocol.
Rule of thumb
Small amount of gel, custom fit, realistic expectations. If an answer promises whitening of restorations or ignores sensitivity management, it is wrong.