PWS Instructions
Contents
1. CALL DC International LLC Toll free US 1 888 472 4807 Tel 1 561 337 8888 Fax 1 561 899 0467 Email sales dcinter com www dcinter com2. on any patient with known allergies to hydrogen peroxide resin based materials or other such chemicals Medical clearance from the patient s physician is advisable when doubt exists regarding treatment Do not use PWS Liquid Dam on patients with known sensitivity to resin It is advisable to test Liquid Dam on a small section of the patient s gum before attempting this procedure When curing the PWS Liquid Dam hold the curing light at least 2 cm away from the resin to reduce any heat induced sensitivity during curing Application on the teeth must be uniform and free from gaps to ensure uniform whitening of teeth surfaces Monitor patient s progress during treatment and discontinue use if patient reports sensitivity or discomfort or if clinical results exceed desired effects for patient and operator DO NOT anesthetize the teeth for this procedure If any sensitivity occurs discontinue the process as stated above Caution must be exercised regarding the inadvertent transferal of whitening gel from gloved hands or dental equipment onto non target tissues Copious irrigation with water is recommended when this occurs Restorations must be intact and areas of exposed dentin must be treated prior to the start of whitening Arebound effect of tooth shade could occur It is recommended to wait two weeks prior to placement of proximal restorations since stabilization of tooth shade may take several days to two weeks after the t
3. speed suction and then flush with an air and water spray to remove any residual gel If the patient s teeth could whiten further a second and third application of gel may be used at the clinician s discretion Perform steps 14 through 17 18 Repeat steps 7 to 12 if necessary up to two times 19 After the sessions are completed wipe the teeth with gauze and rinse well with water 20 Remove the Liquid Dam by sliding the tip of an explorer or forceps between the gingiva and the barrier Lift it away carefully Check interproximaliy for any debris Use an explorer or floss Rinse again 21 A final polish can be performed with PWS desensitizing gel to give a luster and shine to the teeth 22 Remove bite block 23 Measure the shades using the Vita Shade Guide Brightness Scale Compare initial shades with final shades and discuss the outcomes with the patient 24 Remove cheek retractor Optionally vitamin E can be applied to irritated soft tissue at the end of the procedure If additional whitening is necessary the clinician can schedule a new appointment in two weeks E Precautions amp Warnings e It is required that laser protective eye wear is worn by the patient and any dental personnel in the operatory during the procedure Office personnel who do not have any protective eye wear should not enter the operatory while the laser system is in use The protective eye wear received with the system is spec
4. User Manual A Description DC International Pearly White Smile PWS bleaching gel is a dental whitening gel used in combination with Diode laser systems with a wavelength from 810nm to 980 nm and an ND YAG Laser with a wavelength of 1064 nm The laser activates the PWS whitening gel through a specialized hand piece The whitening gel is designed to work with Diode and ND YAG laser systems with bleaching function It is advised that PWS bleaching gel is only used by dental professionals and skilled office staff and they must review this entire document before starting the whitening procedure B Indications The diode and ND YAG laser systems are designed to be adminis tered only by the dental professional for partial and full arch whitening procedures PWS bleaching gel may be used in cases where one or several teeth are desired to be lightened It is designed to be safe and effective and is an excellent means to bleach and whiten dark yellowed or discolored teeth with extrinsic and intrinsic staining A dental cleaning non glycerine based and prophylaxis is recommended to remove any plaque and stain before the PWS bleaching gel whitening procedure The degree of whitening varies from patient to patient based on the type of stain enamel thickness tooth structure and age Typical results range from six to twelve shades on the Vita Shade Guide Brightness Scale Teeth with deep intrinsic stain in the grayer tones generally will not re
5. ific to the laser s wavelength and also protects the operator patient and any dental auxiliary personnel from inadvertent contamination of their eyes with the whitening gel e Protective gloves must be used throughout the whitening procedure It should be noted that the whitening material when in contact with mucosal membranes or unprotected epidermis can be caustic and cause irritation and burning If at any time during the procedure the patient experiences discomfort or burning stop the procedure Irrigate the area with copious quantities of water and evacuate excess water with the high speed suction DO NOT proceed if the patient continues to experience discomfort burning sensations or any other sensations that are uncomfortable to the patient Apply Vitamin E to areas where soft tissue has been irritated by the gel Patient expectations must be discussed prior to the start of the whitening process It is recommended to evaluate tooth shade prior to the procedure and again at the conclusion of the treatment Though it is possible to apply the PWS whitening gel for three 3 applications cycles per patient visit the desired results may be achieved in one or two applications Patients medical histories must be carefully evaluated for conditions such as allergies to hydrogen peroxide or other oxidizing agents heart disease lung disease bleeding disorders or immune system deficiencies PWS bleaching gel should NOT be used
6. in beyond the last tooth to be bleached Where open embrasure s exist express resin through the opening onto lingual filling embrasure space completely This will protect interdental papilla and lingual gingival tissue 13c After Gingival Barrier is applied cure resin with a quality curing light 20 seconds per light guide width Clean teeth with prophy paste to remove any excess resin film Use caution not to dislodge cured Gingival Barrier 13d Vaseline can also be applied onto the mucosa in areas which have not been protected with liquid dam WARNING Do not perform this procedure without gingival protection 14 Apply a thin layer of PWS whitening gel over all teeth to be whitened The gel should be evenly spread over teeth do not push up to dam to about 1 5 mm thickness During the procedure pay close attention to ensure that the gel does not contact patient s gingiva tongue or lip Take adequate precaution to ensure that patient does not swallow any gel If patient experiences tooth sensitivity during this evaluate the procedure stop the procedure and patient s condition DO NOT proceed if the sensitivity continues 15 In one in office visit the doctor can perform a maximum of four 4 Gel Applications on one patient known as session 16 Lase teeth following the instructions of user manual from the laser 16a Please leave gel after laser activation at least 4 minutes on teeth 17 Suck gel using high
7. qualified personnel The PWS gel is designed only for use with all Diode Laser systems from 810nm to 980nm and an ND YAG Laser with a wavelength of 1064 nm DO NOT use this gel with any other laser systems or light sources PWS gel when used with other lasers or light sources may result in damage to the light source and adverse effects to the patient To reduce or prevent tooth sensitivity during and or after the PWS whitening procedure the dentist may recommend appropriate pain relief medication 30 60 minutes prior to the procedure and postoperatively The PWS desensitizing gel may also be recommended for post treatment tooth sensitivity relief CAUTION Read Instructions before Treating Patients For Professional Use Only Avoid Any Eye and Skin Contact Rinse Thoroughly with Water if Exposed I Keep Out of Reach of Children Not for Injection Destroy After Use Strong Oxidizing Agent Shelf Life 6 months unrefrigerated 12 months refrigerated Distributed by DC International LLC Manufactured by Heydent GmbH All rights C Revisionsnumber 1 02 Revisionsdate 10 10 2009 0482 Tooth Sensitivity Pearly White Smile Laser Tooth Whitening Gel This kit contains 1 Container with pre dosed PWS Power Bleaching Powder 9 ml H202 30 basic solution 1 Syringe of PWS Desensitizing Gel 1 Syringe of PWS Liquid Dam 7 Tip for Liquid Dam Syringe 1 Tip for Desensitizing Gel Syringe TO REORDER PLEASE
8. reatment The patient may experience positive lighter or negative darker rebound after this procedure is completed for up to two weeks Existing crowns inlays veneers and composite restorations will not change color due to this whitening process The patient and dental professional should discuss possible cosmetic implications that existing restorations pose in whitening cases Areas of hypo calcification will bleach faster than adjacent tooth structure These are not always clinically evident at the onset of whitening and when visible the gel should be placed carefully adjacent to these areas to blend the remaining surface shade The patient should be advised not to consume products that stain teeth up to 48 hours after treatment This would include but not be limited to some fruits coffee red wine tomato sauces tea tobacco etc t is NOT recommended to use PWS on those who are pregnant or nursing Since PWS whitening gel is an oxidizing agent and oxidizing agents have been reported to potentiate the action of some carcinogens it is recommended that patients discontinue the use of tobacco and alcohol containing products prior to the use of this whitening system and during any part of the whitening procedure f you see any periapical areas of pathology PAT you should be aware of that condition Keep whitening gel out of the reach of children Ensure that whitening gel is not accessible by children or un
9. spond as well as yellow shaded teeth The dentist is encouraged to discuss predictability and efficacy with the patient prior to the start of the whitening process to establish realistic expectations on the part of the patient C Contraindications Patients with periodontal disease exposed root surfaces damaged or fissured enamel gross caries allergies to chemical products such as hydrogen peroxide or other similar conditions are not candidates for laser tooth whitening procedures Doctors should perform a complete intra oral exam before the whitening procedure Make sure the patient has already had a consultation and has realistic expectations of the procedure D PWS bleaching gel Treatment Order 1 Prepare the laser system do to regulations of the user handbook and activate the laser to ensure laser is operating correctly 2 Ensure that you have everything required to perform the whitening treatment 3 Do not mix the PWS and hydrogen peroxide until the patient arrives 4 Make sure you have established a communica tion method with the patient before starting the procedure 5 Ensure vitamin E is on hand and ready to be used with cotton buds 6 Measure and record the shade of the patient s teeth using a Vita Shade guide Use the brightness scale as shown below BRIGHTNESS SCALE B1 A1 B2 D2 A2 C1 C2 D4 A3 D3 B3 A3 5 B4 C3 A4 C4 7 Ensure that the patient is wearing laser goggles at all times during the
10. treatment and that the goggles fit tightly around their nose If not place gauze appropriately to fill the gap 8 Have tissues on hand to wipe applicators and spatulas if necessary 9 Place the bite block and cheek retractor in the patient s mouth prior to commencing the whitening treatment and apply Vaseline to the lips to keep any soft tissue away from the teeth Cotton rolls are recommended for increased protection and patient comfort Do not pumice the teeth until the bite block and cheek retractor are in place 10 Clean teeth surfaces using a pumice that does not contain glycerin Try to remove any dental plaque and superficial stains 11 Rinse and air dry the teeth and especially the gums around the teeth to be whitened to avoid leakage of the PWS Gel under the liquid dam during the whitening treatment Ensure that the teeth are dry before each applica7tion of PWS gel 12 Open the hydrogen peroxide carefully by cutting the top and put everything in the PWS powder container Stir until the desired consistency is achieved 13 Apply PWS Liquid Dam onto the gingiva PWS Liquid Dam Isolation Procedure 13a Remove cap and attach syringe tip securely onto Gingival Barrier syringe 13b Express Gingival Barrier to build a 4 6 mm by 1 5 2 mm thick strip onto gingiva Lap approximately 0 5mm onto enamel If excess resin flows onto enamel secure area with curing light and use a hand instrument to trim back excess Extend res
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