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TEETH WHITENING CONSENT FORM POLA

[PDF]
Teeth Whitening Information and consent form
TEETH WHITENING INFORMATION & CONSENT FORM. 1. General Information. Teeth whitening is designed to lighten the color of your teeth. Significant lightening can be achieved in the vast majority of cases, but the results cannot be guaranteed. When done properly, the whitening will not harm your teeth [DOC]
INFORMED CONSENT FOR POLA OFFICE TOOTH WHITENING
Web viewBefore and after the treatment, the shade of your teeth will be assessed and recorded. Risks: All forms of health treatment, including tooth whitening, have some risks and limitations. Complications that can occur in professional tooth whitening are infrequent and are usually minor in nature.[PDF]
INFORMED CONSENT FORM IN-OFFICE TOOTH WHITENING
After the whitening treatment, it is natural for teeth that underwent the whitening treatment to regress somewhat in their shading after treatment. This is natural and should be very gradual but it can be accelerated by exposing the teeth to various staining agents.
Pola – Advanced Tooth Whitening System
Beginning your whitening journey starts with understanding pola's unique, fast releasing formulation, which acts quickly to remove discolouration and stains from your teeth. “Getting a treatment before a job interview really boosted my confidence.[PDF]
Pola Night Whitening Instructions & Consent Form
8. Brush teeth as per usual. 9. Leave trays to dry in a cool, dry place. Results vary from patient to patient. The final shade will be achieved in about 1-2 weeks. Do not use for more than 2 weeks without consulting your dentist. AVOID: Eating, drinking or smoking while you are wearing your custom trays.[DOC]
INFORMED CONSENT FOR POLA OFFICE TOOTH WHITENING
Web viewDuring the procedure, the whitening gel will be applied to your teeth for three (3) 8-minute sessions. For the duration of the entire treatment, a plastic cheek retractor will be placed in your mouth to help keep it open and your gums will be covered with a barrier to ensure isolation from the hydrogen peroxide gel.[PDF]
HOME WHITENING CONSENT FORM -
HOME WHITENING CONSENT FORM. Tooth whitening is a cosmetic procedure prescribed by a dentist to whiten your teeth. It is done in 2 appointments. The first is to take impressions of your teeth. Trays from these models are then made that are custom-fitted to your mouth to hold the bleaching solution to your teeth.[PDF]
Whitening Consent Form WORD - Private Dental Practice
Whitening!Consent!Form! This!is!a!consent!form!for!whitening!your!teeth.!Everything!we!have!discussed! verbally!is!documented!in!this!form!for!yours!and!our!record.![PDF]
INFORMED CONSENT FOR ZOOM! TOOTH WHITENING -
My dentist has informed me that my teeth are discolored and could be treated by in-office whitening (also known as “bleaching”) of my teeth. Zoom! in-office tooth whitening is a procedure designed to lighten the color of my teeth using a combination of a hydrogen peroxide gel and a
How to use Pola Office+ by SDI | Dental Products Report
Apr 22, 2015Follow the steps below to ensure proper application of Pola Office+: 1. Select an appropriate candidate using the Pola checklist, which includes medical, dental and sensitivity history and an intraoral examination. Visit the SDI website to download the checklist. 2. Ask your patient to sign the consent form. 3.
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