Female patient presents to the dental office for 3^rd tooth bleaching session and sculpting of upper and lower right anterior teeth. Patient was satisfied with previous bleaching sessions and reports no sensitivity. I performed a 3^rd bleaching treatment on the patient for two 12 minute sessions using Opalescence. The patient was very satisfied with the new tooth shade. Following this I performed sculpting on #6, 7, 26, and 27. Her crossbite was corrected and the patient was quite satisfied.

She brought in her lower RPD and we evaluated the fit and option of adding 2 new teeth on the lower right. RPD did not fit well and she had a lisp when she wore it. We decided we would look at it again at the next visit after we finish the bonding. We might try to reline the RPD and add new teeth in, or we might take an impression and make a new RPD.

For the next visit we are going to do bonding of #8, 9, 23, 24, and 25. Also, we are going to prep #21 and 23 for the Maryland bridge we are going to place there. We will be making preps that will be similar to RPD cingulum rests with slots.

N.S., New York University College of Dentistry, Patient 1 – part 4

Female patient presents today for her 2^nd bleaching session. Patient was very satisfied with the results of her first bleaching session which was completed yesterday. Patient states that she had no sensitivity from the bleaching thus far. We retracted the cheeks and lips, placed cotton rolls for isolation, and placed the liquid rubber dam. We did 2 sessions of Opalscence bleach each for 2 sessions. 2 post-bleaching pictures were taken and shown to the patient and she was quite happy.

We then took alginate impressions of the upper and lower arch. 2 models will be poured up—one of which will be a diagnostic cast and the other one I will use to practice the sculpting on prior to the sculpting appointment. A bite registration of the anterior teeth was taken with yellow PVS. There are minimal posterior teeth which was therefore why I took the registration of the anterior teeth.

The patient states she is now interested in fixing #28 and #29 for the wedding, and we will discuss this at the next visit when she brings in her RPD.

N.S., New York University College of Dentistry, Patient 1 – part 3

There are many companies selling tooth whitening/bleaching kits on the Internet. These companies, which advertise on search engines, may be classified into two types: 1) those that sell bleaching trays to be modified by the customer at home and, 2) those that provide impression material to the customer so that the customer can make an impression of their own teeth at home and then send this to the internet companies own dental lab for fabrication of a bleaching tray.
It appears that the latter business model may be illegal for two reasons: 1) A dental lab in New York State requires a written prescription from a dentist in order to fabricate any prosthesis for a patient. This is true in many other states. 2) This may be construed as practicing dentistry across state lines without appropriate state licensure.