Melica Bastani, an award winning dental hygienist, presents an anxious and periodontally compromised tooth whitening case study for a patient ahead of her wedding.
This 32-year-old female patient approached us with a view to having her teeth whitened for her upcoming wedding.
The patient had a clear medical history and did not report any specific dental issues.
However, the first appointment revealed false pocketing and generalised moderate gingivitis. This might have been aggravated by a busy lifestyle, combined with irregular dental visits.
After a couple of restorations, the patient had ceased attending her previous dental practice. She later reported that the way both her dentist and hygienist talked to her led to psychological distress and anxiety.
The patient felt their abrupt and reprehensive approach was not conducive to her trusting them. Let alone discussing new oral hygiene habits.
The treatment plan
As result of this lack of regular appointments, when she presented her gums were bleeding and her gingiva was lax and separating from the teeth.
Gratifyingly, it was apparent that the patient had an instant affinity with how I communicated and sympathised with her. This translated into her opening up from the onset.
She conveyed how worried she was about how the gingivitis would create gaps in her teeth.
A treatment plan was agreed with a view to ensuring that her dental health became stable prior to any cosmetic treatment. In this case, the tooth whitening.
A re-assessment was scheduled three months down the line for a routine hygiene treatment and to measure the bleeding and plaque levels.
These had drastically improved because of how motivated and compliant the patient had been with her oral care using a Sonicare toothbrush in the intervening time.
Initially the patient showed me she was moving the toothbrush across the teeth in the same way as she would have done with a manual. Many areas had been missed.
I recommended that she angled the brush 45 degrees towards the gumline, and very slowly glided the brush back and forth along the teeth as she progressed.
I highlighted that the timer was only there as a guidance. Focusing on better cleaning for longer was more valuable for her.
As well as this, I demonstrated how to use a Sonicare toothbrush as well as interdental brushes for interproximal cleaning.
Ready for tooth whitening
After discussion with the dentist, we agreed that the patient was ready for tooth whitening.
As she wanted her teeth as white as possible, we suggested both Philips Zoom in-chair whitening. This would be followed by take home treatment which is considered to be the gold standard protocol.
The hygiene appointments and ongoing encouragement had already instilled confidence in the patient and restored her faith in dental staff.
We felt that the Zoom in-chair whitening would act as a great motivational tool as it does a lot of the heavy lifting of the teeth’s dark undertones.
The patient had four lots of 15-minute interval sessions with the Zoom lamp. She was also given the Zoom Daywhite kit to top up after being fitted with tailored trays and recommend to use this at home daily for two weeks.
The importance of communication
This case perfectly illustrated how patient compliance was pivotal to the success of the treatment. It also showed how patient communication was a major contributing factor to this compliance.In this instance, the treatment took under five months from start to happy completion.
This case was also an ideal example of how minimally invasive treatment can make such a massive difference to a patient’s smile and confidence.
The patient subsequently sent pictures of her wedding to show off her beautiful smile.
She also wrote a review saying that she would follow me anywhere I went. This proved that compliance was never an issue. Instead, patient communication needed to be fine-tuned to put her at ease and ready to make some oral hygiene changes.
The patient is now very happy with the dentist too and does not miss any appointments. She is now implementing the same brushing techniques with her children and is a lot stricter with the whole family’s brushing and oral hygiene habits.
For more information about Philips Zoom whitening system, please visit philips.co.uk/c-m-pe/teeth-whitening
