Teeth whitening – information and informed consent form

General information

Teeth whitening can effectively lighten the colour of teeth without harmful side effects. Several factors influence the success of the whitening procedure, some of which cannot be determined at the beginning of the treatment and may only become apparent during the procedure.

The patient acknowledges that this is a voluntary, planned treatment.

Tooth sensitivity

Temporary sensitivity lasting 1–3 days may occur. The level of discomfort or sensitivity can vary depending on the structure of the teeth and individual factors.

Patients may experience brief, sharp, lightning-like sensations. These sensations are not continuous but may occur occasionally during the treatment or as an aftereffect.

The exact level of sensitivity cannot be predicted in advance, but it typically subsides and does not persist long-term.

Safety of teeth whitening

Many patients are concerned that whitening may damage enamel. However, during professional whitening, the whitening gel does not penetrate the internal structure of the tooth.

The whitening gel breaks down when exposed to light, releasing oxygen. This oxygen acts within the microscopic surface structure of the enamel and does not alter its integrity.

The released oxygen neutralises pigment molecules responsible for discolouration without damaging the enamel.

This principle applies to all professional whitening procedures.

Contraindications

Teeth whitening should not be performed in the following cases:

• pregnancy
• ongoing chemotherapy treatment
• fixed external orthodontic appliances
  (internal/lingual appliances are not a contraindication)

Expected results and limitations

The degree of whitening depends on the cause of discolouration.

Discolouration caused by external factors (such as coffee, tea, wine, smoking, or certain foods) typically responds well to whitening.

Teeth with naturally more yellow dentin may respond less predictably, and significant changes may not always be achieved.

The final result cannot be guaranteed, as individual teeth may respond differently to treatment.

Fillings may change colour only slightly, and crowns do not change colour. Replacement may be required to achieve a uniform aesthetic result.

Certain enamel irregularities (e.g. hypoplasia or hypocalcification) may become temporarily more visible after whitening but usually diminish as the tooth rehydrates.

Procedure

The procedure begins with professional cleaning (scaling and polishing), which takes approximately 20–25 minutes.

This is followed by the whitening process, consisting of three cycles. After each cycle, the whitening agent is removed and reapplied, with LED light activation.

Teeth typically lighten by 1–3 shades, although results may vary.

The procedure is completed in a single visit lasting approximately 90 minutes.

Photographic documentation is taken before and after treatment.

The procedure is performed by a dentist or dental hygienist.

Aftercare

A colour-free (white) diet is recommended for 7–10 days after treatment.

The following should be avoided:

• coloured foods
• coloured beverages
• coffee
• smoking

These measures help prolong the whitening result. Written aftercare instructions will be provided.

As restorations (fillings, crowns) do not change colour, replacement may be recommended if differences become noticeable.

Duration of results

The longevity of results varies individually:

• with appropriate diet and lifestyle: approximately 6–12 months
• with frequent consumption of staining substances (coffee, tea, wine, smoking): approximately 3–5 months

Repeat treatment

Teeth whitening can be repeated no earlier than 6 months after the previous treatment, and thereafter according to individual preference.

Additional provisions

Photographs may be taken during treatment. These may be used for marketing purposes only in a form that does not allow patient identification.

Due to the nature of the procedure, the cost of treatment already performed is non-refundable, even if the aesthetic result is not as expected.

By signing this document, the patient confirms that they have read, understood, and agree to the above information and consent to the treatment.