The most important factor to success is to use good fresh bleaching product. It should be kept away from light and refrigerated until just before use.  The manufacturers usually suggest removing the gel the night before its intended use. I donâ??t believe most dentists do this, and I certainly do not. 

What I do, that is crucial, is prior to using the gel, I place it in a tall cup of hot water. Not so hot as to scald, but hot. I check it by seeing if I can hold my finger in it comfortably for 20 seconds without having to remove it. I leave the bleaching solution (it is still in its light proof plastic container) in this hot water for at least 10 minutes. It is important that the solution is brought at least to room temperature. It seems that the process is temperature sensitive and works best with warmed bleaching solution (but not hot bleaching solution.)

Prior to applying the solution, I carefully mask all exposed gingival with a specially formulated block out mask that protects the gums from the effects of the bleaching solution and from the UV light that is used to enhance the whitening process. I currently Use the Zoom Advanced Power Light by Discus Dental. This is a UV light which the manufacture claims potentates a better tooth whitening. U.V. rays may be good for whitening, but they are harmful to skin and gingiva. Consequently great care should be taken to mask any tissue and keep it from prolonged U.V. exposure.

 After protecting the gums and skin, the bleaching process begins. The light has a timer and the manufacturer recommends three fifteen minutes bleaching cycles. Before each cycle the teeth should have fresh warmed bleaching gel placed on the teeth and left alone for 15 minutes.

 In theory this whole process could take about an hour, but I find that if I am careful about protecting the soft tissues from the whitening solution and the UV rays  the process takes me about one and a half hours to complete.

 Afterwards most patientâ??s teeth and smiles are noticeably brighter. They also tend to be sensitive to air and cold water. In my experience, this sensitivity tends usually tends to last for less than 24 – hours.

 Patients are instructed post bleaching from temporarily avoiding things that might stain the teeth such as Black teas, Black coffee, and Red teas or juices This precaution is usually only necessary for approximately two weeks when freshly bleached are considered more porous and prone to picking up stains.

 I strongly recommend combining this light assisted in office bleaching with custom tray bleaching.  The combination of the two tooth whitening techniques allows for teeth to be both rapidly whitened and allows patients the opportunity to either continue further whitening their smile and also allows for affordable touch ups at a later time.  Touch ups are often desired in 6 months to a year after initial tooth whitening.

 The cost for this procedure can vary but the Zoom kit that I  use costs me approximately $80 for each treatment and the process should take about an hour and a half .I would be wary of dentist offering deals that seem to good to be true. I would estimate the approximate cost of Zoom Whitening should be between $350-$800 depending on the dental office and who is performing the procedure-the dentist or his hygienist.

 The most important factor to success is to use good fresh bleaching product. It should be kept away from light and refrigerated until just before use.  The manufacturers usually suggest removing the gel the night before its intended use. I donâ??t believe most dentists do this, and I certainly do not. 

What I do, that is crucial, is prior to using the gel, I place it in a tall cup of hot water. Not so hot as to scald, but hot. I check it by seeing if I can hold my finger in it comfortably for 20 seconds without having to remove it. I leave the bleaching solution (it is still in its light proof plastic container) in this hot water for at least 10 minutes. It is important that the solution is brought at least to room temperature. It seems that the process is temperature sensitive and works best with warmed bleaching solution (but not hot bleaching solution.)

Prior to applying the solution, I carefully mask all exposed gingival with a specially formulated block out mask that protects the gums from the effects of the bleaching solution and from the UV light that is used to enhance the whitening process. I currently Use the Zoom Advanced Power Light by Discus Dental. This is a UV light which the manufacture claims potentates a better tooth whitening. U.V. rays may be good for whitening, but they are harmful to skin and gingiva. Consequently great care should be taken to mask any tissue and keep it from prolonged U.V. exposure.

 After protecting the gums and skin, the bleaching process begins. The light has a timer and the manufacturer recommends three fifteen minutes bleaching cycles. Before each cycle the teeth should have fresh warmed bleaching gel placed on the teeth and left alone for 15 minutes.

 In theory this whole process could take about an hour, but I find that if I am careful about protecting the soft tissues from the whitening solution and the UV rays  the process takes me about one and a half hours to complete.

 Afterwards most patientâ??s teeth and smiles are noticeably brighter. They also tend to be sensitive to air and cold water. In my experience, this sensitivity tends usually tends to last for less than 24 – hours.

 Patients are instructed post bleaching from temporarily avoiding things that might stain the teeth such as Black teas, Black coffee, and Red teas or juices This precaution is usually only necessary for approximately two weeks when freshly bleached are considered more porous and prone to picking up stains.

 I strongly recommend combining this light assisted in office bleaching with custom tray bleaching.  The combination of the two tooth whitening techniques allows for teeth to be both rapidly whitened and allows patients the opportunity to either continue further whitening their smile and also allows for affordable touch ups at a later time.  Touch ups are often desired in 6 months to a year after initial tooth whitening.

 The cost for this procedure can vary but the Zoom kit that I  use costs me approximately $80 for each treatment and the process should take about an hour and a half .I would be wary of dentist offering deals that seem to good to be true. I would estimate the approximate cost of Zoom Whitening should be between $350-$800 depending on the dental office and who is performing the procedure-the dentist or his hygienist.

 

             Tobacco is considered to be the single most important cause of  preventable deaths in  the world & it is projected  to be the leading cause of deaths  by  2020, 1 in 8  deaths. Preventing &  treating  all this diseases, and controlling tobacco usage is one of the major challenges of  public health today. The usage of tobacco is  increased to such an extent that it has now been referred to as â??Tobacco Epidemicâ??.

               As far as India is considered, it is 4th largest consumer in world & 3rd largest producer after China & Brazil. There are about 250 million tobacco users in India, accounting for 19% of worldâ??s total 1.3 billion tobacco users. Tobacco use is definitely a Killer for India when statistical data reveals that there are 800,000 deaths per year due to tobacco use & 700,000 of them are due to smoking alone.

In 2005, 5 million deaths occurred around the world due to tobacco use & this number is likely to increase to 10 million deaths annually by 2020, & could kill 1 billion people in 21st century  unless governments takes some action to reduce the tobacco use, as is quoted by WHO in a report recently.

            As dentistâ??s, we all have learned of  the various forms in which tobacco is used & also the plethora of diseases caused by tobacco use including Chronic obstructive lung diseases, bronchial asthama, lung cancer, cancer of oropharynx, larynx, oesophagus,  cardiovascular diseases, sexual impotence, infertility, oral precancer & cancer, periodontal diseases etc.

 There is also a added danger of  Second  Hand Smoke, which is known to cause  diseases in children like â??Sudden Infant Death Syndromeâ??, Acute & Chronic respiratory illness, asthama, middle ear diseases. In adults, â??SHSâ?? has proved to cause lung cancer, cardiovascular & respiratory diseases.

 Governments  around the world collect more than 200 billion dollars in tobacco taxes every year but spends less than 1\5th of 1 % of revenue on tobacco control. This is a very  alarming  fact  & should be considered seriously by all governments if they  are planning  programâ??s  to carry out â??Tobacco Controlâ??.

                WHO has urged the governments to adopt Six â??tobacco control policiesâ??-

1)  Raise taxes &  prices of tobacco

2)  Ban tobacco advertising, promotion, & sponsorship

3)  Protect people from second hand smoke

4)  Warn people of the dangers of tobacco

5)   Help those who want to quit smoking &

6)   Monitor tobacco use to understand & reverse the tobacco epidemic.

                 To control this tobacco menace, there is a need for multifaceted approach which includes Public Health Education, Targeting maternal & Child Health Clinics, Counseling, Government efforts, & use of Nicotine Replacement Therapy.  We as dentists play a major role in Public Health Education & in counseling for tobacco cessation.

 Dentists can work at 2 levels-

 1) in the clinics      

2)in the community  & national level.

In the Clinics- Dentist actually sees the harmful effects of  tobacco use , he\she spends more time with the patient than other physicians & therefore he\she should use this time to counsel the patient . It is the duty of dentist to promote Oral Health & Healthy Lifestyles amongst his patients. Just 5 minutes of focused talk during examination is enough  to make the patient aware & conscious of  harms of tobacco use . Dentists should interact with patients at every visit, & however brief the visit is , it can lead to a significant change in patients attitude & behavior.

                  Guide to  counseling  for Tobacco Cessation (Quitting)

        A) For those willing to quit.

            The 5 â??Aâ?? method

      1)Ask- about tobacco use at every visit

     2)Advise- non users to never use tobacco & users to quit

     3)Assess- the patients readiness to quit &  the level of dependence

     4)Assist â?? with  quitting

     5)Arrange- follow up visits

 B) For those not willing to quit.

      The 5 â??Râ?? method

      Ask and\or advise the patient about

     1) Relevance of  quitting

     2) Risks of continuing tobacco use

     3) Rewards of quitting 

     4) Roadblocks to quitting

     5) Repeat these at every visit

 In the community-

Dentist can be a role model by not using tobacco or by quitting successfully.

Can display educational material in clinics or hospitals

Can write articles about benefits of tobacco control policies

Participate in talk shows,

Link with NGOâ??s to spread health awareness

Bring into limelight success stories

      Tobacco contains nicotine, a powerful & highly addictive substance. It is directly  released to brain bringing on rapid onset of & maintenance of addiction.

So,  quitting tobacco is a hardest challenge a user can face.

Dentist himself should be strongly motivated  for the cause of  Tobacco Cessation, only then his  efforts towards counseling will be fruitful.

Dentistâ??s compassionate & positive support will greatly enhance userâ??s chances of successfully quitting tobacco.

 Success  in relation to cessation  does not only mean that more number of patients have quit, but it  also includes educating the masses, so that the number of individuals taking to this  habit afresh will also reduce.

 Let us imbibe into the minds of people to Choose Life & not Tobacco

 If  all dentists set this as their goal & educate people, India will definitely become tobacco  free

              REFERENCES-

1)Quick reference guide to dentists, by Dr Mihir N. Shah, co-author-Cecily S. Ray, Monika Arora

2)Policy of WHO- strategies to curb smokeless tobacco â?? global perspective, retrieved on 11-02-2008

3)Epidemiology- smokeless tobacco, retrieved on 11-02-2008

4)The global  tobacco epidemic-lecture , from Johns Hopkins Bloomberg School of    Public Health, retrieved on 11-02-2008

5)WHO-Tobacco Epidemic Report, retrieved on 11-02-2008

As with any business that is going to succeed, we have to attract and keep customers; know how to market and sell; and provide quality customer service in order to become and stay profitable. Dentists, just like any other business professional, have to follow certain principles to be successful both personally and professionally. Many dentists are successful in business but not in their personal life. Many business professionals are successful in their work; yet often lack balance or a happy life. Therefore, they don’t have TOTAL SUCCESS.

The daily challenges for dentists are the competition with other dentists and for discretionary dollars. Dentists also deal with pressure from insurance companies to participate in their plans. As part of an insurance plan, we are required to accept a lower payment for our services and are not paid our normal fee. With a lower reimbursement rate comes the increased stress of having to see more patients per day in order to make the same amount of money. To be insurance independent, we must have a well-run practice.

Unless we follow certain principles and systems in our business it is hard to survive and be as successful as we want to be. Chances are this is the same in your industry.

Business success is part of the equation of Total Success. Success in oneâ??s business comes from having systems in place that will give predictable and consistent results in both your business and personal life. It also comes from understanding the relationship of your Product or Service to your Internal and External Marketing and the relationship of these to your Sales Calls and Presentations. It also comes from understanding the relationship between your personal life and your professional life.

In order to have Total Success, you must have success in your personal and business life. Success is fleeting at best if you have it in only one area but not another. In addition, personal and professional success are a direct result of developing a healthy lifestyle, a strong spiritual foundation and respectful and loving relationships in all areas of your life.

Total Success is a direct result of the choices one makes on a day-to-day basis. It is not living with the belief that one day you will make changes you intuitively know you need to make now. It is recognizing areas of your life that are out of balance and making choices today to move closer to a balanced life. Choices that may not always be easy, yet they are wise and beneficial to living a quality of life filled with abundance, joy and happiness beyond most peopleâ??s wildest imaginings.

 

             Tobacco is considered to be the single most important cause of  preventable deaths in  the world & it is projected  to be the leading cause of deaths  by  2020, 1 in 8  deaths. Preventing &  treating  all this diseases, and controlling tobacco usage is one of the major challenges of  public health today. The usage of tobacco is  increased to such an extent that it has now been referred to as â??Tobacco Epidemicâ??.

               As far as India is considered, it is 4th largest consumer in world & 3rd largest producer after China & Brazil. There are about 250 million tobacco users in India, accounting for 19% of worldâ??s total 1.3 billion tobacco users. Tobacco use is definitely a Killer for India when statistical data reveals that there are 800,000 deaths per year due to tobacco use & 700,000 of them are due to smoking alone.

In 2005, 5 million deaths occurred around the world due to tobacco use & this number is likely to increase to 10 million deaths annually by 2020, & could kill 1 billion people in 21st century  unless governments takes some action to reduce the tobacco use, as is quoted by WHO in a report recently.

            As dentistâ??s, we all have learned of  the various forms in which tobacco is used & also the plethora of diseases caused by tobacco use including Chronic obstructive lung diseases, bronchial asthama, lung cancer, cancer of oropharynx, larynx, oesophagus,  cardiovascular diseases, sexual impotence, infertility, oral precancer & cancer, periodontal diseases etc.

 There is also a added danger of  Second  Hand Smoke, which is known to cause  diseases in children like â??Sudden Infant Death Syndromeâ??, Acute & Chronic respiratory illness, asthama, middle ear diseases. In adults, â??SHSâ?? has proved to cause lung cancer, cardiovascular & respiratory diseases.

 Governments  around the world collect more than 200 billion dollars in tobacco taxes every year but spends less than 1\5th of 1 % of revenue on tobacco control. This is a very  alarming  fact  & should be considered seriously by all governments if they  are planning  programâ??s  to carry out â??Tobacco Controlâ??.

                WHO has urged the governments to adopt Six â??tobacco control policiesâ??-

1)  Raise taxes &  prices of tobacco

2)  Ban tobacco advertising, promotion, & sponsorship

3)  Protect people from second hand smoke

4)  Warn people of the dangers of tobacco

5)   Help those who want to quit smoking &

6)   Monitor tobacco use to understand & reverse the tobacco epidemic.

                 To control this tobacco menace, there is a need for multifaceted approach which includes Public Health Education, Targeting maternal & Child Health Clinics, Counseling, Government efforts, & use of Nicotine Replacement Therapy.  We as dentists play a major role in Public Health Education & in counseling for tobacco cessation.

 Dentists can work at 2 levels-

 1) in the clinics      

2)in the community  & national level.

In the Clinics- Dentist actually sees the harmful effects of  tobacco use , he\she spends more time with the patient than other physicians & therefore he\she should use this time to counsel the patient . It is the duty of dentist to promote Oral Health & Healthy Lifestyles amongst his patients. Just 5 minutes of focused talk during examination is enough  to make the patient aware & conscious of  harms of tobacco use . Dentists should interact with patients at every visit, & however brief the visit is , it can lead to a significant change in patients attitude & behavior.

                  Guide to  counseling  for Tobacco Cessation (Quitting)

        A) For those willing to quit.

            The 5 â??Aâ?? method

      1)Ask- about tobacco use at every visit

     2)Advise- non users to never use tobacco & users to quit

     3)Assess- the patients readiness to quit &  the level of dependence

     4)Assist â?? with  quitting

     5)Arrange- follow up visits

 B) For those not willing to quit.

      The 5 â??Râ?? method

      Ask and\or advise the patient about

     1) Relevance of  quitting

     2) Risks of continuing tobacco use

     3) Rewards of quitting 

     4) Roadblocks to quitting

     5) Repeat these at every visit

 In the community-

Dentist can be a role model by not using tobacco or by quitting successfully.

Can display educational material in clinics or hospitals

Can write articles about benefits of tobacco control policies

Participate in talk shows,

Link with NGOâ??s to spread health awareness

Bring into limelight success stories

      Tobacco contains nicotine, a powerful & highly addictive substance. It is directly  released to brain bringing on rapid onset of & maintenance of addiction.

So,  quitting tobacco is a hardest challenge a user can face.

Dentist himself should be strongly motivated  for the cause of  Tobacco Cessation, only then his  efforts towards counseling will be fruitful.

Dentistâ??s compassionate & positive support will greatly enhance userâ??s chances of successfully quitting tobacco.

 Success  in relation to cessation  does not only mean that more number of patients have quit, but it  also includes educating the masses, so that the number of individuals taking to this  habit afresh will also reduce.

 Let us imbibe into the minds of people to Choose Life & not Tobacco

 If  all dentists set this as their goal & educate people, India will definitely become tobacco  free

              REFERENCES-

1)Quick reference guide to dentists, by Dr Mihir N. Shah, co-author-Cecily S. Ray, Monika Arora

2)Policy of WHO- strategies to curb smokeless tobacco â?? global perspective, retrieved on 11-02-2008

3)Epidemiology- smokeless tobacco, retrieved on 11-02-2008

4)The global  tobacco epidemic-lecture , from Johns Hopkins Bloomberg School of    Public Health, retrieved on 11-02-2008

5)WHO-Tobacco Epidemic Report, retrieved on 11-02-2008

Cosmetic dentistry is not just a science. It is actually an art. The cosmetic dentist needs to be very cerebral when it comes to understanding procedures. In addition to this, they also need to have an aesthetic bend of mind whereby they can envision what looks good and convert it into reality on the patient’s face.

Ultimately, cosmetic dentistry directly impacts the self esteem of the patient. It can produce immediate results. So, if the patient does not like what they see, the entire procedure is a failure. Thus, unlike a regular dentist, the cosmetic dentist has to rely heavily on consultation, aesthetics, creativity and expertise.

A cosmetic dentist handles several kinds of procedures like teeth whitening , teeth straightening, dental implants, crowns, putting in inlays and outlays, veneers and smile design services. In each of these procedures, the cosmetic dentist aims for a high level of perfection in blending the real and the artificial in such a way that the end result looks seamless and natural. This is the key to their success.

Due to the above factors, it is important to choose a cosmetic dentist wisely. In Tacoma, you can find the right cosmetic dentist through several resources. You could depend on your physician or general dentist for a referral. Generally, this is the most reliable resource because doctors have a fair idea of the experts in different fields of medicine. Alternatively, you could also check out with friends, relatives, neighbors or colleagues. An understanding of their experience with a particular cosmetic dentist can help you identify the right cosmetic dentist in Tacoma. Alternatively, you could also go through search engine listings and search by geographical location or pin codes to find a listing of cosmetic dentists in Tacoma.

Whichever route you choose, it is important to keep in mind that the list you obtain needs further investigation before you settle for a particular cosmetic dentist. This is because cosmetic dentistry is too intricate to be left to chance. Once a change has been made, it is difficult to reverse or repair it. Therefore, the aim is to get it right the first time. Only sufficient research can help you choose a cosmetic dentist who can provide you with the best dental services.

teeth whitening