it is YOUR responsibility to self-screen and ensure

that you are a candidate for teeth whitening

failure to do so can potentially mean a loss in your deposit

TO KNOW IF YOU QUALIFY FOR WHITENING TREATMENT

YOU MUST ANSWER "NO" TO THE FOLLOWING QUESTIONS 

-Are you under the age of 14?

-Are you pregnant? or think you might be?

-Do you have metal braces or had braces? (whitening can be done when all cement/glue is removed; for those who did invisalign treatment, it must be fully completed and all 'bumps' taken off))

-Have you had any oral surgery or extractions recently? (All should be well healed)

-Are you currently in any dental pain?

-Are your gums inflamed (puffy and/or bright red or heavily bleeding (during brushing/flossing))

-Are you, to your knowledge, allergic to any of the following: hydrogen peroxide, glycerin, or potassium nitrate?

ALWAYS CONSULT WITH YOUR DENTAL PROFESSIONAL

OR MEDICAL DOCTOR IF IN ANY DOUBT

Other questions to consider…

However, if you do answer yes to any of the following, you may still qualify as a good candidate for teeth whitening. Any questions contact us.

-Are you over the age of 45? (Sometimes naturally our enamel yellow as we age and it can at times be difficult to whiten, however is still possible)

-Do you have currently have slightly sensitive teeth or gums?

-Do you take any medication?

-Are you breast feeding?

-Do you smoke?

-Genetically do you feel like you born with or naturally have yellow teeth?

-Do you have any crowns/bridges/veneers/silver fillings located on any of the teeth seen in your smile? (Teeth whitening works only on real enamel)

-Do you have any TMJ problems? Or any gag reflexes?

-Do you have a tongue or lip piercing? (Oral jewellery must be removed during procedure)

-Do you currentlyhave any form of communicable disease, or infection? (examples: respiratory infection, eye infection, etc.)

-Do you see your dentist on a regular basis? (please note: a recent dental cleaning is recommended prior to whitening in order to achieve the best possible results - however, not required)

-Do you naturally have generalized hypo/hyper calcification or dental fluorosis on the enamel of your teeth? (opaque/white chalky spots) - please see picture example below

Disclaimer, Terms & Conditions: This self-screen questionnaire should only be regarded as a general guide and is not intended to replace medical advice. Always consult with your dental provider or medical practitioner before acting on any information in relation to any medical condition or health or dental related circumstance. This form is provided 'as is' without any guarantees, warranties, or liability of any kind, use entirely at yor own risk. Your use of this form is strictly on the basis of your acceptance of the above terms and conditions.

Is there any questions or concerns

that you may have that we did not address?

Please feel free to contact us anytime.

We are here to answer your questions.