Testing the Tools By Ross Isbell, DMD, MBA
In my practice, my usual plan is to extract a tooth as atraumatically as possible and allow the site to heal. This is the least expensive treatment, and we know the body will heal in time. However, I am not always fortunate enough to have patients or sites that heal perfectly — luckily, there are a variety of ways to help heal them. While postoperative management of surgical sites is a commonly encountered situation in practices that extract teeth, past solutions haven’t always been as predictable and easy to deliver.
Go with the GLO GLO® Whitening GlO Science Professional glosciencepro.com As I’m sure is the case for most general dental offices, we always have a whitening product as part of our available services. Our preferred brand was Phillips Zoom for in-office treatment, and we made custom whitening trays to allow for at-home whitening with Opalesence™ from Ultradent™ to maintain the results. Those are great products, but all the work that went into provision of the service just felt cumbersome, and our results weren’t always predictable or comfortable for patients. About a year ago, we swapped to the GLO® whitening system, and it is so much simpler to deliver similar results on the day of treatment and better long-term results. This system is designed to be a dual-whitening system and combines in-office treatment with take-home whitening kits. Using hydrogen peroxide with a double-barreled delivery syringe, the in-office treatment is strong enough at 30% to cause tissue damage unless gingival blockout is applied. However, this proprietary gel mixture, when paired with the closed mouthpiece system, doesn’t require lengthy treatment times and results in significantly less reported sensitivity. The closed mouthpiece I am referencing applies to both the single-use one that we use in the office as well as the reusable one that the patient takes home. It is important to note that it is a closed system because a tightly conforming fit is critical to prevent oxygen-free radicals from escaping after they are activated by the gentle heat and light. You must also limit the introduction of peroxidases from saliva. By maintaining an efficacious level of functioning hydrogen peroxide byproducts for a longer period, the concentration is lower (many other products use 35%) and treatment cycle times are shorter (eight minutes compared to 30) than competitors. Since in-office whitening alone can lose its effects after a week, it is important that your patients commit to continuing the process. Assuming that you have good patient compliance with the at-home regimen of 16 minutes per day for four days, the shade change results actually amplify over time while not having adverse effects. In our office, we recommend a cleaning — or at least a prophy polishing with pumice only and no bioactive materials like fluoride — prior to treatment to remove extrinsic staining and biofilm. Then, we
place the included retractors for initial placement of the gingival block-out resin. The gel is painted directly onto the teeth prior to placement of the mouthpiece. Don’t forget to preheat the mouthpiece since heat is important for the whitening reaction. Cycles last for eight minutes each prior to swapping out the gel. Most patients stop after three cycles due to time constraints, but the kits allow for up to five. Usually, we schedule these appointments as two-hour time blocks for a standalone whitening, but that is to allow for conversation, pre-op photography and pumicing. If scheduled appropriately, this can be completed as a one-hour appointment or less after a hygiene visit. Since we began using the system, GLO has partnered with vVardis to increase rebuilding of healthy enamel mineral structure after removal of intrinsic staining. The GLO whitening system transition has been an easy one for my team, and we are having better and easier results along with decreased chair time.
Ross Isbell, DMD, MBA, currently practices in Gadsden, Alabama, with his father, Gordon Isbell, DMD, MAGD. He attended the University of Alabama at Birmingham (UAB) School of Dentistry and completed a general practice residency at UAB Hospital. Isbell has confirmed to AGD that he has not received any remuneration from the manufacturers of the products reviewed or their affiliates for the past three years. All reviews are the opinions of the author and are not shared or endorsed by AGD Impact or AGD. To comment on this article, email impact@agd.org.
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AGD IMPACT
MARCH 2025