Whitening · Sara M., 20s
Four Shades and a Wedding
A case that is interesting for what we did not do: two composite fillings meant whitening had to happen in the right order.
- Treatment
- Whitening
- Duration
- 3 weeks
- Appointments
- 3 visits
- Clinician
- Dr. Yasmin Al-Rashed
Patient Goal
What they came in for.
Six weeks before her wedding, she wanted her teeth brighter for the photographs. She had bought an online kit and stopped using it after three nights because of the sensitivity.
Initial Condition
What we found.
Generalised extrinsic staining from strong tea, starting shade A3.5 on the VITA classical scale. Two composite restorations on the upper centrals, placed four years earlier and matched to the current shade. Mild gingival recession on both upper canines with exposed root dentine — the likely source of the sensitivity from the unsupervised kit. No decay, good periodontal health.
Final Result
Where it finished.
A four-step lift from A3.5 to B1, achieved with no reported sensitivity at any stage. The two anterior composites now match, which is the part that would have been visible in photographs had the sequence been wrong. Shade held at the six-month review with one top-up night.
Patient Experience
In their words.
She had assumed that sensitivity was simply part of whitening because the kit had convinced her of it. Her comment afterwards was that the two boring weeks at the start were the whole difference.
The plan, before anything started.
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Phase 01
Sequence
Hygiene first, then whitening, then replacement of the two composites — in that order, because composite does not lighten.
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Phase 02
Sensitivity management
Two weeks of potassium nitrate and fluoride desensitising before treatment, targeted at the exposed canine roots.
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Phase 03
Whitening
Custom trays at home for fourteen nights rather than an in-clinic session, chosen specifically to reduce sensitivity.
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Phase 04
Shade stabilisation
Fourteen days between the final tray and the composite replacement, so the final shade was the one that lasted.
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Phase 05
Restoration matching
Both upper central composites replaced to match the new shade under calibrated light.
Treatment process
What actually happened, in order.
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Week 0
Hygiene appointment, shade recorded at A3.5 against the VITA scale under standardised light, and desensitising protocol started.
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Weeks 1 — 2
Desensitising only. No whitening. This is the step the online kit skipped, and it is why it hurt.
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Weeks 3 — 4
Custom trays worn overnight for fourteen nights with 16% carbamide peroxide. She reported no sensitivity at any point.
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Week 6
Final shade recorded at B1 — a four-step lift. Two weeks allowed for the shade to settle before touching the restorations.
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Week 8
Both upper central composites replaced and polished to match. Top-up gel supplied with instructions for one night every six months.
The same mouth.
Photographed under identical lighting, 3 weeks apart
- A3.5 → B1
- Shade change
- 4 steps
- On the VITA scale
- 0
- Days of sensitivity
Technology used
What it took.
- VITA shade calibration
- Custom-milled trays
- Cross-polarised photography
- Potassium nitrate desensitising protocol
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