Kelsey asked: “How long and how many applications of the KöR whitening system do you use for tetracycline patients?”

Hi Kelsey,

When using the KöR Ultra-T whitening system, which was designed specifically to treat tetracycline staining, the patient starts with a quick, very simple, in-office “conditioning” visit:

• The KöR 13% Hydremide® Peroxide gel is simply placed in the patient’s KöR-Seal™ whitening trays. No paint-on dam is required. The gel is chemically accelerated to specifically enhance the oxygenation (scrubbing bubbles) phase of whitening. This gives a “jump-start” by starting the cleansing process I discussed. This makes the at-home, nighttime whitening more effective right from the start. Then the patient whitens nightly with the KöR-Night 16% carbamide peroxide for 6-8 weeks.
• The knee-jerk reaction by us dental professionals is, “Oh, my patients won’t want to wear the trays every night for that many weeks.”, but we forget that we’re not talking about regular patients. We’re talking about people with tetracycline (TCN) staining, who’ve not smiled or have reflexively put their hands over their mouths and have been self-conscious of their smiles for their whole life. And the thought of having 20+ teeth ground on for veneers, and the cost of veneers is something they don’t want. So for these TCN patients, wearing trays for that amount of time is rarely a problem, especially when this is all explained to them.
• These TCN patients have never been given ANY hope, other than jacket crowns or thick, opaque veneers. So when everything is explained (patient management), I personally have never had any problem whatsoever, and we seldom have other dentists telling us anything other than how happy and grateful these TCN patients are. But again, patient management/managing expectations is key.
• For example, when talking with a TCN patient, what should be said is something like this: “KöR Whitening is the only teeth whitening system in the world that has been shown to have a major effect on your TCN staining. But what does that mean? Does that mean you’ll end up with absolutely perfectly white teeth? No. Sure, that does happen some of the time, but usually, we expect around a 75 – 90% improvement. Rarely, we may see only a 50% improvement. But still, when nothing else short of porcelain crowns or veneers will help at all, even just 50% improvement is a miracle.”

Of course, I highly recommend you see the patient every couple weeks just for very quick checks to see how they’re doing and encourage them as they progress through the protocol.

Then at the end of the at-home whitening process, the patient comes in for the high concentration in-office visit using the paint-on dam, etc. Of course, no light or laser is used with the KöR Whitening system.

For a more complete discussion on treating tetracycline staining, click here to read my white paper, “What you MUST know before treating a tetracycline patient.”

Very best regards,

Dr. Rod Kurthy