D ENTAL GRADE INGREDIENTS MEDICAL INDUSTRY DESIGNED … manual and consaent... · D ENTAL GRADE INGREDIENTS MEDICAL INDUSTRY DESIGNED DELIVERS RESULTS Introduction Complete your transformation

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Congratulations on purchasing a Santorini Smile Teeth Whitening System, which complies with European, United Kingdom and Australian regulations.

Introduction 03ExoticNaturalFormula 0318%CarbamidePeroxide 036%HydrogenPeroxide 03Howoftenshouldyouwhitenyourteeth? 04WhyusetheSantoriniSmileTeethWhiteningSystem? 04Doubletreatments 04Maintenance 04The5KeyElementsofTeethWhitening 04StepsintheTeethWhiteningProcess 05InstructionsfortheTeethWhiteningTreatment•Syringes 07•PreloadedTrays 09AfterTreatmentCare 10ProductRange 11BeforeandAfterPhotos 13ConsentForm 15

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IntroductionCompleteyourtransformationfromdrabtoexoticwithSantoriniSmileProfessionalTeethWhiteningSystemsortakehometeethwhiteningsystems.SantoriniSmileTeethWhiteningSystemusesapprovedlevelsofperoxidesandeffectiveexoticnaturalingredientstoproducegorgeousbrightwhiteteethforamoreconfidentyou.Onlythehighestgradeingredientstoproducebetween2-6shadesofwhiterteeth.SantoriniSmilehasworkedtirelesslytoperfecttheultimateteethwhiteningsystem.EnjoyawhitersmilethesafeandhealthywaywithSantoriniSmile!

Can all teeth be whitened?Peroxidegelsaregreatforremovingmostcommonstains(redwine,coffeeandtea,tobacco,aging,etc).Howeverothertypesofstainssuchasthosecausedbyantibioticsordiscolourationoneisbornwitharedifficulttowhiten.Itisnotpossibletoturnteethwhiterthantheiroriginalnaturalwhite.Insomecasesevennormalteethwillachieveonlyminorwhiteningimprovementnomatterwhatproductyouusebecausetheyjustdon’treact.Artificialdentalworksuchascrowns,bonding,caps,veneers,bridgesorcompositefillingswillalsoNOTrespondtobleaching.Customerswithartificialteethwishingtowhitentheirnaturalteethcanuseourproducts.Ingeneralresultswillvaryfromcustomertocustomerdependingontheirenamel.

Santorini Smile Exotic Natural Formula (Removes Stains)SantoriniSmileExoticNaturalFormulaisazeroperoxidewhiteninggel.OurExoticNaturalFormulanotonlywhitensyourteeth,italsocontainsnaturalingredientslikePomegranateandChamomilethatcanboostyourgumsandenamel,thuscreatingbetteroveralloralhealth.Withsomanyteethwhiteningproductsoutthereonthemarketcurrently,findingtherightoneforyouandyourclientscanbeadaunt-ingtask.SantoriniSmileExoticNaturalFormulawillgiveyouthefollowingbenefits:•Removalofsturdyandstubbornstains,alsoknownasintrinsicstains(i.ecoffee,smoking,redwine)•Preparingtheteethforadoubletreatment-allowingtheperoxidetoremoveyellowingoftheteethtoachievebetterresults.•Resultsinonly20minutes•FullycompliantproductwithEurope,UnitedKingdomandAustralianstandards.

Santorini Smile 18% Carbamide Peroxide (Removes Stains & Starts Whitening Teeth)CarbamidePeroxideisconsideredthesecondstepinathreestepprocessofachievingwhiteteeth.Therearecertainadvantagesofusingcarbamideperoxideaswell.Carbamideperoxideisastablecompoundthatbreaksdownintohydrogenperoxideandureaandreleasesfreeradicalstowhitenyouteeth.Thisresultsintheformationofcertainby-productsduringtheprocessofoxidation.Thesebyproductsareusuallycolourless,whichcreatesawhiteningeffectontheteeth.Itisafactthatfreeradicalsarerequiredforwhitening.Themorefreeradialsthemorestainremovalpower.CarbamidePeroxidefinishesremovingstainsandalsobeginsthewhiteningprocess.

Santorini Smile 6% Hydrogen Peroxide (Whitens Teeth)Whenyougetyourteethwhitened,HydrogenPeroxideisthemostcommonlyusedactiveingredient,whilstSantoriniSmileExoticNaturalFormularemovesvisibleintrinsicstains,our6%HydrogenPeroxideformulareactswiththemoleculesthatcausestaininganddiscolouration.Theuseof6%Hydro-genPeroxidecansafelyandgentlyimprovethewhitenessofyourteeth.Teethsensitivityfollowinguseof6%HydrogenPeroxideisverylow.HydrogenPeroxideisthelaststepintheteethwhiteningprocess.

Are both Hydrogen Peroxide and Carbamide Peroxide the same?No!Theyarecompletelydifferentproductsbothcontainingdifferentlevelsofperoxide.Thereisatypicalratioof3:1betweenthesetwocompounds,whichmeans6%ofhydrogenperoxideisequalto18%ofcarbamideperoxide.Thereforeproductscontaininghydrogenperoxideareoftenweakerthanthatofcarbamideperoxide.However,productscontaininghydrogenperoxidearemoreefficientatwhitening(oncestainshavebeenremoved). 03

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Why use Santorini Smile Teeth Whitening System?SantoriniSmilehasarangeofteethwhiteningtreatmentstosuiteveryone.Frominsalontreatmentstotakehomekitswehaveanoptionforeverybody!

How often should you use the Santorini Smile to whiten your teeth?WiththeSantoriniSmileTeethWhiteningSystemwerecommendthatyouofferyourcustomersadouble-treatmentthefirsttimetheygettheirteethwhitened.

Option 1 - Forclientswhoarenew to teeth whitening,thefollowingdoubletreatmentoptionisrecom-mended:•SantoriniSmileExoticNaturalFormula (Availableinasyringeonly)•SantoriniSmile18%CarbamidePeroxide (Availableinasyringeandapreloadedtray)Thiscombinationisrecommendedforthosenewtoteethwhiteningastheperoxide-freeExoticNaturalFormulaisperfectforstartingthestainremovalprocess.Itworksonremovingstubbornintrinsicstains(i.ecoffee,smoking,redwine)andpreparestheclient’steethforan18%CarbamidePeroxidedoubletreatment.CarbamidePeroxidecontinuestoremovebuiltupstainsandalsobeginsthewhiteningprocess.Thistreatmentcombinationisperfectforclientsnewtoteethwhitening!

Option 2 - Forclientswhohavepreviously whitened their teeth,thefollowingdoubletreatmentoptionisrecommended:•SantoriniSmile18%CarbamidePeroxide (Availableinasyringeandapreloadedtray)•SantoriniSmile6%HydrogenPeroxide (Availableinasyringeandapreloadedtray)Thiscombinationisrecommendedforthosewhohavepreviouslywhitenedtheirteethastheseclientswillhavelessintrinsicstains(i.ecoffee,smoking,redwine)toremoveandcanfocusmoreontheperoxidebasedteethwhiteningprocess.The18%CarbamidePeroxidetreatmentistheperfectstartingpointasitwillfreshenupteethandremovestainswhilstbeginningtheteethwhiteningprocess.Thesecondtreamentis6%HydrogenPeroxide-whichismoreefficientatwhiteningteethoncestainshavebeenremovedwith18%CarbamidePeroxide.The6%HydrogenPeroxideisthefinalstepintheteethwhiteningprocessandwilltrulybrightenyourclient’ssmile.

Afterthedoubletreatment,werecommendthattheygettheirteethwhitenedevery3-6months.Dependingonaperson’sconsumptionofcoffee,tea,redwine,colasandotherdarkeningagentssuchastobacco,mostpeoplecouldprobablyusuallybenefitfromacourseevery3months.

Maintenance between treatmentsContinuingthewhiteningprocessathomebetweensalontreatmentsensuresalastingwhiteningeffect.TakeHomeWhiteningPensandgelsareanecessarypartofthetreatmentregimesothatthecustomerscangettheirteethafewshadeswhiterorworkonspecificteeththatneedmorewhiteningthanothers(usuallythelowerteeth).PleaserefertoAfterTreatmentCaresection.

The 5 key elements of teeth whitening:Exotic Natural Formula/Hydrogen Peroxide/Carbamide PeroxideWhenExoticNaturalFormula/HydrogenPeroxide/CarbamidePeroxidecombineswiththemoistureinyourmouthandreleasesstainsthathavebuiltupovertime.

LightTheconversionofhydrogenperoxidetohydroxylradicalscanbeacceleratedandsustainedbyexposuretocertainwavelengthsoflight,basicallyfromabout400to560nanometers.ThesimulatedlightfromtheblueLEDacceleratestheconversionofhydrogenperoxideintopowerful,whiteninghydroxylradicals.Ourflexiblemouthtrayactsasalenstofocusthelight.

PressurePressureandcontactarerequiredtoforcehydroxylradicalsontotheenamelofyourteeth.Onceinsertedintheflexiblemouthtray,mildpressureforcesthegelontotheteeth.

HeatHydrogenPeroxidebecomesmoreactiveasitheatsup,releasingmoreofitspowerfulhydroxylradicalsthanwouldoccuratlowertemperatures.Theheatgeneratedbyyourmouthisessentialinfacilitatingthisprocess.

ExposureLengthofexposureiskeytoeffectivewhitening.SantoriniSmileTeethWhiteningSystemtechnologywillbrightenyoursmileinaslittleas20minutes.

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Steps in the Teeth Whitening Process

Step 1: Client Enquiry – Booking In the ClientThisistheperfectchancetoupsellanentiresystempriortomeetingwiththeclient.DiscusswithclientthefantasticteethwhiteningsystemandthebenefitsofthethreedifferentSantoriniSmiletreatmentsoptions(Pleaserefertodoubletreatmentinformationonpreviouspage)Mostclientswillseeatwoshadedifferencehoweverclientscanseeresultsproducedupto4+shadeswiththeuseoftheentiresystem.

Suggested Pricing to entice a customer to purchase the entire system

Asinglesessionof20minutes $99.00

Adoublesessionof20minuteswitha15minutebreak $149.00normally$198.00(Totaltime55minutes)

Adoublesessionof20minuteswitha15minutebreak $176.00normally$243.00(Totaltime55minutes)plusatakehomemaintenancepen

Step 2: Setting Up the RoomPriortotheclientarrivingensuretheroomisclean,neatandwellpresented.Somepeopleusearomatherapy,whichfurtherenhancetheclientexperience.Thisisindividualtoeachsalon,howevernicetouchessuchasthesearerememberedbytheclient.

Checklist1.Bed/Chairprepared2.Trolleywiththefollowing a.OneTrayPackwhichcontains:- i.MouthTray ii.DentalBib(chainseparate) iii.FingerWipe iv.VitaminEandAloeswab v.PaperShadeGuide b.FirstTreatmentSyringe/PreloadedTray (Pleaserefertodoubletreatmentinformationonpreviouspage) c.SecondTreatmentSyringe/PreloadedTray (Pleaserefertodoubletreatmentinformationonpreviouspage) d.Chainfordentalbib e.ProtectiveGlasses f.Papercupwithroomtemperaturewater g.Glovesfortechnician. h.Mirror i.Sealablesandwichbagfortheclienttotakehomethemouthtrayforhomeuse.3.Wastepaperbinwithplasticbaginserted

Step 3: Prior to Treatment – Booking In the ClientWhenyoubookintheclientaskthemtocleantheirteethpriortotheappointmentandiftheywishtobringwiththemearphonessothattheycanenjoysomeoftheirownpreferredmusicduringthetreatment.Also,ensuretheclientisawareoftheappointmentduration-dependingontheteethwhiteningtreatmentoptiontheyselect.

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Step 4: Prior to Treatment – Preparation of ClientItisimportantfortheclienttobewellinformedandfeelcomfortablethatallstaffaretrainedandknowledgeableabouttheteethwhiteningprocess.Itisalsoimportantthatstafflookprofessionalandareconfidentindealingwiththeclient.Introduceyourselftotheclientandletthemknowyouwillbelookingafterthemtodaythroughouttheentireprocess.Nowisthetimetotalkaboutthe3stepsystemandlockintheentirefollowupprogramof3monthlyvisits.

Discusswiththeclientaboutthefollowing:•FirstTreatment-(Pleaserefertodoubletreatmentinformationonpage4)•SecondTreatment-(Pleaserefertodoubletreatmentinformationonpage4)•Maintenancebetweentreatments•3-6Monthlyvisits.

Step 5: Client Treatment1.Taketheclienttothepresetroomandsitdownwiththemtodiscusstheprocess.2.Givetheclienttheinformationsheettoread.3.AsktheclienttofillouttheConsentForm.4.TakeafewminutestoexplainthebenefitsoftheSantoriniSmileTeethWhiteningSystemoverothers.5.Goovertherecommendedprogramfortheclient.(RememberaDouble-Treatmentisalwaysrecommendedforfirsttimeclients.)6.Seattheclientcomfortablyandleanthechairbackorliedownonamassagetable.7.TakeameasurementontheSalonShadeGuideofthecurrentteethcolour–useamirrorandconfirmthecolourwiththeclient.8.Notethecolourontheclienttreatmentcard.9.Ensuretheclientsheadistiltedbackassalivacandripfromthemouth.Explaintotheclientthatthisisnormal.10.Putongloves.11.Placethedentalbibonthecustomer’schesttoprotectagainstsalviaorspilledliquids.Usechaintosecure.12.Givetheclientoneofthefingerteethwipessohe/shebrusheshis/herteeth.Thewhiteninggelismoreeffectiveoncleanteeth.Discardintorubbish.13.GiveclientthevitaminEandaloeswabtoapplytolipstokeepgumsandlipsmoistduringtreatment.14.Openthemouthwhiteningtrayandfillthetraywithsyringethengiveittotheclientandexplainhowtoinsertintomouth.Restthelipsonthecheekretractor.15.Repeatstepsfordoubletreatment.

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Instructions for the Teeth Whitening Treatment - Syringes

Step 1: Filling the Mouth TrayHoldthemouthtraybythehandle.Placethetipofthesyringeonthecentreoftheupperinsidewallofthetray.Squeezealineofwhiteninggelfromthecentretotherightuntilyoureachtheendofthetraymakingitthinnerasyoumovetowardstheendofthetray.Repeattheprocessbutmakingyourlinetotheleft.

Nowspreadthegelevenlyovertheinsidewallofthetrayfromtoptobottom.Repeattheprocessonthebottompartofthetray.Whenapplyingthegelintothemouthtray,makesurenottousetoomuchgel.Doingsomaycausethegeltosqueezeontothegumsandirritatethem.Oursyringescomewith3mlofgel,whichisenoughfor3treatments.Onthetoppartofthetrayyoushoulduse0.5mlofgelandthesameamountonthebottompart.

Youshouldneverputanythinginthecustomer’smouth;insteadaskthemtodoitthemselves.Thisisacosmeticprocedure,andassuchyouarenotallowedtoputanythingdirectlyinthecustomer’smouth.Ifyoudo,itcouldbeconsideredpracticingdentistrywithoutalicense.Thiscouldeasilygetyouintotroublesopleaserememberitatalltimesandmakesureyoutrainyouremployeesaccordingly.

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Step 2: Double Treatment - Part 1(Pleaserefertodoubletreatmentinformationonpage4)Oncethetimehasbeensetat20minutes,placetheheadofthelampwithin5cmoftheclientsmouthwithoutthelampactuallytouchingthecustomer.Thelightmustshinedirectlyontheteethinordertoactivatethegel.

Themouthguardwillholdthelipsapartsothattheteethreceivemaximumexposuretothelight.Atthispoint,beforeturningonthelight,itisagoodideatowarnthecustomerthatduringtheprocesssomeofthegelmightsqueezeontothegumsandthatthismightproduceatinglingorevenstingingsensation.Tellthemthatthisisnormalandverytolerable.Ifyoudon’twarnthemandtheirgumsbegintostingduringtheprocedure,theywilltrytogetyourattentionandaskyouifitisnormalortheymightwanttostop.Soitisalwaysbesttowarnthemaheadoftime.Mostofthemwillgothroughtheentireprocesseveniftheirgumsarestingingalittle.

NB:Ifthestingingbecomesintolerable,ceasetreatmentimmediately.

Oncethecustomer’smouthisopenandyouhaveputthelampclosetothemouth,presstheStartbutton.Youcannowleavethecustomeranddootherthingswhilethelightisoninpracticewerecommendthatyoucheckuponthecustomereveryfewminutes.

A20minutetreatment(singlesession)typicallyyieldsanimprovementof2-4shades.

Beforethetimerstopsyoushouldprepare2disposablecups-oneofthememptyandtheotherwithwater.

Thelampwillstopautomaticallyoncethetimerhascounteddowntozero.Onceitstopsaskthecustomertogiveyouhis/hertrayandsetitaside(youwillneedtocleanitandapplyfreshgelfromthecustomer’ssyringe).Immediatelyafterreceivingthetraygivethecustomerthe2cupssohe/shecanspitintotheemptyoneandrinsewiththeonewithwater.Afterthecustomerhasfinishedrinsing,provideamirrorsothathe/shecanseehis/herteethandappreciatetheamountofwhiteningthathasalreadytakenplace.

Step 3: Double Treatment - Part 2

Youshouldrecommendtoyourcustomersthattheygetadoubletreatmentbecausetheresultsaremoredramatic.Especiallyiftheyhaveneverwhitenedtheirteethbefore!(Pleaserefertodoubletreatmentinformationonpage4)Withbetterresults,yourcustomerswillbemoreinclinedtorefertheirfriends.Werecommendthatyougivecustomersa15minutebreakbeforeproceedingwiththesecondtreatmentinarow.Thisisagoodtimefortheclienttohaveastretchgotothebathroomortoreadsomesaloninformationonotherservic-esavailable.Adoubletreatment(whichistwoconsecutive20minutetreatmentsinasinglevisit)typicallyyieldsanimprovementof4plusshades.Themoretreatmentsapersondoesthewhitertheirteethget.

Check the clients teeth/gumsBesurethattherearenotanywhitespotsorirritationpriortothesecondtreatment.TheclientshouldreapplythevitaminE.

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Instructions for the Teeth Whitening Treatment - Preloaded Trays

Step 1: Usingpreloadedtraystakesthehassleoutofinsalonteethwhiteningtreatments.Therapistsdonotneedtoplacetheteethwhiteningproductinthetrayatall!

Step 2: Double Treatment - Part 1(PleaserefertodoubletreatmentOption2informationonpage4)

Simplyopenthe18%CarbamidePeroxidepreloadedtraypackagingasktheclienttoplaceintheirmouththemselves.Thisisacosmeticprocedure,andassuchyouarenotallowedtoputanythingdirectlyinthecustomer’smouth.Ifyoudo,itcouldbeconsideredpracticingdentistrywithoutalicense.Thiscouldeasilygetyouintotroublesopleaserememberitatalltimesandmakesureyoutrainyouremployeesaccordingly.Oncethetimehasbeensetat20minutes,placetheheadofthelampwithin5cmoftheclientsmouthwithoutthelampactuallytouchingthecustomer.Thelightmustshinedirectlyontheteethinordertoactivatethegel.

Themouthguardwillholdthelipsapartsothattheteethreceivemaximumexposuretothelight.Atthispoint,beforeturningonthelight,itisagoodideatowarnthecustomerthatduringtheprocesssomeofthegelmightsqueezeontothegumsandthatthismightproduceatinglingorevenstingingsensation.Tellthemthatthisisnormalandverytolerable.Ifyoudon’twarnthemandtheirgumsbegintostingduringtheprocedure,theywilltrytogetyourattentionandaskyouifitisnormalortheymightwanttostop.Soitisalwaysbesttowarnthemaheadoftime.Mostofthemwillgothroughtheentireprocesseveniftheirgumsarestingingalittle.

NB:Ifthestingingbecomesintolerable,ceasetreatmentimmediately.

Oncethecustomer’smouthisopenandyouhaveputthelampclosetothemouth,presstheStartbutton.Youcannowleavethecustomeranddootherthingswhilethelightisoninpracticewerecommendthatyoucheckuponthecustomereveryfewminutes.

A20minutetreatment(singlesession)typicallyyieldsanimprovementof2-4shades.Beforethetimerstopsyoushouldprepare2disposablecups-oneofthememptyandtheotherwithwater.

Thelampwillstopautomaticallyoncethetimerhascounteddowntozero.Onceitstopsaskthecustomertogiveyouhis/hertrayandsetitaside.Immediatelyafterreceivingthetraygivethecustomerthe2cupssohe/shecanspitintotheemptyoneandrinsewiththeonewithwater.Afterthecustomerhasfinishedrinsing,provideamirrorsothathe/shecanseehis/herteethandappreciatetheamountofwhiteningthathasalreadytakenplace.

Step 3: Double Treatment - Part 2

Theclientcannoweitherchoosetouseanew6%HydrogenPeroxidepreloadedtrayoryoucancleanthepreviouslyusedtrayandapplyfreshgelfromthecustomer’ssyringe.Youshouldrecommendtoyourcustomersthattheygetadoubletreatmentbecausetheresultsaremoredramatic.Especiallyiftheyhaveneverwhitenedtheirteethbefore!(Pleaserefertodoubletreatmentinformationonpage4)Withbetterresults,yourcustomerswillbemoreinclinedtorefertheirfriends.Werecommendthatyougivecustomersa15minutebreakbeforeproceedingwiththesecondtreatmentinarow.Thisisagoodtimefortheclienttohaveastretchgotothebathroomortoreadsomesaloninformationonotherservic-esavailable.Adoubletreatment(whichistwoconsecutive20minutetreatmentsinasinglevisit)typicallyyieldsanimprovementof4plusshades.Themoretreatmentsapersondoesthewhitertheirteethget.

Check the clients teeth/gumsBesurethattherearenotanywhitespotsorirritationpriortothesecondtreatment.TheclientshouldreapplythevitaminE.

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After Treatment Care - Take Home Whitening PenContinuingthewhiteningprocessathomebetweensalontreatmentsensuresalastingwhiteningeffect.TakeHomeWhiteningPensareanecessarypartofthetreatmentregimesothatthecustomerscangettheirteethafewshadeswhiterorworkonspecificteeththatneedmorewhiteningthanothers(usuallythelowerteeth).Thistwistandclickpenisveryeasytouse.

Thecustomerneedstoturnthehandleafewclicksuntilthegelextrudesthroughthebrushtip,brushthegelonthevisiblepartoftheteeth.Thecustomershoulddothisfor15minutesdailyfor7daysinordertocontinuethewhiteningprocess.Dependingontheirteethwhiteninghistorytheyshouldalternativebetweentwodifferenttypesofpens(Pleaserefertodoubletreatmentinformationonpage4)

IMPORTANT: MakesureyoutellyourcustomersNOTtoeatordrinkanythingexceptwaterforatleastonehourandpreferablytwohoursafterthetreatment.Theyshouldalsoavoidcoffee,tea,cola’s,redwine,grapejuice,otherdarkliquids,saucesforatleast24hoursandpreferably48hours.

Santorini Smile Teeth Whitening System is not suitable for the following clients:•Pregnantorlactatingwomen•Peoplewithpoorenamelordecalcificationcausedbyexcessiveuseoffluorides.•Peoplewithperiodontaldiseaseincludinggingivitisorgumsinpoorcondition•Peoplewhowearbracesorwhohadtheirbracesremovedlessthan6monthsago•Peoplewhorecentlyhadoralsurgery•Peoplewithdecayingteethorexposedroots•Peoplewithopencavities•Peoplewithahistoryofallergicreactionstoperoxideproducts•Peoplewithsilverfillingsin,nearorbehindthefrontteeth•Peopleundertheageof18

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SantoriniSmile™TeethWhiteningSalonInvestmentDeal2

SyringesCarbamidePeroxide18%

ExpressLEDLamp

ProfessionalTeethWhiteningLEDLamp

SyringesHydrogenPeroxide6%

PreloadedWhiteningTrayCarbamidePeroxide18%

SantoriniSmile™TeethWhiteningSalon

InvestmentDeal

SyringesZeroPeroxideWhiteningGel

PreloadedWhiteningTrayHydrogenPeroxide6%

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WhiteningPensHydrogenPeroxide6%

SantoriniSmile™RefillGelKit

TrayPack

WhiteningPensZeroPeroxideWhiteningGel

SantoriniSmile™ActivatedTeethWhiteningCharcoal

SantoriniSmile™TeethWhiteningBox

RemineralizerGel

SantoriniSmile™CompleteTakeHomeCollection

SantoriniSmile™TeethWhiteningSystem

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Santorini Smile - Teeth Whitening System Consent Form

Thisproductisbeingpurchasedat_______________________________________________(SalonName)ThankyouforpurchasingtheSantoriniSmileTeethWhiteningSystem.Thisteethwhiteningsystemisconsideredasanoverthecounterwhiteningsystem.Thisteethwhiteningsystemisselfadministeredus-ingatrayandapplicatorandtrainedstaffmaydemonstrateitsusebutareinnowayentitledorcertifiedtoplacetheirhandsinyourmouthatanytimeduringthisselfadministeredtreatment.Youarewelcometouseourledlightsourceundertheguidedparametersonceyouhavereadandsignedthisstandardinformedconsentform.Indications for use: Forcosmetictreatmentofnaturallydiscolouredteeth.Thisgelwillnotwhitencrowns,denturesorveneers,orwillnotharmdentalwork.Ournewformulawhiteninggelenterstheporousenameloftheteethandgentlyoxygenatesthediscolourationoftheteethwithoutchangingthestructureoftheteethwhatsoever.Cautions and disclaimer: Alightsourcemayaidinacceleratingtheionsinthegelproducingfasterresults.Whenusedproperlytheresultsaredramaticbutactualresultsmayvary.WhileanLEDlightsourceisconsideredsafebyindependentstudies,useofthislightisatyourownriskandwe,bynomeanswarranttheresultsorsubstantiateclaimsthatthelightsourcewhitensyourteeth.TheactiveingredienthydrogenperoxideiswhatmakesyourteethwhiternottheLEDlamp.Signingthisconsentformfreesalldistributors,manufacturers,andaffiliatesfromallliabilityassociatedwiththeuseofthisformulationorsystemoradditionaluseofanylightsource.Alwayscheckwithyourdentistbeforeusinganyteethproducts.Donotuseifpregnantorlactating.Donotuseifperiodontaldis-easeorothermedicalconditionsexistinthemouth.Donotuseifyouhaveahistoryofallergicreactionstoperoxideproducts.Donotcheworusetobaccoordrinkalcoholduringyourtreatment.Temporarysideeffectsoftoothsensitivityormildtissueirritationmayoccurbutareusuallytransientandmaylastforadayortwo.Avoidbeveragesthatcontaincitrusandhotandcolddrinksforthenext24hours.Ifyouhaveanyadversereactionsterminatetreatmentandconsultyourhealthprofessional.I_____________________________________________________________________(Pleaseprintname)freeallassociates,manufacturers,theirdistributors,andourstafffromallliabilityinassociationwiththeuseofthisproductorlightsource.Furthermore,Iwillnotholdliabletheabovementionedassociatesforanydamagesgeneralorunforeseen,presentorfuture,foranyadverseconditionsofanytype,causeddi-rectlyorindirectlybytheuseofthisproductorlightsource.Iunderstandthatanyclaims,representations,andadvicebyourtrainedprofessionalsinregardstoteethwhiteningorourlightsourceisnotwarrantedandthereforeisnotguaranteed.IherebydeclarethatIam18yearsoldandhaveconsultedwithmyden-tistbeforeusingthisselfadministeredoverthecounterteethwhiteningproduct.Ihavereadtheabovedeclarationsandconsenttotheuseofhydrogenperoxideanditscomponentsorlightsourceforuseatmyownrisk.Iunderstandthattheuseofouroranylightsourceusedatmydiscretionandnotbytheadviceofaboveaffiliatesmaynothavebearingontheoveralleffectofthisoranyformulationasameanstowhitenteeth.Signed: _______________________________ Date: _______________________________Email: _______________________________ MobileNumber:_______________________Address: _________________________________________________________________________Suburb: _______________________________ State: _________ PostCode:_________

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