Frequently Asked Questions 1. What is Zoom? 2. Do many people whiten their teeth? 3. How does Zoom work? 4. How long does Zoom Chairside Whitening take? 5. What is the ADA code for whitening? 6. Where can I find training on the Zoom procedure? 7. Why is it important to complete Zoom Training again after upgrading the lamp or receiving a new Zoom 8. Where can I find another copy of the Patient Consent Form?
Candidate Qualifications and Contradictions
9. What are the Zoom Candidate Qualifications? 10. What causes tooth discoloration? 11. Who may benefit from tooth whitening? 12. Can Zoom Whitening Gel be used for internal bleaching of the tooth? 13. Is Zoom recommended for patients with dental implants? 14. What if a patient has heavy salivation? 15. Which Zoom Lamps was the new Zoom Kits designed to work with? 16. Why can I only use the Light Guide with one patient? 17. What makes the new Zoom Kit different than previous Zoom kits? 18. What is new about the IsoPrep retractor? 19. I’m having trouble inserting the IsoPrep retractor, what can I do? 20. What is the purpose of Vitamin E? 21. Why has the foam been removed from the Light Guides? 22. Why have the pre-treatment swabs been removed? 23. Why are there only 6 gauze squares in the new Zoom Kit? 24. The cotton rolls do not fit in my patient’s mouth, what should I do? 25. How has the Liquidam barrier material changed? 26. What happens if I forget to take out the Zoom Gel from the refrigerator 6 hours before my patient comes in? 27. How long do the results last? 28. How does contact time between enamel and the Zoom Whitening Gel affect results? 29. I am not seeing an 8 shade difference, what am I doing wrong? 30. Following a Zoom procedure what type of maintenance is recommended? 31. How often can a patient Zoom? 32. Can a forth Zoom session be performed? 33. Is tooth whitening safe? 34. How is exposure to the Zoom light controlled? 35. What are the best Isolation methods? 36. Am I able to place a composite filling, immediately following a Zoom whitening procedure? 37. What do I do if the lower lip gauze gets wet? 38. Can the Zoom Lamp burn tissue? 39. Is the Zoom System gluten-free? 40. Is the Zoom System latex-free? 41. Can the gauze be substituted?
42. What Causes tooth sensitivity? 43. What type of care is recommended for tooth sensitivity? 44. What type of care is recommended if sensitivity to heat occurs? 45. What is the purpose of the Relief® ACP? 46. Does Discus only sell Zoom products to dental professionals? 47. Can Zoom products be purchased online?
Lamp Maintenance & Technical Questions
48. What makes the Zoom bulb unique and effective? 49. Does the Zoom Lamp emit a specific wavelength? 50. What is the pH of the 25% hydrogen peroxide Zoom Whitening Gel? Introduction 1. What is Zoom? The Zoom Chairside Whitening System (the “Zoom System”) is a light assisted tooth whitening procedure for use in whitening discolored teeth. It is the sole property of Discus Dental, LLC (“Discus”). 2. Do many people whiten their teeth? More people whiten their teeth than one might imagine. In addition to making a difference in patients’ lives, a bright sparkling smile can also make better patients who take better care of their teeth. The Zoom System makes it easier and faster than ever before. 3. How does Zoom work? The Zoom Whitening Gel’s active ingredient is hydrogen peroxide. As the hydrogen peroxide is broken down, oxygen enters the enamel and dentin, bleaching colored substances white, leaving the structure of the tooth unchanged. The Zoom Lamp aids in activating the hydrogen peroxide and helps it penetrate the surface of the tooth. 4. How long does Zoom Chairside Whitening take? After the initial recommended oral exam, the complete procedure takes one office visit. The procedure begins with a preparation period followed by three, 15 minutes of bleaching with an optional forth, 15 minute session to be dispensed at the discretion of the dental professional. 5. What is the ADA code for whitening?
The ADA code for external bleaching is D9972 per arch, however Zoom is an elective procedure not usually covered by insurance.
6. Where can I find training on the Zoom procedure? It is important to train any new staff members who are going to be performing the Zoom procedure. Retraining is also recommended as refresher for those who do not regularly perform Zoom. Training can be found on www.ZoomTraining.com or you can speak to your sales representative about have a Training DVD sent to your practice. 7. Why is it important to complete Zoom Training again after upgrading the lamp or receiving a new Zoom kit? Due to the high output of the Zoom Lamp, patient tissue isolation is extremely important. We recommend all offices are required to watch the training DVD and complete Zoom Training when an upgrade is purchased. We also recommend re-training to use the new Zoom kit. In an effort to increase ease of use and patient safety, much of the isolation process has been improved so it is important to familiarize yourself with these changes. Training helps to ensure patient safety and proper administration of the Zoom procedure. 8. Where can I find another copy of the Patient Consent Form?
One copy is located in the Reference Folder included with your Zoom Lamp. These forms are also available in English & Spanish online at the Discus Dental website: http://www.discusdental.com It is recommended to make several copies. Patients should sign this form before the Zoom procedure.
Candidate Qualifications and Contradictions
9. What are the Zoom Candidate Qualifications? A consultation is recommended to ensure no underlying oral health issues. You may want to treat existing issues before recommending a whitening treatment and disquailify any patient who is erio-involved, exhibits failing restorations or is otherwise in an unhealthy oral state. Research has not evaluated possible effects of whitening procedure on all patient types. Discus Dental recommends the following whitening candidates consult a medical doctor before use:
a. Pregnant and lactating mothers b. Those currently treated by their physician for a serious illness or disorder e.g. immune compromised,
c. Children under the age of 13 years d. Light sensitive individuals, including those on PUVA (Psoralen + UV Radiation) or other photo-
e. Patients taking any photo-reactive drugs or substances, whether over-the-counter (O.T.C.),
Anyone who is not eligible for Zoom Chairside Whitening for these reasons may be an excellent candidate for Zoom Weekender, NiteWhite or DayWhite Take Home Whitening Systems. These are professional formula products designed to keep teeth their brightest. They are available only through a dental professional. 10. What causes tooth discoloration? There are many causes of tooth discoloration. The most common include aging and consumption of staining substances such as coffee, tea, colas, tobacco, red wine, etc. During tooth formation, consumption of tetracycline, certain antibiotics, or excessive fluoride may also cause tooth discoloration. 11. Who may benefit from tooth whitening? Almost anyone may benefit from tooth whitening. However, treatment may not be as effective for some as it is for others. Yellow staining from aging, tobacco, dark cola, tea, coffee and red wine will achieve the greatest success with this procedure. Those patients with grey shading from tetracycline or other chemicals may experience less dramatic results, but should expect improvement from this brief procedure. For those patients with severe stains, the use of the Zoom Chairside System in combination with take home products will provide the greatest results in the shortest period of time (See #5). It is recommended that all patients receive an oral prophylaxis prior to their tooth whitening appointment. As with any other whitening product, Zoom will not lighten porcelain, composite or any other restorative material. Patients with bruxism or mal-opposed teeth are harder to bleach.
It is the responsibility of the dental professional to determine if a patient is a viable candidate for this procedure through an oral exam, including a shade assessment. It is important to manage patient expectations based on the findings of the oral exam to ensure patient satisfaction.
12. Can the Zoom Whitening Gel be used for internal bleaching of the tooth? Zoom Whitening Gel is approved and tested for external bleaching only. There has been no testing for internal bleaching. 13. Is Zoom recommended for patients with dental implants? It is not recommended that the Zoom procedure is performed on for patients with implants in the anterior teeth (upper six, lower six) or titanium implants that could absorb heat and could cause discomfort. Heating of the bone around implants can lead to failure. Other types of dental implants have not been found to cause problems during the Zoom procedure. 14. What if a patient has heavy salivation? Encourage your patients to swallow as often as is needed and make sure to suction out the tongue area in between sessions. The second face bib can be applied if the first gets wet. If the patient is a very heavy salivator (i.e., sialorrhoea) such that a saliva ejector and/or cotton rolls are not sufficient, the patient may not be a good candidate for the procedure. 15. Which Zoom Lamps was the new Zoom Kits designed to work with?
The new Zoom kits were specifically formulated for and tested with the Zoom2, Zoom AP and Zoom AP Plus Lamps. So as to ensure patient satisfaction and safety, Discus Dental will only warrant results when the Zoom Kits are used with the above mentioned lamps as instructed in the directions for use. Furthermore, Discus Dental will not sell any Zoom kits to any office that has not yet acquired a Zoom2, Zoom AP or Zoom AP Plus Lamp. Please refer to the Letter of Agreement.
16. Why can I only use the Light Guide with one patient?
Zoom Procedure Kit uses the Light Guide to ensure patient safety, optimal results and ease of use. Each Light Guide provides 3, 15 minutes of bleaching with an optional 4th session to be dispensed at the discretion of the dental professional. The Light Guide ensures that the light is optimally focused on the patient’s smile zone for both efficacy and safety. The Guide is a single use, disposable unit that is sanitary for your patients.
17. What makes the new Zoom Kit different than previous Zoom kits?
We’ve made the new Zoom Kit easier and faster to administer. This includes adding and removing several isolation components. The kit features a new look and feel with step-by-step pictorial instructions on both the kit lid and the directions for use. The retractor has been completely re-engineered to provide complete lip coverage and easier access. For more details on the new Zoom kit, please contact your sales representative.
18. What is new about the IsoPrep retractor?
The IsoPrep retractor now comes in the Zoom kit. It has been reengineered to completely cover and protect lips from UV light while increasing patient comfort. The IsoPrep is more stable and less likely to cause isolation to dislodge by popping out of the patient’s mouth.
19. I’m having trouble inserting the IsoPrep retractor, what can I do?
First make sure the correct size IsoPrep is being used. Patient’s who would require a small impression tray probably need to use a small retractor which can be purchased separately. Once the right size has been determined, grip the IsoPrep by the middle, pinching in
20. Why has the foam been removed from the Light Guides?
The foam on the tip of the Light Guide is no longer needed in the new Zoom kit because the new IsoPrep retractor provides a better fit with the Light Guide.
21. What is the purpose of Vitamin E?
Vitamin E is an anti-oxidant that reacts with free radicals that oxidize. The Vitamin E swab provided in the Zoom Whitening System serves two purposes 1) It is used to moisturize the lips before inserting the retractor to ensure patient comfort and prevent the lips from cracking if chapped, 2) it can be used topically as a soothing agent. If isolation is not performed properly and issue has been exposed to the whitening gel, apply Vitamin E after removing the isolation material. Please note that Liquidam will not stay in place if Vitamin E oil has been applied because it creates a slick surface.
22. Why have the pre-treatment swabs been removed?
The Zoom whitening gel has been reformulated to optimize pH, eliminating the need for pre-treatment swabs.
23. Why are there only 6 gauze squares in the new Zoom Kit?
Six gauze squares is more than enough to effectively complete Zoom isolation. However, as part of the new kit we’ve also added cotton rolls as an option to reduce the need to roll the gauze for placement in the upper and lower vestibules.
24. The cotton rolls do not fit in my patient’s mouth, what should I do?
If a patient’s mouth is small, sometimes the cotton rolls will not fit properly or may cause discomfort. In this case, replace with gauze by rolling into the shape of a cotton rolls. There is more than enough gauze provided to effectively complete Zoom isolation without the use of cotton rolls.
25. How has the Liquidam barrier material changed?
The new Liquidam material has been placed in a single syringe and is now white in color. It is an improved material which has been tested to provide 30-40% more protection of the soft tissue and is dentist preferred.
26. What happens if I forget to take out the Zoom Gel from the refrigerator 6 hours before my patient comes in? If the syringe is removed from refrigeration just prior to use, place the syringe in a cup of hot tap water 120 degrees Fahrenheit/49 degrees Celsius) for 10 minutes to restore to room temperature. Once the syringe is removed from the water, wait 5 minutes before extruding the gel. 27. How long do the results last? By following some simple post whitening care instructions, teeth that have been whitened with the Zoom System will always remain lighter than they would have been without whitening. To keep teeth looking their best, we recommend flossing, brushing twice daily, and occasional maintenance or touchups with Zoom Weekender, NiteWhite® or DayWhite® Take Home Whitening Systems. These are professional
formula products designed to keep teeth their brightest. They are available only through a dental professional. 28. How does contact time between enamel and the Zoom Whitening Gel affect results? Studies have shown that contact time is an important factor in all whitening products. We believe that offering our system in three session intervals allows for the amount of contact time necessary for optimal results. The simple fact is that the correctly designed light is only an activator for the gel. The best results occur when you have active peroxide in contact with the tooth for as long as possible. Any time you have a shorter contact time with the peroxide or compromise the quality of light activation, you are diminishing your whitening potential. 29. I am not getting 8 shades, what am I doing wrong? We recommend using a VitaPan® Shade Guide, arranged in Value Order, or the Bleached Shade Guide which is already arranged correctly. This will give you a true measurement of the results you are able to obtain from the Zoom System.
VitaPan Shade Guide arranged in Value Order
B1 – A1 – B2 - D2 - A2 - C1 - C2 - D4 - A3 - D3 - B3 - A3.5 - B4 - C3 - A4 - C4
Additionally, the Zoom procedure works best on patients with yellow and brown staining. Those patients with gray shading from tetracycline or with Fluorosis may experience less dramatic results (See #3). Please contact customer service for more information 800-422-9448. 30. Following a Zoom procedure what type of maintenance is recommended? Some patients will never need to repeat the whitening process. However, to maintain results while at home or to further enhance whitening results, there are several maintenance options included in the Zoom Procedure Kit. NiteWhite ACP 22%, NiteWhite Turbo ACP or DayWhite ACP 9.5% are provided for take home use. Please dispense the maintenance kit in addition to ACP syringe for sensitivity, with previously fabricated trays in the tray case provided. 31. How often can a patient Zoom? There are no known limitations on the number of Zoom procedures a patient can undergo. However, it is recommended to wait at least 1 week between Zoom procedures. The following options can also be offered for touch-ups and maintenance; Zoom Weekender, NiteWhite or DayWhite Take Home Whitening Systems. These are professional formula products designed to keep teeth their brightest. They are available only through a dental professional. 32. Can a forth Zoom session be performed? Yes. There is enough Zoom Whitening Gel included in the syringe for an extra forth session when the appropriate amount of gel is used. The Light Guide allows for a forth session to be dispensed at the discretion of a dental professional. 33. Is tooth whitening safe? Yes. Extensive research and clinical studies indicate that whitening teeth under the supervision of a dentist is safe. In fact, many dentists consider whitening the safest cosmetic dental procedure available. Please consult candidate qualifications before performing a procedure. Please contact customer service for more information, at 800-422-9448. 34. How is exposure to the Zoom light controlled? Protective eyewear is required during the procedure. The Zoom procedure requires that all soft tissue in and around the mouth be protected (no pink should be visible). A dental professional is recommended to monitor the procedure to insure any exposed skin or tissue is isolated and protected. 35. What are the best Isolation methods?
• To ensure proper isolation, please apply LiquidamTM material slightly past the edge of the gum
• Scrupulously inspect and verify that all soft tissue is covered and no pink can be seen through the
Liquidam, this is especially important in the areas around the front teeth (anterior centrals & laterals).
• If a patient notes discomfort during a procedure, place a second layer of Liquidam over the area
and cure. Please note that Liquidam will not stay in place if Vitamin E oil has been applied because it creates a slick surface.
• Ensure that the Liquidam is fully cured and not runny before applying peroxide gel or exposing
• Place enough gauze in the mouth (i.e., around and covering the tongue, covering the pallet, etc)
to block all light exposure to those areas.
• During the Zoom procedure, check the gauze in the lower vestibule and on the lower lip to
ensure the gauze remains properly in place.
• If the gauze becomes wet it will become translucent and lose its ability to protect against UV.
Use surgical suction to dry the wet gauze and then place a new, dry, piece of gauze over it. Do not use high vacuum suction or you may displace the isolation material.
Please visit www.Zoomtraining.com or contact customer service, at 800-422-9448 for more information. 36. Am I able to place a composite filling, immediately following a Zoom whitening procedure? The use of bonding agents and composite on freshly bleached teeth is not recommended. Wait 7-10 days before performing a Zoom procedure. If done sooner, the bond strength will be decrease by 30% and the composite will fail. 37. What do I do if the lower lip gauze gets wet? Because the lower lip gauze should be connected to the Liquidam, the gauze should not be removed. If the gauze becomes saturated with saliva, carefully lift it and place a dry piece of gauze under it to avoid a lip burn from the bleaching gel. 38. Can the Zoom Lamp burn tissue? The Zoom Lamp emits (UVA and UVB) light. Just like a tanning lamp, it can burn uncovered tissue. Be sure to fully cover the tongue, lips and all gingival tissue before using the Zoom Lamp. 39. Is the Zoom System gluten-free?
All of Discus manufactured products, including Zoom, do not use gluten as an intended ingredient and none of the raw materials used have gluten as an intentional ingredient. However, since many of these products use natural, plant-based raw materials, we cannot guarantee products are 100% free of gluten. 40. Is the Zoom System latex-free? The Zoom System does not use latex as an intended ingredient. However, since during the manufacturing process workers might be wearing latex gloves when handling the product, we cannot guarantee products are 100% free of latex. 41. Can the gauze be substituted? The gauze provided in the kit should not be substituted. The gauze supplied is 4-ply double woven, tested by Discus to effectively block the light from the tissue. Sensitivity 42. What causes tooth sensitivity? The most likely cause of sensitivity after a Zoom procedure comes from existing tooth sensitivity. Be sure to ask your patients if they have a history of dental sensitivity. If they do, remind them that the Zoom procedure may cause such sensitivity to flare up a bit, but that it is transient and can usually be treated. Also, before starting the Zoom procedure, be sure to check for recession, dentin exposure, severe caries, cracks or abfractions, all of which should be discussed as possible sources of sensitivity. It is recommended that sensitivity is discussed with patients before the procedure. 43. What type of care is recommended for tooth sensitivity? Sensitivity during and/or after treatment may occur with some patients, but will always dissipate. Those who are susceptible are people with existing sensitivity, recession, exposed dentin, exposed root surfaces, recently cracked teeth, abfactions (micro-cracks), open cavities, leaking fillings, or other dental conditions that cause sensitivity or allow penetration of the gel into the tooth. Please consult the Sensitivity Protocol for complete instructions on how to minimize sensitivity before, during, and after the procedure for the most effective results. This document can be found after logging into www.zoomtraining.com. If needed, the lamp head can be backed up slightly or a Light Guide Extender can be used, however it should be explained that the whitening results will be affected. Please contact customer service for more information, at 800-422-9448. 44. What type of care is recommended if sensitivity to heat occurs? Sensitivity to heat can occur in rare occasions. If the patient complains about heat to the lips or gingival tissue around the front teeth (anterior centrals & laterals) verify that all soft tissue is properly covered. A Light Guide Extender can be used or the lamp can slightly be backed away from the patient, however it should be explained that the whitening results will be affected. There is room within the interlocking light guide and retractor to move the lamp head back a bit without it coming out of the retractor completely. Do not attempt to operate the lamp outside of the retractor. Doing so may expose uncovered areas to the lamp. 45. What is the purpose of Relief® ACP? Relief® ACP Oral Care Gel is the post procedure desensitizing gel that combines fluoride and KNO3 to minimize transient sensitivity 46. Does Discus only sell Zoom products to dental professionals? We sell Zoom products exclusively to dental professionals for use in their practice 47. Can Zoom products be purchased online? Zoom products can be purchased safely by dental professionals through the authorized Discus Dental website: www.discusdental.com We do not recommend purchasing Zoom products from unauthorized online sources. Many times the product is expired and there is no recourse for the consumer. Unauthorized sites do not provide a guarantee that you are getting what you paid for. For patients, products should only be dispensed by a dental professional because a dentist visit is highly recommended prior to treatment so the dentist can review medical and dental histories of the patient to assure results are attainable (i.e. veneers will not whiten) and to set realistic expectations.
Lamp Maintenance & Technical Questions
48. What makes the Zoom bulb unique and effective? The proprietary science lies in how the light is filtered, the output and the specific wavelengths of the output. The Zoom System uses a custom bulb and carefully-engineered, proprietary filtration to isolate specific bands of light that activate our whitening gel and produce optimal results. 49. Does the Zoom Lamp emit a specific wavelength? A particular wavelength combination of UV and visible light has been shown through testing to be optimal for accelerating the whitening process, while keeping the likelihood of potential burns from the light exposure, low. Our Zoom System is uniquely engineered to utilize this wavelength combination and our Zoom Whitening Gel formula is designed specifically to work within particular bands of light to produce optimal results. 50. What is the pH of the 25% hydrogen peroxide Zoom Whitening Gel? The pH of the Zoom Whitening Gel is 8.
Introducción A lo largo de los últimos 10-20 años se ha obtenido información nueva respecto a los efectos de la nutrición sobre las enfermedades psiquiátricas y neurológicas. Los efectos de los diferentes alimentos sobre el sueño se investigaron durante las décadas de 1960 y 1970, pero sorprendentemente aún todavía existe muy poca información acerca de los efectos de los aliment
PIOGLITAZONE VERSUS METFORMIN IN TWO RAT MODELS OF GLUCOSE INTOLERANCE AND DIABETES MOHAMED Z GADa*, NOHA A EHSSANb, MANSOUR H GHIETc AND LOBNA F WAHMANb aBiochemistry Department, Faculty of Pharmacy, Ain Shams University, Cairo, Egypt bHormone Evaluation and cBiochemistry Departments, National Organization of Drug Control and Research ABSTRACT Insulin resistance has been impl