I. Detailed
Instructions for the Two Tray, Dual Thermoplastic Tray System
Step
1: Heat water in a microwave on high for approximately 1.5 minutes,
depending on microwave wattage, container size and amount of water used.
(Select temperature below boiling at approximately 160 degrees Fahrenheit.)
Step 2: Place a white
tray inside the colored tray and press the two together firmly. Holding by the handle, insert the combined
trays into the water so that the trays are completely submerged. Shake
the trays to remove any bubbles trapped between the trays to avoid having
an unheated area.
Step 3: Slowly wave
the trays in the water by the handle until the handle becomes very flexible, and the white horseshoe insert
begins to separate from the colored tray at the edges. A slight loss
of shape as the horseshoe collapses will be noticed.
Step 4: Remove the
trays from the water and test for flexibility. Insure that both trays
are well adapted to each other. The material should be soft enough that
the seam between the front bite portion of the white tray can be erased;
use your finger to slightly flatten and flare the front segment and
spread the tray to avoid the tray from folding on itself and to adjust
for the length of the front teeth.
Step 5:
Step 6: Insert the tray
system into the mouth.
Step
7: Form the tray over the front teeth, then the rest of the teeth,
by pressing firmly from the outside and tongue side with first finger and
thumb of both hands. The tray is conformed to the surfaces of the teeth.
Move hands away from the midline towards the back teeth, continuing
to press firmly on the sides of the outer tray. The finger motion is a repeated squeezing and pushing toward
the gums of the teeth.
Step 8: Remove your
hands and purse your lips around the tray and try
to "suck the water out of the tray while pressing on the roof of the mouth
with your tongue". Repeat this exercise 3-4 times.
Step 9: With your lips still together, bite
lightly a few times.
Step
10: Pump the tray off and back on once without completely removing
it. As it cools, the tray will shrink. If it does not feel very tight
now, do not remove, but either adapt by squeezing more on the sides,
or continue the pursing/sucking exercise. If the tray
is too tight, continue to remove and replace the tray as it cools to
stretch the tray. Pump a few more times then wait a minute and try again.
Step 11: When you
can no longer feel any heat in the tray, remove the tray from the mouth
and separate the white insert from the colored tray. The white insert
is the custom-fitted tray that will be used for bleaching.
Step 12: Evaluate
the white tray in your mouth for adaptation or sharp edges.
Areas that are rough should be reheated by dipping that portion only
in the hot water until flexible to the touch, then repositioning and
smoothing allowing you to smooth with your finger.
Step
13: Relax you are almost done.
Step 14: If a major
amount of tray material in the gum area must be removed, that can
be done with sharp scissors. However, smoothing by re-heating in warm water
and applying finger pressure leaves a better finish.
Step 15: When the
edges of the tray are smooth, re-warm the entire tray a few seconds
and insert one last time to relieve tightness. Pump off and on to insure
no significant undercuts are engaged, and a smooth removal with some
retention is present.
Step 16: Instruct
the patient not to rinse the tray with warm water when cleaning after
treatment, and to store the tray dry in the case.
