Composition
NOW 10 Carbamide Peroxide 10% w/v

Actions
Carbamide Peroxide gel has demonstrated an ability to bleach tooth structure with varying degrees of effectiveness over extended periods. Studies show that Carbamide Peroxide is as effective as other whitening treatments available in the market today providing patients are compliant with their treatment plan.

Indications
Teeth which have become darkened with age or poor hygiene can be brightened by approximately 6-8 increments on the re-arranged Vita shade guide. (Vita shade guide set from lightest to darkest shades) on effective application within 7-10 days Teeth affected by fluorosis, tobacco and mild tetracycline staining can also be bleached on treatment over a 10 – 15 day period. Results are case dependent upon the extent of staining and the duration of application. The tray may be worn for as long as desired on the understanding that it should be removed for a day if discomfort occurs.

Contraindications
Lichen Planus may be exacerbated by Carbamide Peroxide Gel and tooth bleaching is contraindicated for these patients. Carbamide Peroxide 10% and 16% will remove the smear layer from dentine but has no reported deleterious effects on tooth structure. NOW whitening gel has no effect on amalgam or gold restorations. Porcelain and composite resin restorations have demonstrated slight surface roughening under severe laboratory conditions.

Precautions
Isolated cases of uneven bleaching or banding may occur, and patients must be advised of this rare possibility. Tooth hypersensitivity and soft tooth lesions may occur if the gel is used continuously for 3 days or more. Sore throats from swallowing gel leaching out from poorly fitting trays have been reported. As with most medication, use during pregnancy is not advised. The tray should not be worn during eating, teeth cleaning, playing contact sport or swimming and should be stored in the container provided whilst out of the mouth. Do not overfill the NOW whitening tray. Refer to the patient instructions for filling the tray.

Directions for use
Identify the upper (UP) and lower (LO) trays as written on the base of each tray
Place a thin strip (approximately 2mm thick) of whitening gel directly under the finger grips in each tray, finishing about half a centimetre short from either end. As the gel is very viscous it will generally stay beneath the fingers with minimal gel leaking into the patient’s mouth
Insert the upper and lower trays and leave for 20 minutes. This can be repeated up to 3 times a day until results are achieved
Successful whitening depends upon the time and frequency. Results will usually occur over 10 days. There is sufficient gel in the 30 ml tube for at least 10 applications for both upper and lower trays

Patient instructions
Teeth should be cleaned before applying the gel. Comprehensive Clinical, Product and Patient Information Sheets are provided in each NOW whitening kit.

Poisoning
If poisoning occurs contact a doctor or Poisons Information Centre. If swallowed, DO NOT induce vomiting. Give a glass of water. If skin contact occurs, remove contaminated clothing and wash skin thoroughly.

Presentation
1 x 30ml Tube of High Viscosity 10% Carbamide Peroxide Gel
2 x Whitening Trays (1 x upper tray and 1 x lower tray)
1 x Whitening Tray Container
Patient Information & Instructions

Storage
Store below 30°C