Whiten, align, and shine: whitening with aligners

Through this case study on teeth whitening with aligners, Dr. Brigham Stoker illustrates how this patient achieved his whitening goals and also boosted his confidence and self-esteem.

Dr. Brigham Stoker illustrates a combination of treatment over 4 years

Achieving the bright, confident smile our patients desire can often take a combination of treatments to attain. In this case, the patient was seen over the course of roughly 4 years — he initially sought teeth whitening and eventually embraced aligners to get the smile he wanted. Walking bleach (internal), whitening gel, and aligners were used during the course of the treatment.

Figure 1: Initial Smile, taken November 19, 2018. Patient came into the office as a regular new patient, mostly asking about whitening his front tooth (No. 8). He was moderately interested in straightening his teeth, but we didn’t start aligners until a few years after this
Figure 2: After walking (internal) bleach, this photo was taken on January 22, 2019. This was immediately after completing a walking (internal) bleaching on tooth No. 8. We whitened it whiter than the surrounding teeth, knowing it would fade slightly, which it did as you can see in the next photos
Figure 3: First shade, taken January 28, 2021. At this time, the patient decided to move forward with aligners and whitening, using the aligners during treatment. We started at an A3 shade
Figure 4: Mid-shade 1, was taken March 18, 2021. Most of the whitening happened in the first 2 months of the patient using Opalescence PF 10% whitening at night, placing the whitening gel inside his aligners while he slept. You can see that we are already almost at an A1. He used the whitening gel anywhere from 2–3 times per week during this time frame
Figure 5: Mid-shade 2. This photo was taken May 6, 2021
Figures 6 and 7: 6. Mid-shade 3, and 4. This photo was taken June 17, 2021. 7. Mid-shade 4. This photo was taken July 16, 2021. The changes here are more subtle. The patient was happy with the shade, and as a result, he wasn’t
using his whitening treatment as frequently as he was prior. He used the whitening gel 1–2 times per week at this point
Figure 8: Final shade was taken April 20, 2022. The patient had moved out of state after the mid-shade 4 photo, but I sent him with the rest of the aligners and some additional whitening gel. He came back to my office to finalize treatment and fabricate his retainers. He wasn’t whitening very much during this time (he said, “every once in a while”). Even without regular usage of the whitening gel, the color remained after 8–9 months

The transformation of a smile is not just about a change in esthetics; it’s about the boost in confidence and self-esteem that follows. The journey can often be winding, with multiple treatments needed before the patient is able to achieve his/her goal smile.

In this case, the use of aligners in combination with teeth whitening allowed the patient to achieve a stable A1 shade, maintaining the shade months after the treatment concluded.

Drs. Jaimeé Morgan and Stan Presley wrote about how teeth whitening and orthodontic treatment can be a perfect match. Read it here to find out how patients’ esthetic needs can drive treatment goals. https://orthopracticeus.com/ce-articles/smile-bleaching-and-orthodontic-treatment-is-a-perfect-match/

Brigham Stoker, DDS, attended the University of Utah where earned his bachelor’s degree in Physics and Mathematics Education followed by a master’s degree in Instrumentational Physics. He attended the University of North Carolina at Chapel Hill for dental school, and then returned home to start up his private practice in Salt Lake City where he has practiced for 12 years. He has hundreds of hours of continuing education in all aspects of dentistry, including implants, orthodontics, Invisalign, lasers, and oral sedation. When not practicing dentistry, he enjoys time with his wife and 4 children, or riding his mountain bike somewhere in Utah.

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