Whitening For Life!
Simmons Family Dental Care is proud to offer this new,
unprecedented program to our patients. We pride ourselves on the smiles that
leave our practice. We also pride ourselves on knowing our patients are
maintaining the best possible oral health.
For Life! was developed for those patients that are already taking their
dental health seriously, and as an incentive for those who need a little help
keeping up with their dental care. The
patient will receive custom made, professional, take home whitening trays and
bleaching gel for personal use.
As with any program, there is always fine print, but the
details are simple. Outlined below are the details for the Whitening For Life! program.
At your next appointment, a staff member will explain in detail and have
you read and sign the necessary forms to participate.
Simmons Family Dental Care will fabricate custom whitening
trays for any of our current patients age 18 and older that are medically and
dentally able to receive tooth whitening. (See exclusions below), following a
regular cleaning and exam.
For new patients, Whitening
For Life! is free with a paid exam, x-rays and the completion of any needed
The patient will be scheduled for custom impressions of their
teeth, after which the whitening trays will be ready for pick up within two
The custom trays will be delivered along with 2 syringes of
whitening gel. Patients will be given instructions on the proper usage and
answer any patient questions or concerns.
Upon examination by the dentist, there may be circumstances
which would not make a patient a candidate for the program if you currently
have any of these dental conditions. The dental exclusions are as follows:
decay is present.
or active infection.
( pocket depths of greater than 3 mm) requiring deep cleaning.
recession ( teeth will become too sensitive for take-home bleaching)
sensitivity from past bleaching procedures.
anterior restorations (do not respond to whitening)
exclusions ,limitations and conditions
currently on Government subsidized dental coverage is ineligible for this
Must not have
any outstanding accounts
maintain all scheduled appointments and checkup visits. Your long-term oral
health is as important to us as it is to you. Our patients have found that
regular checkups greatly reduce dental pain and the cost of dental services
Therefore, we are happy to provide this extra bonus to our patients who are
committed to their oral health.
4. A minimum of 24 hours’ notice must be given
for cancellations, and the original appointment
must be rescheduled within the following 2 weeks. In order to provide
exceptional services like Whitening For Life! to all our patients, we ask that
you give us the courtesy of advance notice for all schedule changes.
5. Must be 18 years of age.
6. Two whitening
gel syringes will be rewarded at each cleaning appointment. Additional syringes can be purchased for $15.00
7. Lost or
destroyed trays will be replaced at a cost of $50 per tray to the patient.
8. Should any
of the rules not be met, you will be disqualified from the program but will be
provided the opportunity to re-enroll for a $99.00 reactivation fee.
whitening is considered by the American Dental Association as a cosmetic
procedure. If you become sensitive through the use of these products, it is
imperative that you discontinue the use of the product and inform us
immediately. Constant stimulation of soft tissues and teeth with bleaching
agent may permanently damage the nervous ttissue within the tooth or chemically
burn the gingival tissues. If the nerve within a tooth become overexcited ( inflammation of the
pulpal tissues inside the tooth), you may need root canal therapy followed by a
build up and crown to treat the symptoms and protect and seal the tooth.