LaserWhite20 Whitening Gel Frequently Asked Questions

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1 What are the main benefits of the LaserWhite20 gel, and laser whitening in general? The LaserWhite20 teeth whitening system, used in conjunction with the ezlase 940 or LaserSmile laser, is a true laser-activated whitening system that is the most efficient whitening solution available. This combination accelerates the whitening process and takes less than 20 minutes to complete, compared to other products which require over an hour. 1 Thus, ezlase or LaserSmile Whitening reduces overall chair time, allowing patients to spend less time at the dental office and clinicians to see more patients in a day. Studies have shown that typical results from laser whitening range from six to twelve shades of improvement on the Vita Shade Guide Brightness Scale. When compared in similar tests, no other whitening solution consistently matches laser whitening. A common misconception of teeth whitening systems such as Zoom and BriteSmile is that they are laser teeth whitening systems they are not. Although they are light-activated, they are not laser-activated. 1 Does not include prep and post treatment preparation. Does laser whitening really make my teeth white? Yes! Laser whitening is designed to be safe and effective, and is an excellent means of bleaching and whitening dark, yellowed, or discolored teeth with extrinsic and intrinsic staining. The degree of whitening that can be achieved varies among patients based on the types of staining, enamel thickness, tooth structure, and age. But typical results range from six to twelve shades on the Vita Shade Guide Brightness Scale. Does laser whitening work on dark stains? Teeth with deep, intrinsic staining in the grayer tones generally will not respond as well as yellow shaded teeth. Some patients have teeth that are a natural yellow shade because enamel transparency allows the color of dentin to be visualized. In this case, patients may not show improvement after the LaserWhite20 treatment. Dentists are encouraged to discuss predictability and efficacy with the patient prior to the start of the whitening process to establish realistic expectations on the part of the patient. How does laser whitening work? The LaserWhite20 gel has been specifically formulated to work with Biolase diode laser systems. The laser energy is absorbed by special particles in the LaserWhite20 gel to activate the hydrogen peroxide, accelerating the whitening procedure. Page 1 І July 2009

2 First, the LaserWhite20 gel is placed on the teeth. The teeth are divided into 4 sections (quadrants). Each quadrant receives two treatments of 30 seconds of laser exposure with the ezlase 940 (or four treatments of 15 seconds with the LaserSmile). Dividing the teeth into quadrants allows the laser to accelerate the whitening process while minimizing heat induced to the teeth. The gel is left on the teeth for an additional 5 minutes after the ezlase 940 laser exposures (1 minute for LaserSmile) to allow the teeth to absorb the laser-activated hydrogen peroxide, allowing continued whitening after the laser exposures. Two gel applications are required. How long does a procedure take? The ezlase and LaserSmile Whitening procedures with LaserWhite20 gel take less than 20 minutes, compared to over an hour for other whitening systems, and 40 minutes for the LaserWhite10. (Note that this does not include prep and post treatment preparation.) Does someone have to hold the Whitening Handpiece during the procedure, or can the patient be left alone? Since each quadrant of teeth is exposed for only about 15 or 30 seconds of continuous laser energy before moving to the next quadrant, a dental professional (or appropriate dental auxiliary staff, as permitted by local or state guidelines) must hold the handpiece in place during laser exposure, move the handpiece to another quadrant between exposures, and operate the ezlase 940 or LaserSmile laser throughout the procedure. How soon will a patient notice improvement? Great whitening results should already be noticeable immediately after the procedure, when the LaserWhite20 gel is removed. After 24 hours, there will be even more dramatic improvement! The patient should be advised not to consume products that can stain teeth for up to 48 hours after the treatment including, but are not limited to, some fruits, coffee, red wine, tomato sauces, tea, and tobacco. Does laser whitening hurt? The LaserWhite20 procedure should not cause patient discomfort if used correctly. To reduce or prevent tooth sensitivity during and after the procedure, the dentist may recommend appropriate pain relief medication 30 to 60 minutes prior to the procedure and postoperatively. A desensitizing gel containing potassium nitrate is included in the LaserWhite20 kit, and may be used in a custom tray in the same manner as a take-home whitening gel as needed. Also, vitamin E ointment may be applied to irritated gum tissue at the end of the procedure. Page 2 І July 2009

3 If at any time during the procedure the patient experiences discomfort or burning, the procedure should be stopped. The liquid dam material supplied in the LaserWhite20 kit must not be used on patients with known sensitivity to resin. The dentist should test the liquid dam material on a small section of the patient s gum before attempting this procedure. Is anesthetic required for laser whitening? Teeth should not be anesthetized for this procedure. If at any time during the procedure the patient experiences discomfort or burning, the procedure should be stopped. How does laser Whitening with LaserWhite20 gel compare to other whitening systems? First of all, the ezlase and LaserSmile are the only laser-based whitening systems. Although other products such as BriteSmile and Zoom utilize light as part of their system, they do not use a laser. Studies have shown that laser-based whitening systems (1) take less time to administer and (2) deliver superior results compared to non-laser systems. According to an American Dental Association Professional Product Review from Spring 2008, the treatment cycles of BriteSmile and Zoom 2 are 90 and 60 minutes, respectively. By comparison, the protocol developed for the LaserWhite20 gel and ezlase 940 or LaserSmile laser system takes less than 20 minutes! The ADA Professional Product Review from Spring 2008 and a study published in the Journal of Cosmetic Dentistry in Summer 2003 both concluded that the LaserSmile with LaserWhite10 gel provided approximately 9 shades of improvement, compared to approximately 8 shades of improvement from non-laser systems. We expect that the LaserWhite20 gel and either ezlase 940 or LaserSmile will deliver even better whitening results compared to the LaserSmile with LaserWhite10 gel. For more details on these studies, please see (1) ADA Professional Product Review, Vol. 3, Issue 2, Spring 2008 and (2) LaserSmile Tooth-Whitening System: A Study by Two Independent Clinical Sites from The Journal of Cosmetic Dentistry, Volume 19, Number 2, Summer Has the LaserWhite20 gel been reviewed by the FDA? The ezlase 940 and LaserSmile laser systems have been cleared by the FDA. The LaserWhite20 gel is regulated, but not enforced by the FDA no approval is required. Page 3 І July 2009

4 Does use of the LaserWhite20 require special training? The LaserWhite20 Whitening System does not require special training. However, the ezlase 940 or LaserSmile laser system should be used by trained personnel in states where it is legal to operate a medical laser device. What laser systems is the LaserWhite20 gel compatible with? The LaserWhite20 gel is compatible with (1) ezlase 940 nm laser system for a maximum power of 7 W and (2) LaserSmile. The procedure (protocol) for each laser system is slightly different, although the overall treatment time is similar. The LaserWhite20 includes detailed instructions for use with either laser system. Is the LaserWhite20 gel compatible with the ezlase 810 nm laser? Not at this time. Will the LaserWhite10 gel still be available? If so, for what lasers? Biolase intends to discontinue the LaserWhite10 as quickly as possible. The LaserWhite20 is a superior product with longer shelf life, so there is no need to offer the LaserWhite10 anymore. What are the differences between the LaserWhite20 and LaserWhite10? The LaserWhite20 has an improved formulation to provide better whitening results with reduced procedure time. The procedure time with the LaserWhite20 has been reduced from about 40 minutes to less than 20 minutes, compared to the LaserWhite10. Also, the LaserWhite20 requires much fewer laser exposures than the LaserWhite10 did. A desensitizer is now included with the LaserWhite20 kit to reduce possible sensitivity after the whitening procedure. (LaserWhite10 kit does not include desensitizer.) Will I need to change the settings on my ezlase 940 nm laser to use the LaserWhite20 instead of the LaserWhite10? The LaserWhite20 requires 200 Joules per quadrant for each laser exposure, compared to the LaserWhite10 which requires 150 Joules. So the total energy ( Joules countdown ) must be set to the appropriate value. Seven Watts of power in continuous wave mode remains the same for each type of gel. Page 4 І July 2009

5 Will I need to change the settings on my LaserSmile laser to use the LaserWhite20 instead of the LaserWhite10? The settings on the LaserSmile will not need to change, but fewer laser exposures, and hence less chair time, is required for the LaserWhite20 compared to the LaserWhite10. What is the cost of the LaserWhite20 gel? Suggested retail price is $295 for a package of 5 kits. What is the cost of an ezlase 940 nm laser with whitening handpiece? Suggested retail price for the ezlase 940 nm laser is $13,940, and the ezlase Whitening Handpiece is $1,250. Please contact your Biolase or Henry Schein representative for special limited time promotional offers that can significantly reduce the price of the ezlase 940 laser system. When will the LaserWhite20 gel be available for delivery? It has been available for delivery since June What is included in the LaserWhite20 gel package? Each LaserWhite20 package contains 5 kits. Each kit contains everything needed for one complete whitening procedure: 1 syringe of whitening base gel 1 syringe of activator gel 1 syringe of liquid dam 1 syringe of desensitizer 2 applicator tips 5 brushed applicator tips 2 syringe caps 1 disposable clear cap for the whitening handpiece Instructions for use How many laser whitening procedures can be performed with a single LaserWhite20 gel kit? One complete whitening procedure can be performed with each LaserWhite20 kit. Page 5 І July 2009

6 What is the shelf life of the LaserWhite20 gel? 18 months, refrigeration is required. Does the LaserWhite20 gel have to be refrigerated? Yes, the LaserWhite20 gel requires refrigeration. How do you mix the base and activator components? The base and activator gels are in separate syringes. To mix the two components, connect the activator syringe to the base syringe and press the chemicals from one syringe to the other. Reverse action and mix a minimum of 25 times rapidly. Ensure the two components are properly mixed by checking the color uniformity of the mixed gel. Mixing the gel should take no more than 30 to 45 seconds. How do you apply the gel and other components (e.g. liquid dam, desensitizer) to the patient? The liquid dam is first applied directly onto the gingival margin and cured by a curing light. The whitening gel is applied to the teeth through a brushed applicator tip (after the base and the activator components of the gel have been mixed together). The desensitizing gel contains potassium nitrate. It is designed to be used in a custom tray and applied in the same manner as a take-home whitening gel. While the length of use may vary depending on conditions, the patient, and the dental professional, the recommended length of use is between 15 and 60 minutes. BriteSmile and Zoom are trademarks of Discus Dental. ezlase, LaserWhite10, LaserWhite20 and LaserSmile are trademarks of Biolase Technology, Inc. Page 6 І July 2009