Alternative to fluorosis

Case study evaluates using MI Paste protocol instead of veneers

by Angela Nordstrom, RDH

Our office's very first experience with MI Paste was, to say the least, very rewarding. We had recently viewed the

Feb. 23 appointment

product's brochures with a healthy dose of skepticism mingled with hopefulness. It did seem too good to be true. However, the results were soon undeniable.

Case Study

The 30-year-old patient presented for a checkup and cleaning. She indicated that she was aware – after years of discussing options with previous dental professionals – that the best treatment option available to improve the esthetics of her smile was veneers. She was now seriously considering spending the money on veneers to make what she called her "ugly but strong" teeth beautiful.

We saw an opportunity to try MI Paste, as she had nothing to lose, but a everything to gain if it did indeed work. Home-care compliance was excellent. No restorative treatment was done on any of the anterior teeth. The

March 22 appointment

patient used whitening strips for the third week in every month for the three months that the MI Paste was being used.

Protocol

The course of action was the following:
February 23, 2010

Photos were taken of moderate fluorosis mottling and discoloration.

Retractor placed.

Anteriors pumiced (and rinsed and flossed).

Etch was placed on all maxillary anterior facial tooth surfaces (starting at most discolored areas) for 1.5 minutes.

Rinsed.

Applied pea-sized amount of MI Paste on anteriors (retractor left on for entire five minutes).

Patient advised to reapply night and morning, letting the MI Paste sit on teeth without disturbance for

April 22 appointment

three to five minutes before expectorating or swallowing.

Patient was also advised to use Crest 3D Whitestrips in three weeks from date of etching appointment.

March 22, 2010

Patient returned for further treatment.
Patient was unsure if there had been actual improvement.
"Before" pictures were compared to one-month photos and improvement was noted.
The Feb. 23 procedure was repeated.
Patient reported that her only concern is that teeth felt "rough" after etching.

April 22, 2010

Patient returned for two-month MI Paste appointment.

May 18 appointment

Results were now dramatic, and the patient was happy enough with the results to consider stopping further treatment.

Patient decided to continue with another etching.

Initial procedure repeated.

May 18, 2010

Patient returned for follow-up appointment and final photographs.
Patient was exceedingly happy with results.
A slight mottling was noted on tooth #11, however patient was not concerned with this, and it was only noticeable very close-up.
Pictures were printed for patient to take home
Permission to share photos and case details granted.

Details

In-office etching was performed a total of three times for this patient. She was very compliant with her home care, as well as the use of Crest 3D Whitestrips monthly. Having an in-office camera with a macro lens certainly helped accurately document the changes occurring.

Encouraging results

I found that this case was rewarding not only for the patient for obvious reasons, but as a dental professional as well. Her self-esteem had been affected by her "ugly but strong" teeth most of her life. After treatment, she sent our office a gift and a lovely card on which she wrote "Thank you for making my teeth pretty! I'm so happy to finally have a beautiful smile!" She gave us all of the credit and gratitude but we were certainly just as amazed at how well MI Paste works. The success of this case has encouraged our office to offer MI Paste with great frequency as a valuable option for remineralization of both environmental and innate enamel defects.

Angela Nordstrom, RDH, and her husband Derek Nordstrom, DDS, own and operate a general dentistry practice in Wainwright, Alberta. She is a graduate of the University of Alberta.