Tooth whitening is big business. Generating over $1 billion in sales every year, professional whitening stands out as the most frequently-requested dental procedure. It’s also major source of revenue for dental practices across North America.
Together, a dentist and their hygiene team can create comprehensive whitening programs that integrate whitening into a long-term oral care plan. That way, whitening can serve to facilitate financial gain to hygiene and other ancillary offerings.
In a recent piece for Hygiene Town, Mary Jane Livingston and Jennifer Vasquez provide insight into the process of creating a professional whitening program at your practice. Here’s what to keep in mind in offering tooth whitening to your patients.
There are several reasons why teeth lose their natural whiteness: diet, genes and oral hygiene all play a part.
Darkening can occur both in the tooth’s outer enamel layer and the secondary layer of dentin. Tooth enamel, made of phosphate and hydroxyapatite, can develop surface stains that attach to the biofilm. These so-called extrinsic stains typically stem from the patient’s diet and habits – frequent smokers and red wine drinkers are likely to have enamel stains.
Stains within the dentin, known as intrinsic stains, can result from medications, fluoride exposure, genetic conditions or systemic conditions. It is more difficult to remove stains from dentin than enamel.
Professional whitening gels use hydrogen peroxide (or a compound containing H2O2) to break the bonds of light-absorbing colour molecules on the teeth. These molecules, called chromophores, contribute to the darkened or stained appearance of teeth. Once the peroxide breaks the molecular ‘glue’ that holds the chromophores together, the teeth look whiter and brighter than before.
Tooth whitening is not a one-time solution – the procedure has a cumulative effect of breaking down stains over time. Additionally, since the average person’s teeth become two to three shades darker every ten years, requiring multiple whitening treatments to maintain the results.
Still, the popularity of professional tooth whitening (not to mention sales of whitening strips, tooth whitening strips and other home treatments) speaks for itself. Many patients are more than willing to invest the time and money necessary to improve the appearance of their smile. Dental practitioners can benefit by investing in a tooth whitening program.
The benefits of a teeth whitening program go beyond offering your patients brighter smiles.
Tooth whitening brings an emotional component to your dental care. It gives people a greater sense of confidence and satisfaction, which in turn boosts their motivation to maintain better oral health overall. A whitening program increases the likelihood of patients returning for hygiene appointments and other treatments.
Consider the following in determining the best teeth whitening system for your patients.
1. Contact time. Modern whitening systems use a heat-activated mouthpiece to decrease treatment time, which reduces the risk of the bleaching agent causing sensitive teeth. Shorter contact time also means shorter appointments and increased efficiency.
2. Concentration. Higher concentrations of hydrogen peroxide (24 to 38%) produce more dramatic results, but also the risk of sensitivity. More concentrated whitening products may not be suitable for all patients.
3. Hydrogen peroxide versus carbamide peroxide. Carbamide peroxide provides a lower concentration of hydrogen peroxide and increases contact time, which can increase the risk of tooth and gum line sensitivity. A more concentrated formula with shorter contact time may be preferable for patients who require a shorter contact time.
4. Open versus closed environments. Closed-system environments (such as bleaching trays and whitening mouthpieces) result in superior whitening results by keeping the active ingredients in the whitening compound concentrated.
5. pH level. Consider the patient’s enamel health and sensitivity when choosing a whitening gel. When mouth pH drops below 5.7, enamel demineralization can occur.
Thinking of introducing a whitening program to your practice? Get the right start with industry-leading instruments. Browse our catalog of dental handpieces, supplies and other dental tools.
Most of us chew gum, and we chew it for a variety of reasons. Whether it’s a piece before a first date, or after a particularly strong cup of coffee, many of us use the chewy stuff to keep our mouths smelling clean and fresh as we go about our day.
We see gum promoted in advertisements as something you can use not only to keep your breath smelling fresh; but to whiten and clean your teeth, improving your oral health.
Exaggerated marketing, or bona-fide fact? The answer lies in the ingredients of the gum you choose to chew.
It comes as no surprise that if you’re chewing gum with a lot of sugar in it, it’s going to be bad for your teeth. Sugar promotes the growth of plaque bacteria, which in turn promotes the development of cavities, the decay of enamel, and other issues.
It’s because of this that many companies, such as Wrigley’s, have begun to use both aspartame and a substance known as Xylitol as a substitute for sugar in their products.
A naturally occurring compound that has been shown to prevent tooth decay, the National Centre for Biotechnology Information writes that Xylitol, “reduces the levels of mutans streptococci … in plaque and saliva by disrupting their energy production processes, leading to futile energy cycle and cell death … Consumption of xylitol chewing gum for >3 weeks leads to both long-term and short-term reduction in salivary and plaque S. mutans levels.”
Sounds pretty good, doesn’t it? Less bacteria on your teeth means less enamel-eating acid created, which means a healthier mouth. Brands like Confadent advertise and discuss their use of Xylitol as a safe alternative to aspartame, and a plaque reducer.
According to Delta Dental of California, “With xylitol use over a period of time, the types of bacteria in the mouth change and fewer decay-causing bacteria survive on tooth surfaces.”
This sounds like a big-time benefit for your pearly whites, but how do the results compare to projection? Some research shows that the evidence regarding the long term benefits of Xylitol as a dental hygiene product is still unclear.
According to a review published by the American Dental Association in 2015, while there is some evidence that Xylitol may reduce tooth decay over a period of years, the evidence is low quality.
Research published by the Cochrane Library website suggests that there just isn’t enough high quality evidence to confirm that Xylitol prevents tooth decay.
Philip Riley, M.P.H., of the School of Dentistry at the University of Manchester in the UK, is quoted as writing, “More well-conducted, randomized placebo-controlled trials that are large enough (in terms of number of randomized participants) to show a difference, if one exists, are needed.”
The Cochrane Library review stresses in its conclusions, “We found some low quality evidence to suggest that fluoride toothpaste containing xylitol may be more effective than fluoride-only toothpaste … The effect estimate should be interpreted with caution due to high risk of bias and the fact that it results from two studies that were carried out by the same authors in the same population.”
In the end, the conclusions are yours to draw based on the evidence given, but it’s safe to say that chewing gum with Xylitol is better for your teeth than its sugary counterparts. While there needs to be some more research done to better reinforce this conclusion, Xylitol has indeed been shown to reduce cavity causing bacteria in the mouth.
Still, if you want to keep your teeth healthy, at the end of the day no gum is a substitute for regular brushing and flossing. For more information on Xylitol, its benefits and drawbacks, you can check out this article from Access Dental, or this one from Delta Dental.