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.
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