Protecting our patients’ smiles before, during, and after whitening
A tooth whitening case is currently before the United States Supreme Court. This case is not a lawsuit about a person’s teeth being too white or not white enough. This case is not about how whitening procedures are performed. Instead, it’s about who can offer whitening services. The outcome of North Carolina State Board of Dental Examiners v. Federal Trade Commission will determine who has the right to provide whitening services.
Our patients want bright, white, natural-looking smiles. Cosmetic Dental professionals can easily differentiate professional care from whitening provided by commercial, unlicensed whitening businesses. Professionals know the benefits and the risks of whitening and have the know-how to help patients prevent and treat sensitivity.
50 shades of white
Playing off of the popularity of the book and soon-to-be movie, 50 Shades of Grey, the American Academy of Cosmetic Dentistry (AACD) created a paper called the 50 Shades of White, based on the results of a 2014 whitening survey…The conclusion, according to AACD President Dr. James Hastings, is that: “Teeth whitening is still the most popular cosmetic dentistry procedure … People want to look like they were born with their smile, not like they have purchased it.”
A huge variety of products and procedures are available to help patients gain the natural look. Any invasive procedure has pros and cons, however, and the most common effect of whitening is producing or exacerbating sensitivity. Prevention is always the best method for creating excellent outcomes.
Chemical reactions
The active ingredient in whitening products is either carbamide peroxide or hydrogen peroxide, both of which dehydrate the enamel structure and create a chemical reaction by destroying the chromospheres in the pigments that stain teeth. Chemical destruction and dehydration are the irritating effects of peroxides, although patients’ reactions to these processes vary from no noticeable symptoms to extreme sensitivity.
Whether the patient feels an effect should not be the basis for protecting the tooth structure and preventing pain. The symptoms are not the cause of the health problem.
Instead, accurately depicts the cause-and-effect relationship between symptoms, diseases, and dysfunctions. Symptoms are not the first indication of a health problem; they are the last….
Products to evaluate
Evaluating the tooth structure prior to teeth whitening procedures is a more effective mode of problem prevention, and it establishes care as professional. As a dental hygiene clinician, I have seen practice after practice watch and wait for breakdown to occur – not because of bad intent but because the gold-standard detection devices could not detect problems until significant damage was done to enamel. Risk assessment with, for example, the Spectra by Air Techniques is an objective means of monitoring previous “watch” areas to help clinicians know whether preventive care or remineralization therapy should be increased, decreased, or continued as is. Remineralization therapy is needed when the whitening process causes chemical dehydration that destroys tooth structure.
Most teeth whitening gels contain potassium nitrate and sodium fluoride to seal dentinal tubules and thereby reduce sensitivity. Many fluoride varnishes are on the market, as well…read more
In the UK only registered dental professional with the GDC allowed to provide teeth whitening procedure
