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Tuesday, August 19, 2008

Teeth Whitening at the mall, county fair, and even Costco??? Buyer Beware!

It seems everyone (and anyone) has gotten into the Teeth Whitening business lately. Teeth Whitening kiosks are popping up everywhere. The folks manning the booths are dressed in white coats, but they aren't dentists. They aren't in the dental profession at all. So, how do they get away with it?

They get away with it because they don't touch you. Their clients place the bleaching products in their own mouths. So, it's classified as a "cosmetic" rather than "dental treatment." They've taken advantage of a loophole. I've heard that some states are trying to close that loophole.

While on the surface it may seem that dentists would want to simply protect their "turf," there are serious concerns about non-dentists performing dental procedures... Yes, even though they aren't touching their "clients." Undiagnosed gum problems and cavities, for example can become very sensitive or "flare up" with bleaching gel application. Existing crowns and fillings won't change color. Teeth with thin or worn enamel won't change color, either. And, ultimately the results are quite disappointing. These untrained sales people in "white coats" couldn't possibly determine whether any of this applies to you. They have ZERO dental training.

The advertising, posters, and brochures are quite impressive at these mall kiosks. They "guarantee a 5 (or some other arbitrary number) shade improvement." And, that's just it. How much is a shade? On which scale? It means little to nothing. But, it sure sounds good. They'll also tell you that this is the same process used in dental offices. That's simply not true. (We actually touch you, for starters!) The results immediately after the procedure might impress you. But, it will fade, and it will fade very quickly. Why? The next paragraph will tell you.

First of all... bleach is bleach. The primary difference from one product to another is the concentration of the bleaching material (either carbamide peroxide or hydrogen peroxide). Each company may put in its own version of additional "desensitizing" ingredients. The primary determinants of bleaching effectiveness are CONCENTRATION and TIME. The higher the concentration, the bigger the effect. The same thing goes for time. The longer the bleach is in contact with the teeth, the better. In my own experience, time has been the more important of the two factors. I have found that even a lower concentration of bleach with a longer application time will work more predictably than a high concentration for a short time. And, that's why home whitening with a precision-fitted custom tray has been the most predictable and most effective in my experience.

These kiosk operators claim all you need is 15 - 20 minutes. In my 20 years of experience as a dentist, I cannot see any bleaching treatment for such a short time being effective. The results will be very superficial and short-lived.

Now... Here's the part that will ruffle some feathers - even some dentists. It's about the "special light." You will see these operations using a "special light" that is placed close to the teeth during the bleaching process. They are usually a focused bright blue light. Here's the big secret: THEY DON'T DO ANYTHING!!! The lights are 100% HYPE!! The lights are 100% marketing hype. The truth is that the public likes bright lights and lasers. They look high-tech. But, I must repeat: The lights don't do a thing for whitening the teeth. Not one iota! And, this has been proven time and again by independent scientific studies. The only thing the light accomplishes is dehydration of the teeth that makes them LOOK whiter - temporarily. The light dries out the teeth. Clever, eh? Sure, the bleach will whiten the teeth... but only a tiny amount in the 15 minutes, or so, that you're sitting in the chair at the mall. The light just dehydrates the teeth and makes them look even whiter.... until they RE-hydrate. The whitening effect relapses rather quickly.

Unfortunately, there are dentists who use similar lights in their offices. And, I believe they have bought into the marketing of the companies who sell the lights. I believe those dentists truly believe they are helping. But, science is science. And, the scientist in this particular dentist (me) happens to have a louder voice than the marketer in this dentist. I have to call them as I see them. And, I know that some of my colleagues won't like it. And, it's why I don't have the "special light" in my practice. If it really worked, I'd surely have one in my office.

So, while I am very much in favor of a free market, I cannot endorse or acknowledge the industry of whitening provided by non-dental professionals. I believe many clients will ultimately be disappointed, be lighter in the wallet, and not have any recourse. While I believe in a free market, I also believe in the old adage, "Buyer beware."

It's worth noting that in most (if not all states) it's illegal for a dental assistant or dental hygienist to whiten a patient's teeth without the supervision of a dentist. At least those dental personel have some dental training! But, they cannot legally whiten your teeth without a dentist present. So, how is it that someone can buy a "whitening franchise" on the internet and set up shop in the mall or big-box discount store??

There is no doubt that the best and most predictable way to get your teeth whitened is at a dentist's office. A dentist can let you know if it will be effective for you. Not everyone is a candidate for whitening. Secondly, a dentist can monitor your results and make adjustments as needed. I have found the best, most effective whitening is with home bleaching with professionally made custom-fitted bleaching trays. In-office "power bleaching" helps, but it is best used IN ADDITION to home bleaching with custom trays.

I suspect the mall, county fair, and big-box discount store whitening kiosks may disappear as quickly as they appeared. Either the public will become aware of the poor long-term results, or the state dental boards will shut them down due to possible health risks.

If you're not happy with the appearance of your smile, your best bet isn't with someone who bought a "whitening franchise-in-a-box" on the internet and threw on a white coat and fake eyeglasses to make himself / herself look sophisticated. Your best bet is with a licensed dentist. You only get one set of teeth. Trust them to a professional.

For more information on teeth whitening and photos of actual cases in Boynton Beach click on Palm Beach Smiles.

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