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Tooth whitening tips & troubleshooting

Jan. 1, 2007
I am excited to be a part of this new publication for dental professionals. Being a dental assistant has been rewarding and oftentimes challenging.

By Victoria L. Wallace, CDA, RDA

I am excited to be a part of this new publication for dental professionals. Being a dental assistant has been rewarding and oftentimes challenging.

The dental team is constantly being bombarded with new products and new procedures. It is our responsibility to seek the education needed to stay on top of the always changing dental technology.

Tooth whitening is still very popular amongst our “health conscience” and “anti-aging” society. Studies show that this isn’t going to change. Big, bright smiles are a huge part of looking good, and looking younger. I am assuming if you are reading this, you are a dental professional. Have you noticed someone lately that has not whitened their teeth, and wondered why they haven’t? I have. In fact, I was talking with a dentist at the ADA meeting in Las Vegas who had beautiful teeth, but they were totally yellow. I really wanted to say something, but thought it was not my place. However, if that gentleman had been a patient at my office, I would have been right on it! Why? Because it is our responsibility as dental professionals to educate patients on their smile options.

Are you afraid to ask your patients if they would like a whiter, brighter smile? If so, I challenge you to change that...DO NOT BE AFRAID. One way to reach all of your new patients is to include some questions on the new patient questionnaire. Here are just a few examples.

  • Are you happy / satisfied with your smile?
  • What would you like to change about your smile?
  • Has anyone ever talked to you about whitening your smile?
  • Would you like to hear about the whitening options we offer?
  • Do you have any questions about tooth whitening?

Of course you can word them any way you like, but I highly recommend you have something similar on your forms. We can’t assume that patients know about this, or any other procedure for that matter. Ask the questions. Listen to the needs of your patients.

Results from the Sapphire™ chairside whitening system. Photos courtesy of DentMat
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Whiten your teeth first. Practice what you promote. Patients love to see their dental professional have a big bright gleaming smile ... especially when they are selling it to the patient. Not only does it help to convince the patient it is the right thing to do, it shows that you believe in what you are talking about. It is only common knowledge that if you have experienced something firsthand, you are able to guide someone else through the same experience.

Whitening Options

Don’t limit your practice to just one option. We are an options-available society. If you don’t offer it, the office down the street does. Don’t lose a patient because you have that “I don’t believe in that” attitude. Or, “it doesn’t work” mentality. Challenge. Get out of your box. Get with the times. Give them what they want. Educate yourself.

So let’s talk about the options available.

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First and foremost, a custom fit tray with a take home carbamide peroxide solution still provides the patient with the best results. Depending on your patients’ needs, manufacturers provide carbamide peroxide solutions ranging from 10 to 35 percent. You, the dental professional, need to decide what solution percentage is right. Back to options; keep some of each in stock. Not all smiles are created equal.

How do you decide what percentage to use? Here are some factors that I have used.

  • Age
  • Existing shade
  • Do they have a time constraint?
  • Are they OK with wearing the trays to bed?
  • Are they a bruxer?
  • Do they have wear facets and fractured lower incisors?
  • Can they bite into an ice cream cone comfortably? (this one is great for patients with sensitivity)
  • Is the cost an issue?
  • Do they have a particular whitening option in mind?
  • Have they whitened in the past, and if so, why are they doing it again?
  • Is this just for a touch-up?

Just from experience I will tell you that most patients like the higher percentage, worn over a shorter period of time. “Daytime” whiteners are now more popular than our original “nighttime whiteners.” Ask your patients if they have a preference. If they choose to wear it to bed, prescribe a 10 or 15 percent solution. Save your higher percentages, like a 20 percent, for two to four hours and the 35 percent for 30 minutes. If you choose a 35 percent carbamide, please educate the patient on getting all of the excess solution off the soft tissue, and to not wear it any longer than advised. I personally love anything over 20 percent for touch-ups. It’s fast and effective, and that is what patients love.

In-Office Tooth Whitening Systems

If you have invested in a whitening system with a light, use it! Please don’t let it sit and collect dust. Patients have been exposed to the lights due to our media. Take advantage of the free advertising. Lights are great for marketing.

All I truly have to say about the in - office systems is to know how to do the procedure properly with the least amount of discomfort to the patient.

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Have the manufacturer’s rep educate you and the entire dental team.

Whitening is still a wonderful way to spread the selling responsibility around to the whole dental team. Whitening patients will continue to visit their dentists for tooth whitening. Stay on top of the newest/latest/greatest in tooth whitening, and just have fun making humans smile brighter.

ShopTalk Tip on a Personal Note:

The items I share with you in this article are my opinion of important tidbits to help troubleshoot dental procedures and products. My sole intention is that I share with all of you some vital information that might just make your life a little bit easier and more fun. OK, and rewarding! I am an outspoken sort of person, so just let me know if I go too far.

Welcome to the New Year!
Good Luck, Have Fun.
See you next time!

Biographical Sketch

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Victoria L. Wallace, CDA, RDA has been a CDA, RDA, since 1976. Her chairside career has included general dentistry and cosmetic/esthetic dentistry. Wallace has lectured nationally and internationally on dental products and procedures. She has a strong interest in tooth whitening and adhesive dentistry.

In 1996, Wallace started working for Ultradent Products, Inc. She has been a Product Education Specialist, the West Coast Regional Manager, and is currently the Western U.S. Major Accounts Manager.

Wallace is an active member of the ADAA, president of the Nevada Dental Assistants Association and president of her local society. She also serves as a director for the American Dental Assistants Association Foundation.

ShopTalk Tip:

If the patient has numerous wear facets throughout their mouth, do not recommend nighttime use. They will just pump all the solution out of the tray within a short time and swallow it. If you have a patient return for a mid-treatment appointment and they have not seen a change in shade, ask them if when they wake up and take the trays out there is still solution in the tray. If not, instruct them to wear only while awake.

ShopTalk Tip:

Give the in-office whitening patient a little pad of paper with a writing utensil to communicate with you during the process. This makes it easier for the patient without trying to talk and possibly get a high percentage of hydrogen peroxide on the soft tissue.

Another great money saving tip is to purchase the new TresWhite Supreme pre-fill tray hydrogen peroxide. Send 3 to 4 applications of this whitener home with the patient to continue to whiten. This eliminates the extra time and cost it takes to make them custom fit trays. They can then purchase more for future touch-ups.