Director's Message: Are malls for shopping or whitening?

April 25, 2008
Is it OK that consumers can buy cell phones, get their nails done, and have their teeth bleached all in one mall?

Are shopping malls for consumer goods or bleaching services? I recently visited a Simon Mall and noticed a new open concept storefront — a "cosmetic bleaching center."

My emotions ranged from disgust to disbelief to curiosity, and finally to despondency. It makes me wonder what messages our patients have been receiving about whitening their teeth.

For the patrons of such establishments, I surmise that the answer may support that bleaching is strictly a cosmetic procedure with no health connection. It's on the same level as coloring hair, applying make-up, and getting artificial nails. They may believe that dentists charge too much for the service and may resent the dental practice's profit. They have yet to fully connect oral and systemic wellness and the importance of professional care. And if I'm correct in any of my assumptions, have we as professionals somehow led to this thinking?

So, I ask you reader — How you feel about the newest trend of pop-up whitening centers and/ or kiosks? Whether they're in shopping malls, health fairs, hair salons, spas, tanning businesses or wherever?

As a professional, do you view these places as business models and just the old-fashioned American entrepreneurial spirit at work? Do you see them as competitors to your bottom line? Are you on the board of such an emerging enterprise, receiving a stipend or referrals, or do you own one? I would love to hear comments from owners, board members or professionals, all who have noticed these businesses or have had some sort of opinion about them.

I realize we are in an "on the go" and "multitasking" world, and we have professionals who participate in such start-ups and employ non-dental-educated counter help. Have they sold their ethics for the almighty dollar? The debate has just begun, and I am very curious to learn about all sides of the issue.

Now I'd like to address the picture that accompanies this Director's Message. It is a post-op image of an administrative dental professional who used a professionally dispensed carbamide peroxide whitening solution in her dental-fabricated home whitening trays. Yikes! That was my reaction when I saw her.

I neglected to take a picture of her lips. Think lip fullers gone wild. She was excessively swollen and so uncomfortable that she could hardly eat or speak. Did you catch that I mentioned "dental fabricated trays"? Professionals created her trays, but the reality is that she is more knowledgeable on whitening and dentistry because she works within the profession. And look what happened to her!

This is the position we should consider when discussing these bleaching clinics — how it may harm our patients or consumers. Who is handling the post-op burning of the non- protective gingival tissues or sensitive teeth? How about multiple consumer visits to achieve results? When I was asking questions at my local bleach center, a gentleman in the chair for a second time was told he would benefit from a third go round. OK, let's do the math — $100 for the initial 20-minute bleaching session, and $75 for each one after. This consumer will invest close to $300 for unsupervised bleaching. I know there are dental practices that perform comprehensive exams and whitening procedure for similar fees. So where is the savings?

Plus, who's present at these mall locations to determine if consumers are viable candidates? OK, I acknowledge that you have to sign off before beginning the procedure to protect the business from liability, yet when I visited the kindly counter person, she held up a shade guide to my friend and said that she could get great results with whitening. My friend has had full mouth reconstruction. Where is the knowledge worker now?

Who is on site to determine if the teeth are discolored due to untreated disease vs. coffee or tobacco? Who takes a complete medial history? I saw nothing that asked about latex allergies or an allergy to hydrogen peroxide. How about consumers who are taking light-sensitive medications or substances, and then have a light directed on them for 20 minutes? In this particular store, anyone 16 years or older could whiten. Do they check IDs, because it didn't appear that a parent or guardian needed to sign a consent form for minors. Lastly, should I mention OSHA or infection control training? I noted no hazard waste stickers on any of the trash receptacles.

I have lots of questions and am very curious to learn about other readers' experiences. I believe that our patients' health and well-being should come first. When it comes to unsupervised, lay-person generated bleaching, I am worried that some people will be harmed, not healed.

Kristine A. Hodsdon RDH, BS
Director, RDH eVillage