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Whitening center ... why not?

March 1, 2005
As a team player, the dental assistant is always instrumental in offering products and services to our patients, in addition to clinical chairside, sterilization, and business office assistance.

As a team player, the dental assistant is always instrumental in offering products and services to our patients, in addition to clinical chairside, sterilization, and business office assistance. Patients have treatment options from basic to comprehensive. Some patients may not be willing to leap into the most expensive option available, but would consider a wade in the shallow end of the pool with full knowledge that the less expensive treatment may be just fine for right now. Several newer ideas are available to enhance the esthetic aspect of the dental office. Collecting them all in a whitening center is a genuine idea to increase productivity and profit at the same time.

We have a built-in audience to listen to our oratories. With the patient in the chair, we have several opportunities for uninterrupted talk time. And, let’s face it, all they can do is listen (unless you have headphones with music or a DVD plugged in). For the most part, we want to inspire good oral hygiene habits. Our dialogue usually centers on how to keep what they have healthy, but what about the patients who are interested in more? What about the patient who may be on the edge of wanting something but may not know about all the new techniques available to attain that “more?”

Patients are often more willing to chat about their dental needs with the chairside dental assistant than the dentist. They feel more at ease asking what they feel may be “silly” questions - even though we all know that no question is silly. Patients feel very comfortable asking us what our favorite toothpaste is or which toothbrush we buy. They want to use what we use, especially if our teeth are whiter and brighter than theirs. With all of the products available for distribution in the dental office, we should take advantage of the audience at our fingertips. As many of our practices are focusing on esthetics, a wonderful idea would be to establish a whitening center with the assistant involved in marketing the variety of options the practice has available.

How many times do we take diagnostic cast impressions? These diagnostic casts can serve two purposes. Why not offer that whitening product to the patient? The impressions are already snapped, so all we have to do is fabricate the trays. Patients enjoy instant gratification. If the patient has minimal anterior restorative needs and receives whitening early on in the professional relationship, it establishes a very happy patient who is more receptive to other dental procedures. Careful case selection is always important. For those patients with extensive restorative needs, whitening may need to occur later in the treatment plan. When the post-orthodontic patient is in the chair, we are taking a set of impressions for his or her retainer. The bruxism patient presents another opportunity to offer whitening. With the plethora of carbamide and hydrogen peroxide products available, it would be very easy to discuss the benefit of double duty for the impression.

What about the patient who is interested in whitening but, no matter how much we may list the benefits, is either not ready, willing, or able to take the jump into a higher-priced esthetic procedure? Or, how about those who are willing to spend a little more time and invest a little less money?

Office-dispensed whitening products are varied with respect to strength, duration of usable product available in the package, and cost to the dental office. The main focus of these products range from enticing the patient to enter the world of whitening or offering patients the ability to enhance their self-esteem with a quality product that may be all they feel they could afford. With the variety of whitening products on the market today, there are also a variety of fees.

We have options at almost every price range. Some are in-office and some are offered in retail outlets. Proper treatment planning and diagnosis must come into play with these choices, as well as lengthy discussions of expectations. As long as patients understand that the whitening may take a little longer than the “tray” option and may only affect the anterior segment, this may be a reasonable option for that person who is “on the fence” regarding esthetics.

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Crest White Strips has been available for many years. Proctor and Gamble offers a variety of strengths, with the highest potency available only through dental offices. A clear plastic strip is affixed to the teeth for a prescribed period of time. Patients can use them on the way to work, at the gym, or in the privacy of their home. The strips are virtually invisible and usually extend to the distal of the canines. Two formulas are offered for dental office distribution - a Professional kit, which has 6.5% H2O2 concentration, and a Supreme kit, which has a 14% H2O2 concentration. Both kits offer a three-week supply. Patients may see a difference earlier than the three-week process and will have the possibility of two “uses” from one kit. The strength of the product distributed in the dental office is equal to four boxes available through retail outlets.

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Ultradent introduced Opalescence Trèswhite (above) last year. The whitening product is comprised of a 9% H2O2 gel set into a disposable adaptive arch delivery tray, with a gingival barrier gel. Two flavors are available for this product. Patients wear this tray for 30 minutes and the package contains 20 trays. Treswhite is only distributed through dental offices.

Oral-B has joined forces with Rembrandt to introduce their Whitening Strips. The strips are composed of 8% H2O2 gel. This option has recently been introduced to the retail market, but is available to dental offices. There are 14 strips in the package, which is approximately one week’s worth. Application time is 30 minutes. All of these adhesive products whiten over the course of five to seven days. Whiteness is dependant on the starting shade and the ever-important patient compliance.

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Paint-on products are also available. Colgate Simply White, sold in retail outlets, offers two strengths for the patient to brush on the carbamide peroxide gel - the day version is applied twice during the day, and the night version needs just one application. The gel contains a polymer that dries on the teeth, eliminating the need for a tray. Oral-B Rembrandt Whitening Pen consists of gel delivered via an applicator. The patient paints on a quick-drying gel and leaves it on all night. BriteSmile also has a brush-on whitening gel option. It is being marketed as an optional extra to the company’s whitening system and is also available on the retail market.

What about some other adjuncts to help brighten and dazzle? We adorn ourselves with gold, silver, and diamonds, so why not do the same for our teeth? Two ingenious dental companies - Twindent SA and Decodent - have brought into the market some jewelry items for teeth. These tooth gems are relatively easily affixed to the enamel with bonding and create quite a sparkle! I have added this to my practice, and it truly is a rewarding experience - both for the patient and me. For the “Sweet 16” party, homecoming dance, prom, or graduation gift, these little sparklers are a fun option to offer. Not only are teenagers getting into these gems, but patients of all ages. You never know who would be interested in adorning their teeth unless you ask them.

Bonding these tooth gems is easy. The dental assistant can place them on any buccal or facial surface, using a similar clear bonding material used with dental sealants. The time and materials involved are minimal. Once the crystal is attached, it usually is maintenance-free. These adornments are very popular in Europe and are just coming into the market in this country. Utilizing these newer options may open a sparking marketing opportunity for your practice.

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We are always looking for a little niche or manner to make our practice and our place in our practice unique. Utilizing any of the above entry-level whitening procedures or tooth gems are great ideas for internal and external marketing. Not only for the young woman before a special event, but for a special birthday celebration, weddings, anniversaries, or just plain for fun.

Finding alternatives for our patients to enhance their esthetic and self-esteem sense assists in improving the marketability of our dental practices. With these other options we may offer to our patients, we are able to outreach to a wider variety of patients who may be on the verge of a more elaborate treatment plan. Helping patients place more interest in their dentition and more dazzle in their smile are our primary concerns. The dental assistant is integral in attaining these goals.

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Dr. Sheri B. Doniger has been in private practice of family and preventive dentistry for 20 years. She is currently focusing on women’s health and well-being issues. She can be contacted at (847) 677-1101 or [email protected].