By Karen Davis, RDH, BSDH
The world of teeth whitening is alive and well, as evidenced by the number of hits you'll see when searching for the words "teeth whitening" on Google, viewing dental practice website promotions, or examining the latest Groupon specials. People still want white (or whiter) teeth. By and large, the topic of teeth whitening still generates a great deal of interest among dental patients. So perhaps it's time to examine a somewhat underutilized opportunity to make your patients happier while simultaneously influencing the practice's bottom line. Let's take a look at how whitening pens are a win-win.
Regardless of what method of in-office whitening you offer, we all know that patients benefit from touch-ups, yet compliance for wearing trays at home or returning for an annual in-office whitening touch-up isn't at 100% with patients. While examining methods to increase professional and at-home whitening warrants having a brainstorming session at an upcoming team meeting, providing whitening pens for your patients requires little planning, and little chair time is necessary for instructions. The Nike method works well: "Just do it."
Those of you who saw the movie Field of Dreams can relate to the "if you build it, they will come" directive. But rather than building a baseball field in the middle of a cornfield, with whitening pens all you need to do is offer them, coupled with a small amount of enthusiasm. Surprisingly, according to research conducted by Philips Oral Healthcare, only 10% to 15% of whitening conversations in the dental office are initiated by dental professionals, despite the fact that 80% of U.S. patients surveyed are concerned about yellowing teeth. This is a golden opportunity that can be capitalized on daily in your practices.
The difference between products
Not all dental professionals understand the differences between hydrogen peroxide and carbamide peroxide products, so here's a quick review of some basics. Carbamide peroxide is essentially hydrogen peroxide with a urea molecule added to it. During the whitening process, carbamide peroxide becomes hydrogen peroxide as the molecules break down, with approximately a three-to-one ratio, so a whitening gel containing 10% carbamide peroxide breaks down into 3.6% hydrogen peroxide. The results of whitening are determined by the exposure time of the agent and the concentration of active ingredients of the formula, with lower sensitivity typically corresponding to lower concentrations of whitening agents. Compared to hydrogen peroxide, carbamide peroxide has a longer shelf life and some-although not all-studies have found carbamide peroxide to cause less sensitivity compared to hydrogen peroxide when used for whitening. That said, most whitening pens on the market today are hydrogen peroxide-based, as it produces maximum whitening significantly faster than carbamide peroxide.
There are a wide variety of types of agents and concentrations available in the whitening pen market. For example, the Philips Zoom Whitening Pen contains a 5.25% hydrogen peroxide gel, Heraeus Kulzer's Venus White Teeth Whitening Touch-Up Brush contains 9% hydrogen peroxide, the Liquid Smile Professional Whitening Pen contains 12% hydrogen peroxide, and OraPharma's EZ White Pro Whitening Pen contains 18% carbamide peroxide. These pens are compact and easy to carry with you, as seen in Figure 1.
Figure 1: Compact and easy-to-carry whitening pens.
Do whitening pens work?
The answer to this question depends upon the intended use and expectations of the user. Whitening pens can be highly effective as a "touch-up" to in-office whitening or when used prior to special occasions as a boost to lighten teeth. Evidence-based data on this subject is almost nonexistent, but an external study of the Philips Zoom Whitening Pen provides some insight into patients' experiences.
In 2012 Metrix Labs surveyed 78 users, aged 18-60, who were "interested in whitening solutions." After two weeks of daily usage of the Philips Zoom Whitening Pen, 80% of users reported that they found the process to be easy and effective in lightening teeth and said they would recommend the process to others. My experiences have been similar with users in the dental office and a high percentage of repeat sales, which indicate patient satisfaction with the outcomes.
Depending upon the pen and the agent used, patients can expect whitening by three to four shades at the end of a two-week regimen of daily whitening. The ease of use that whitening pens offer increases the likelihood of compliance for a two-week period, and therefore the potential for satisfaction is high; however, one wouldn't want to select a two-packs-a-day cigarette smoker and heavy coffee drinker who has never even used a whitening toothpaste as the first candidate for whitening pens. It is important to set realistic expectations for what whitening pens can accomplish.
The win of whitening pens for the patient
No time in the dental office is required to whiten your teeth. No trays are necessary. You have a pen loaded with whitening gel at home, at the beach, at the office, or anywhere, and you click the pen to expel gel onto the tip (see Figure 2). Then you simply "brush" or "paint" the front surfaces of the teeth with gel while smiling to ensure all teeth in the smile line are included. That's it.
Figure 2: Applicator tip for the Philips Zoom Whitening Pen.
Naturally, you avoid painting the gel onto the soft tissue, restorative materials, and exposed root surfaces, but the process is easy. The viscosity of the gel enables it to remain in contact with the tooth surface long enough to penetrate into the enamel and lighten darkened areas.
Whitening pens will hold enough gel for 30-60 applications, depending on the product. Most manufacturers advise the user to apply the whitening gel twice daily for a two-week period. The taste is pleasant and noticeable results are generally seen within the first couple of days.
The business win for the practice
Return on investment for initiating conversations with patients about whitening pens can be substantial. Only one to two minutes of chair-time instruction is required to demonstrate how to use the pens while on the go. Selling five pens per day in a four-day work week at a price point between $20-$30 could yield a $10,000-$15,000 profit per year. If only two pens were sold per day in a four-day week for higher priced pens, the profit could easily be over $20,000 annually.
And, don't forget, this is for a U.S. market that spent $13.5 billion on surgical and nonsurgical cosmetic procedures in 2015, according to the American Society for Aesthetic Plastic Surgery. People are willing to invest in methods to look younger and improve appearances. Dental professionals should not miss this opportunity to make patients happy and increase practice revenue.
If you are not currently seeing whitening pens walking out the door in your practice, come up with an overall plan to tap into the whitening desires of your patients. This could include strategies to increase in-office and take-home whitening-just don't forget to include whitening pens in your menu of whitening options. Also, here's some good news: Philips Oral Healthcare recently developed a well-planned success guide for Philips Zoom users, and many of the same strategies to increase Zoom sales also apply to whitening pens. Tap into this free resource at zoomsuccessguide.com.
If you aren't currently offering whitening pens, decide which brand of whitening pens to offer to your patients and have all team members use them twice daily for two weeks to experience your own results. Sharing your own experiences increases trust and excitement among patients. Use social media to share your experiences.
As a team, role-play and brainstorm about how to initiate whitening conversations with your patients so it is "top of mind" and comfortable for all team members to engage in conversations about the benefits of using whitening pens. Remember, less than 15% of whitening conversations are initiated by dental professionals, and you can change that experience for your patients.
Ask patients to report their experiences with whitening pens on social media. With their permission, post before-and-after photos on your practice's social media sites. Also be sure to keep whitening pens visibly available where patients check out in case they forget to pick one up during their dental procedures.
When it comes to whitening pens, it is a clear win-win for patients and the practice if you are willing to employ the Field of Dreams commitment to get it started and the Nike method to keep it going. RDH
Ideas for integrating whitening pens
Whitening pens can be dispensed easily due to their ease of use, low price point for sales in the office, and low tooth sensitivity outcomes. Following are ideal indications for whitening pens:
- Patients who have previously completed in-office professional whitening or at-home whitening who are in need of a touch-up
- Patients who are noncompliant with the tray system for touch-up whitening
- Patients with darker isolated teeth surrounding crowns, veneers, or resins
- Busy patients interested in easily maintaining professional whitening results
- Whitening candidates seeking to "test the water"
- Patients who tend to be sensitive to other whitening options
- Welcome gifts presented to new patients joining your practice
- Unexpected gifts presented to patients having completed necessary nonsurgical treatment
- Loyalty gifts for long-term patients
- Birthday, Valentine's Day, and special occasion gifts
- Kind of like flowers . . . for no reason at all!
Likely, your team can creatively suggest many more indications to sell or gift whitening pens to patients. This would be a great topic for your next team meeting because the investment is minimal and the satisfaction high.
Karen Davis, RDH, BSDH, is the founder of Cutting Edge Concepts, an international continuing education company, and practices dental hygiene in Dallas, Texas. She is an independent consultant to the Philips Corp., Periosciences, and Hu-Friedy/EMS. She can be reached at [email protected].