According to the American Academy of Cosmetic Dentistry, tooth whitening is the most requested cosmetic dental procedure by patients of all ages. Dental consumers wanting affordable, fast results often try over–the–counter products. The dental hygienist is in a unique role as educator and advocate to provide guidance in making wise choices about cosmetic dental products marketed for at–home use.
by Donna Solovan-Gleason, RDH, PhD.
In today’s world, everyone wants to flash an esthetically pleasing smile. According to the American Academy of Cosmetic Dentistry, tooth whitening is the most requested cosmetic dental procedure by patients of all ages.1 Consumers wanting affordable, fast results often try over–the–counter products. In the search for a whitening product that works, the dental consumer looks for one that is easy to use while producing effective, long–lasting results. A myriad of whitening products are available for at–home use, making the selection difficult. Dental consumers lack current information about whitening products and turn to dental professionals for recommendations.
Cosmetic Whitening Products
Tooth whitening products for at–home use are marketed in toothpastes and as gels or liquids that are applied in trays, cellophane strips, or with a brush applicator. Toothpastes contain either a whitening agent or abrasive compounds that break down stained debris on the enamel surface of the tooth. Whitening toothpastes help to retard the buildup of stain and are typically used to extend the effect of dental office whitening procedures. Gels and liquids contain higher concentrations of whitening agent as professional strength products for home use, and are available to the consumer either over–the–counter (OTC) or through dental offices. These products are designed to produce full whitening effects in a period of one to two weeks.
The Whitening Process
Gel and liquid whitening products designed for at–home use contain either hydrogen peroxide or carbamide peroxide as the active ingredient. Whitening strips deliver 6 percent to 14 percent hydrogen peroxide. Tray systems use either hydrogen peroxide or carbamide peroxide gels or liquids with concentrations varying from 10 percent to 35 percent. The active ingredient — peroxide — works by releasing free radicals to oxidize stain–producing compounds that reside in the enamel matrix. The result of oxidation produces the whitening effect.2
Successful whitening requires application of the whitening product for the appropriate time duration and depends upon timed release of the active ingredient. Hydrogen peroxide products release 50 percent of the peroxide within 30 minutes of application. Carbamide peroxide releases peroxide at a slower rate and continues to release for up to six hours after application.3 According to Haywood, the safest, most efficacious, and cost–effective whitening product is one containing 10 percent carbamide peroxide.4 Products with higher concentrations of carbamide peroxide are safe and effective but may cause increased tissue sensitivity.
Whitening Product Trends
At–home whitening should be a technique that is easy to apply and one that requires minimal application time with quick results. Whitening products marketed for at–home use should be provided in concentrations that minimize tooth and tissue sensitivity as a common side effect of whitening. A product containing 16 percent carbamide peroxide is now available for at–home use in a brush applicator form.
Mirawhite Pro, distributed by Hager Worldwide, is a whitening gel in a pen–brush applicator that produces professional level whitening results of up to three shades in just seven days.5 The product whitens by the discharge of active oxygen to remove tooth stains and deeper discolorations of the enamel. The product is easy to use and application is complete in five easy steps.
To complete the whitening procedure, the patient completes the following steps:
- Brush and floss all teeth.
- Turn dosage wheel on applicator wand to expel gel onto the brush tip.
- Apply a thin layer of gel to each tooth.
- Allow whitening gel to sit on teeth for eight to 10 minutes.
- Rinse mouth with warm water after application.
The procedure is simple to complete, economically priced, and produces whitening results quickly, thus increasing patient compliance. The brush–on technique minimizes tissue sensitivity, which is often a factor that affects the patient being able to use a whitening product at home on a daily basis for a short period of time. Convenient home use and minimal application time further encourage patient compliance for completing the whitening regimen.
Guiding The Consumer
Dental consumers continue to search for at–home whitening products that are cost–effective and produce immediate results. The hygienist’s role as educator and advocate helps patients receive current information about dental products and treatment options. When making recommendations, hygienists should first remind patients about the need for a dental evaluation prior to whitening. Hygienists are in a unique position to provide guidance based on individual needs and preferences and assist the dental consumer in making wise choices about products marketed for at–home use.
About the Author
Donna Solovan–Gleason, RDH, PhD, is an assistant professor at Clayton State University in Morrow, Ga. You may contact her at donnasolovan–[email protected].
1. American Academy of Cosmetic Dentistry membership poll 2000. Available at http://www.aacd.com/media/market/_research_data.aspx.
2. Raposa, K. The Whitening Generation: What you need to know to help your patients and your practice make the right decisions about tooth whitening. Access 2006; 20(8): 24–28.
3. Haywood, VB. Whitening particulars. Dimensions of Dent Hyg 2006; 4(5):22–24.
4. Haywood, VB. New bleaching considerations compared with at–home bleaching. J. Esthet Restorative Dent 2003; 15: 184–187.
5. Data on file. www.hagerworldwide.com/MSDS/MiraWhitePro.