Tuesday, August 17, 2004
Copyright © Las Vegas Review-Journal

BRIGHT WHITES: Whiten Up

What was once difficult is now a cinch, making whitening your teeth a popular choice

Illustration by David Stroud.

Americans are, it seems, getting brighter all the time -- at least as far as their teeth are concerned.

For proof of that, you need only page through the telephone book and scan the ads for the dozens of local dentists who offer whitening procedures. Or, visit your neighborhood drugstore and take a look at the over-the-counter kits.

"Tooth-whitening products have gained in popularity considerably over the last two years to the point where they're one of the fastest-growing segments of the dental-care category," said Todd Andrews, a Rhode Island-based spokesman for CVS pharmacy. "We've also increased our shelf space devoted to whitening products."

Demand is huge, agreed Dr. Robert Thalgott, president-elect of the Nevada Dental Association. Thalgott's an orthodontist, so he doesn't perform whitening procedures, but says he makes many referrals for interested patients.

And who's interested?

"Every patient," Thalgott said. "Even patients with very white teeth -- everybody wants whiter teeth."

Why the sudden surge?

"I would say it's in line with the heightened interest in grooming and appearance that's been going on the last several years among both men and women," Andrews said.

Dr. Dwyte Brooks has another theory.

"It's gotten to be such a simple process, people say, `I can do that, why wouldn't I do it?' " said Brooks, a dentist and immediate past-president of the Nevada Dental Association.

Brooks said he did his first whitening procedure shortly after graduating from dental school 29 years ago.

"At that time, we were using very high concentrations of pure hydrogen peroxide," he said. Heat sources were used to intensify the effects of the peroxide -- "highly focused infrared lights -- really expensive little lights -- and actually temperature-controlled soldering irons.

"The temperature was basically about the temperature of very hot coffee. We would apply that to the hydrogen peroxide solution, a 35 percent solution. There'd be a little sizzle, almost, as the peroxide would go totally crazy. That activated the whitening."

But Brooks said dentists had to take care not to burn patients' gum tissue, or to overheat the teeth.

Later, he said, periodontists discovered by accident that a substance -- carbamide peroxide -- they were using to treat patients' gums whitened their teeth.

"The problem you had with all of these techniques was that they created a lot of sensitivity to hot and cold," he said. "There was a tremendous problem with that in the early days."

The fact the products were slow-acting and unstable made whiter teeth hardly seem worth it.

Then two or three years ago, Brooks said, the products were refined. The new ones, he said, were stable and storable, produced little sensitivity and had high energy activation, so the treatment period was shortened.

"They spent a lot of time and energy on that," Brooks said.

Product improvement led to the development of numerous over-the-counter whiteners. Patients also can purchase kits from some dental offices, and perform the treatment at home. Brooks said studies have found no discernible difference between the in-office whitening systems that employ lights and the home, or tray systems.

Except for time.

"The newest thing is called Zoom," Thalgott said. "Basically it's the same bleaching formulation, but it's formulated so you put a light on it" and shorten bleaching time.

"It's basically a one-hour thing, and then a bit of touch-up," he said.

Brooks said he does in-office whitening using lights and lasers, but the only advantage he sees is if "you've put it off and suddenly you have a wedding coming up. Otherwise, I don't know why you'd spend the extra money."

Light treatments start at about $500 and run to $750 to $800, Brooks said, while tray systems are about $200. (Brooks' practice donates all proceeds from all whitening systems to charity through the Smiles for Life program, contributing more than $100,000 so far. He's one of 100 dentists nationwide participating in the program, he said.) Drugstore treatments generally run in the vicinity of $25 to $30.

"The thing we like about the tray system is you can continue to maintain it throughout your life," Brooks said. "You have to use a minimum amount of material. It has minimum contact with gum tissue. There's not much issue with irritation. Over the hundreds that we have done, we've seen very little tissue irritation."

The average person using a tray system should see results in three to four days, he said. Those who smoke, drink a lot of tea or drink a lot of coffee -- in that order -- will generally have more staining and need a longer process, he said.

Most people, Brooks said, would need a touch-up in six months to a year. Touch-up kits are $60 and last for a year or two, he said.

Brooks said he'd have no hesitation advising members of his own family to use the products, but there are a few caveats.

"We tell people that like anything, if you overuse this, you can have potential damages," he said. "These are active chemicals, they're not totally harmless.

"We know there are people abusing this. They want this super-super-white. I don't like teeth that are too white. I see all too often that people are overdoing it."

Brooks said he thinks the popularity of whitening is parallel to that of adult orthodontics, which is being performed in greater numbers than at any other time in history.

"It's just the boomers," he said. "We want to look good. It's a generational thing."