1. Are you offering an in-office whitening program? If so, what system are you using?
There are likely many who disagree, but I truly am not a fan of in-office whitening programs. Why? Because patient expectations are way too high (thanks to social media), and many patients can’t understand why their A4 teeth didn’t get as white as your lab coat and subsequently stay that way! Disclosures and procedural explanations don’t seem to hold a lot of value to protect you as a provider, especially when the patient is investing a significant amount to have in-office whitening services. Now, have I tried in-office whitening? Yes—however, it’s not something I currently offer, mainly for two reasons: First, there isn’t a demand for it. I live in a rural area. Does that mean I don’t advertise or push for it? Perhaps, but in response, I will defer to patient expectations. Second, the majority of patients interested in tooth whitening want to make it an economical and long-term investment, so I push for the at-home systems.
2. What at-home system do you use?
I’ve used several whitening systems in the past, but my go-to and favorite is the Ultradent Opalescence system. The cost is favorable, there are five different bleach concentrations, and it’s patient friendly. I’m a “simplicity is the ultimate sophistication” kind of person, and as a result, my office fabricates quite a few at-home bleaching systems. Patients love purchasing them as Christmas or birthday gifts for spouses and other family members.
3. How are you handling any sensitivity?
Most patients have sensitivity to some degree with bleaching, so I’ll always advise them to do a variation or combination of the following:
1. Use sensitivity toothpaste. I’ll recommend over-the-counter and prescription products.
2. Shorten the duration of bleach time sessions, bleach every other day, etc. Custom trays make this easy.
3. For the extreme cases, I also suggest Ultradent’s UltraEZ gel, which can be used in the bleach trays themselves or in disposable prefilled trays.
1. Are you offering an in-office whitening program? If so, what system are you using?
We currently do not offer an in-office whitening system. We focus on a few home-based systems.
2. What at-home system do you use?
We use two whitening gels with custom trays that patients can wear at night or during the day: Opalescence by Ultradent and PolaNight by SDI. Our office focuses on innovative models of caries prevention, and we often use these custom trays to achieve biofilm control (by using whitening gels) and for remineralization agents in high-caries-risk patients.
3. How are you handling any sensitivity?
We handle sensitivity first by controlling how much and how often the patient uses the product. I live by the “low and slow” model of whitening: start out with a low percentage of the active ingredient, and only use the materials for a short amount of time before working your way up to a stronger product for a longer period of time. For patients who are extrasensitive, we use Curodont D’Senz to control discomfort.
Stacey L. Gividen, DDS, a graduate of Marquette University School of Dentistry, is in private practice in Hamilton, Montana. She is a guest lecturer at the University of Montana in the Anatomy and Physiology Department. Dr. Gividen is the editorial director of Endeavor Business Media’s clinical dental specialties e-newsletter, Breakthrough Clinical, and a contributing author for DentistryIQ, Perio-Implant Advisory, and Dental Economics. She also serves on the Dental Economics editorial advisory board. You may contact her at [email protected].
Erinne Kennedy, DMD, MPH, MMSc, graduated from Nova Southeastern College of Dental Medicine in 2015. She is a board-certified public health dentist with a master’s in dental education from the Harvard School of Dental Medicine. She serves in an innovative practice model for the Massachusetts State Employee Fund at Alliance Dental Center LLC in Quincy, Massachusetts. Contact her at [email protected].
