By Bradley Dykstra, DDS

In-Office Whitening — Just do it

April 1, 2010
Esthetic dentistry, including tooth whitening, is a major type of dentistry sought after in the United States today.

For more on this topic, go to and search using the following key words: in-office teeth whitening, esthetic dentistry, profitable, Dr. Bradley Dykstra.

Esthetic dentistry, including tooth whitening, is a major type of dentistry sought after in the United States today. The quest of the baby boomers to stay forever young and society's expectations to look our best drive this demand.

Whether your practice offers whitening or not, it is important to understand that patients, both male and female, want whiter teeth — period. If your practice does not provide it, patients have several options available to them, all of which call for them to leave your practice.

Patients' choices include professional in-office whitening; professional take-home whitening with custom-fitted trays constructed in the dental office; over-the-counter whitening strips and solutions from drugstores, supermarkets, or online; and in some areas, a whitening kiosk in the mall.

Whitening benefits dentistry because it shows that patients are taking a more proactive interest in the appearance of their mouth and smile. This often leads to a desire for more comprehensive dental care. Tooth whitening provides more conservative treatment options for some patients.

Orthodontics and whitening often give the esthetic results that patients desire, as opposed to cutting down or placing veneers or crowns, both of which come with a lifetime of maintenance.

From a patient care and safety perspective, which is the best choice? Having patients go to the mall and have some untrained person advise them to put chemicals in their mouths in an environment with no infection-control guidelines and little efficacy; ordering something over the Internet that they use unsupervised; or having a whitening treatment supervised by a trained dental professional who will monitor results and be concerned for the total oral health of the patient?

How does whitening benefit you?

Is professional whitening profitable from a business perspective? Yes. Whitening can be a profitable part of your core practice and be used to promote patient retention and even acquire new patients from offices not providing whitening procedures. Whitening has never been easier due to the increased productivity of whitening procedures.

Whitening also often leads to an increased patient awareness of additional dental needs that they may choose to have done. It is important to remember that the long-term value of a patient is much greater than the initial treatment.

It is generally accepted that professionally dispensed take-home whitening is the most effective and can produce the best long-term results. The economics of this system is a no-brainer. The time needed for a dental auxiliary to create a custom-fitted tray is well worth the value of having a satisfied patient who purchases whitening gel for the next several years.

The delivery, photo documentation, and monitoring is also mainly done by trained dental auxiliaries under the dentist’s supervision. There are only minimal costs to the practice such as impression material, staff time, whitening kits, and the one-time investment in the vacuum-forming machine to construct the trays.

What are the economics of in-office whitening? The first and most important one that is often overlooked is that some patients want immediate results and are willing to pay the extra cost.

They are also willing to find a new dentist who provides this service if their regular dentist does not. The loss of the fee for the procedure is only the tip of the iceberg. The potential loss of the patient's business, his or her family's business, and potential referrals is substantial.

Providing in-office whitening can be easy and profitable. Many of the current in-office products are used in combination with a light source, heat source, special curing light, or laser. Please note that the curing lights (Sapphire by Den-Mat) or lasers (Diode Easylase by Biolase) have a dual purpose of whitening as well, which helps justify the high costs.

In the future if no light, heat, or laser is needed, that’s even better. Most procedures take up to 90 minutes of trained auxiliary time and chairtime, but with proper scheduling will not interfere with the doctor’s productivity, so again the cost of doing in-office whitening is negligible. The fee for providing whitening in one office visit is often 50% more than the take-home systems, and this more than covers the increased cost of the in-office materials and time to perform the procedure.

Another valuable feature of in-office whitening systems is that the product is comprehensive — for example, Dash by Discus Dental. Dash provides everything to complete the procedure — from the cotton rolls, face bib, and gauze, to the lip retractor, surgical suction tip, and dental dam, to the whitening and desensitizing gels — all in one kit.

This reduces the time the clinician needs to set up a room for the procedure and hunt for any additional materials around the office. Remember, time is money not only for the doctor, but also for the auxiliaries.

Also, the total operatory time needed to prepare for and complete the procedure efficiently is important. A major key to practice profitability is having effective systems, and everything in one whitening kit certainly fits the bill.

In-office whitening systems are the quickest way to whiten teeth. They are convenient for patients, and easy and profitable for the practice. Results can be seen in one, 30- to 90-minute treatment. In certain patients, results are dramatic. But for patients with stubborn discolorations, the jump-start of in-office whitening should be followed up with take-home whitening systems to achieve the desired long-term results.

Dr. Bradley Dykstra is a general dentist in private practice in Hudsonville, Mich. A graduate of the University of Michigan's dental school, he earned his MBA from Grand Valley State University. He speaks on integrating technology into dentistry, and consults via his company, Anchor Dental Consulting. Reach him at [email protected] or at (616) 669-6600.

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