Center for Cosmetic Dentistry

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Demand surges for teeth whitening procedures and products

By Debra Carr-Elsing The Capital Times

February 18, 2003

Teeth shouldn't glow in the dark. Nor do you want chompers so impossibly white that your smile enters a room way before you do.

"But whiter teeth are perceived as younger teeth," says Dr. Michael Kokott of Associated Dentists in Verona and at 4506 Regent St.

The desire for bright smiles is the latest trend in cosmetic dentistry that's sweeping the country. In fact, tooth whitening is the No. 1 requested cosmetic dental procedure, according to the American Academy of Cosmetic Dentistry, which is headquartered in Madison.

"Consumer demand for tooth whitening has grown by 300 percent in the past five years," says Dr. Christian Kammer, who runs Madison's Center for Cosmetic Dentistry, 2709 Marshall Ct.

Besides that, new over-the-counter products such as whitening strips, paint-on gels and toothpastes seem to hit the market every week, boosting annual sales of the tooth whitening industry to billions of dollars.

"Whitening procedures in the dental office are more affordable now than ever before," says Kammer, who is a founding member of the AACD and a frequent lecturer for the organization's annual scientific sessions.

In-office bleaching procedures using either hydrogen or carbamide peroxide, for example, typically cost $350 to $600, while custom-made teeth trays prepared by a dentist for home use run about half that.

Over-the-counter products, which contain solutions with weaker peroxide concentrations than those dispensed by dentists, cost between $15 and $40.

"For folks who just want to dabble with whitening, these store-purchased kits can work, but they're not as effective -- or as strong -- as what patients can get in a dental office," Kammer says.

Inappropriate use of over-the-counter bleaching products also can cause significant damage to tooth enamel, Kokott warns. So package directions should be followed.

During chairside bleaching, a rubber shield may be used to protect a patient's gums, and a special light generally enhances the bleaching agent's action, says Dr. Joe Carrick, a dentist with OakPark Dental, 330 S. Whitney Way.

"Teeth whitening has been around for years," he says. "The older, teeth-tray method has mixed results because it's based on patient compliance." Besides that, teeth trays have a peroxide gel that gets diluted with saliva in the mouth, reducing its effectiveness, says Carrick, who also is a past president of the AACD.

These tray methods -- with varying usage regimens that range from twice a day to twice a week -- also generally take at least 4 to 7 weeks for significant improvement in teeth discoloration, he adds.

A home regimen, however, may be prescribed by dentists to maintain whitened teeth following an office procedure. Teeth bleaching isn't permanent because of continued exposure to foods that stain.

"Grayish stains on teeth that come from being given the antibiotic tetracycline early in life -- before teeth were completely formed -- are very difficult to remove," Carrick says.

It's easier to lighten outer tooth stains caused by coffee, cola, teas, red wines and smoking, for example. Plus, the bleaching process is inhibited by plaque and tartar buildup, so teeth need to be completely clean before beginning the process, Kokott suggests.

"Bleaching does not lighten porcelain crowns and tooth-colored restorations," Kokott warns. So previous dental work may no longer blend in as well if surrounding teeth are lightened.

Another snag can be sensitivity, he says. "People with root surface exposure and who already are sensitive to hot and cold may have some sensitivity to the bleaching process."

The good news, Kokott adds, is that such sensitivity isn't extremely painful, nor does it usually last long.

If sensitivity is an issue, Kammer suggests caution with tray systems that cover gums with a peroxide solution. A better option may be dental office procedures that apply bleaching gels directly to tooth enamel.

"Bleaching is safe and effective, but ideally patients need to be screened to make sure that they're good candidates for the procedure," Kammer says.

Keep an eye on the labels of whitening toothpastes, too. Many of these products don't actually have a bleach component, Kammer says. They merely are abrasives that lighten teeth by polishing stains off.