Teeth-whitening products flood shoppers with choices

By Susan Jenks, Florida Today

Once confined to a small section of the grocery store or pharmacy, teeth-whitening products are so numerous today, they occupy the "dental aisle of confusion," according to many dentists.
Consumers face an array of over-the-counter whitening gels; toothpaste with whitener in them; and even an oral mouthwash or two, which claim to whiten your teeth as you swish.
"It's a huge market," says Dr. Kimberly Harms, a private-practice dentist in Farmington, Minn., and a consumer spokeswoman for the American Dental Association in Chicago.
"So many people are bleaching their teeth today, we had to adjust our shade guides upward recently" to reflect the demand for brighter, whiter teeth, she says.
Another dental group, the American Academy of Cosmetic Dentistry, which represents dentists who specialize in cosmetic treatments, estimates the demand for tooth whitening has risen 300% in the past decade. Millions of Americans buy whitening products over the counter, or turn to dentists for a brighter, more dazzling smile.
"Bleaching is the No. 1 dental procedure requested by patients under 20, and in those 30 to 50 years of age, as well," says Dr. Bert Chodorov, a dentist who is an accredited-Academy member and runs the Center for Advanced Cosmetic Dentistry in Melbourne, Fla. "Older individuals also want this. White and bright is beautiful."
Chodorov cautions that, while some people want "white, white, white," his personal preference is for a more natural look, which sometimes is the only realistic option.
"You don't want the first thing that comes into the room to be your teeth," he jokes.
Dentist Dr. Lisa Goff describes the tooth-whitening demand as "absolutely huge" with costs that range from $300 to $550. Although there are two in-office dental whitening procedures available, neither is covered by insurance.
The lowest price tag is for standard whitening, which involves creating a customized plastic model of the mouth for in-home bleaching. Typically, individuals wear customized mouth "trays" containing a whitening solution for several hours a day or overnight, for two weeks, after a proper fitting.
"In about two weeks, you're usually set," Goff says, with the trays reusable for touch-ups, whenever necessary.
Plus, because they slide snugly into the mouth, the solution "doesn't gush out everywhere," as so often is the case with an over-the-counter product, she says — thus providing a higher concentration of bleach where you want it.
Light treatment whitening
The alternative, a more expensive whitening procedure, uses a light to accelerate the bleaching process during a one- to two-hour visit to the dentist's office. The best known system is called the "Zoom."
What makes it so much more expensive is the chair time, Goff says, although "the Zoom gives you a great jump-start" on whitening, and there is less gum irritation and sensitivity than with the trays.
Cindy Ville, an Indialantic, Fla., resident who recently underwent the procedure at Goff's office, says she is happy with the results, seeing an immediate difference in her teeth in the "before" and "after" photos.
"It was a long time to sit in the chair," she concedes. "But, from what I understand, you use the Zoom just once and then maintain with the trays and the (whitening) gel."
Still, the American Dental Association's Harms calls the light treatment "an accessory" at this point.
"The question is: Does it matter if you use the light or not?" she asks. "Does it actually accelerate the whitening process? The results, so far, vary, so we aren't sure."
But, no matter which treatment individuals choose, the at-home tray approach or the light-based treatment, Harms stressed, the teeth get bleached by the concentrated hydrogen peroxide solution that is a part of each.
"You are getting your teeth bleached in a few hours," she said. "And, for some patients who can't stand the trays, this is the way to go."
Dr. Ronald Richardson also emphasized the convenience of the Zoom, especially for the busy businessman or — woman who want whiter-looking teeth in a hurry.
He says he combines the light-based treatment with a backup tray, so whitening is easily touched up later at home — a practice commonly followed.
Offerings vary
As to the difference with over-the-counter products, Richardson, like his colleagues, cites several:
Most over-the-counter whitening products tend to have weaker bleaching solutions, and while many of them work, the process tends to take longer to whiten the teeth.
"It takes so long, many consumers get discouraged," Richardson says. "Dentists use prescription-grade products," with a hydrogen-peroxide strength of 20% or more, compared with less than 10% in most over-the-counter products.
Some over-the-counter whiteners, especially strips, are difficult to position, except on the front teeth, so you may get whitening in front, but the side teeth stay yellow, according to several dentists. Dentists treat the whole mouth to ensure a totally white smile, they say. How white is white enough, and at what point does too much whitening erode enamel? Although not clearly defined, with over-the-counter whiteners, Chodorov says, consumers make these judgments themselves, and that's "the biggest problem."
Moreover, "if they think it will whiten the crowns or fillings, they are wasting their money," he says. Office-based whitening will not do this, either, the dental group's Harms says, as bleach does not whiten porcelain, "and if you have a lot of fillings, they don't bleach."
"This is for natural teeth," she says.
Some individuals who need a new crown in front can have their natural teeth whitened to match it first, she says, and if that fails to work, there are other options available to spruce up a smile, such as bonding or creating veneers.
Ultimately, "the biggest thing (with whitening) is what you're comfortable with" — whether it's custom-made trays, a quick zap with the Zoom or a whitening product found in a drugstore.
In this latter case, however, she advises, read the labels.
Those carrying the American Dental Association's seal of approval, "at least shows there has been some independent evaluation of the product," she says.

Fonte: http://www.usatoday.com/news/health/2007-01-06-teeth_x.htm - 05/01/07