Tips for Chairside Whitening

More Than Cleaning

Incorporate elective services into routine visits

Standardizing and organizing examination protocols creates a framework for recare and restorative visits. Here is an “old school” way to integrate whitening acceptance into your daily routine. The two key pieces of equipment for this tip are: a hand mirror and a shade guide.

Shade GuideOne way to increase whitening business is for assistants and hygienists to make a habit of doing a “color analysis” for each patient. With the patient looking into a mirror, simply say to them, “We know that teeth can change color over time. What I’d like to do now is to determine the current color of your teeth. I’ll need your help with this part.” This immediately gets the patient involved in their care and gives you an opportunity to talk whitening options.

Each operatory (hygiene too) should be equipped with shade guides. Set it up from lightest to darkest; make sure the shade guide also includes newer ‘bleaching’ colors. Hold the shade guide so that your patient can see the colors.

Next, have the patient guide the selection of the shade–this gives them an idea of what their teeth could look like. If your patient has an interest in whitening, he/she will normally take up the issue with you and you will have permission to ask other questions. These might include: “Other than the color shifts, is there anything else that you notice about your smile?”

Thanks to mainstream media, talk shows and magazines, patients are more knowledgeable about tooth discoloration, malodor and the importance of a healthy mouth to overall health. Incorporating something as basic as a shade guide review (at least yearly) is a powerful way to make regular inquiries into all of your aesthetic services.

Tips and Pointers in Selecting Shades

  • For most accurate results, the colors in the room should be neutral as well as the patient’s clothes. Drape the patient with a neutral gray bib or towel when taking a shade. It neutralizes the eyes’ color perception.
  • Female patients: If applicable, remove lipstick.
  • Make sure teeth are not dehydrated.
  • The mouth of the patient should be at eye level.
  • Determine the amber or gray color type of the patient.
  • Determine the base shade of the patient and remove matching shade group (Chromascope).
  • Determine the shade intensity within the shade group.
  • Compare the selected shade once again with the natural tooth.
  • Color Map: Note range of shade, striations, and color banding or mottling. Close examination will reveal a blending of various colors.
  • Collaborative Whitening: All team members can perform color assessments.

In sum, incorporating simple, “old school” basics into your protocols will help your patients understand the full menu of services offered by your practice and can help drive elective procedures such as whitening

Best Whitening Options

What’s In Your Whitening?

With patients requesting whitening procedures like they’re going out of style, now’s the time to brush up on your bleaching basics

‘Tis the season for whitening procedures, but sifting through the dozens of whitening systems on the market can be a headache for even the most seasoned dental professionals. There are many options available to dentists and consumers alike, including in-office whitening, office-distributed take-home kits, and a variety of over-the-counter products. Because of this, you might find your patients asking you, “what’s the best method?” The answer is partly subjective and includes consideration of the speed of whitening, in-office or at-home treatment, convenience, and cost.

Teeth whitening procedures are in demand for the Holidays

Teeth whitening procedures are in demand for the Holidays

Types of whitening agents

Tooth whitening is affected by (1) the concentration of the peroxide in the whitening agent and (2) the length of time it is in contact with the enamel. Higher concentrations are faster but lower concentrations can achieve the same result by extending the amount of time it is on the enamel. In-office products contain the highest concentration of active ingredients, making them more efficient in rapid whitening.

Types of active ingredients

There are two types of active ingredients that can be used for whitening procedures: carbamide peroxide and hydrogen peroxide. Both agents remove both intrinsic and extrinsic stains (unlike whitening toothpastes, which only remove extrinsic stains). Carbamide peroxide is a combination of urea and hydrogen peroxide. Once applied, it breaks down into these two components, thus releasing hydrogen peroxide. The addition of urea to hydrogen peroxide acts to stabilize the hydrogen peroxide and increases its shelf life. Thus, carbamide peroxide is most often found in OTC whitening products as well as some take-home kits. The hydrogen peroxide released is about 1/3 the concentration of the original carbamide peroxide, a process that takes about 4-6 hours. As a result, carbamide peroxide is best used in overnight trays.

In comparison, uncut hydrogen peroxide is less stable and more potent. High-concentration hydrogen peroxide whitening agents are more appropriate for in-office use.

Managing sensitivity

Tooth sensitivity is a common complaint during tooth whitening that can actually be well-managed. Sensitivity results in sharp, painful impulses in individual teeth. Continuing to remind patients that these “zingers” are not abnormal is a good way to mitigate their distress. There are many options available to reduce and treat sensitivity:

  • Advising your patient to use a desensitizing toothpaste containing potassium nitrate for 2 weeks prior to their whitening procedure
  • Administering a whitening agent that contains potassium nitrate
  • Using potassium nitrate alone or with fluoride
  • Applying a high-level (5,000 ppm) fluoride dentifrice
  • Using amorphous calcium phosphate (ACP) in the whitening agent or as a stand-alone gel

Potassium nitrate desensitizes the nerves, while fluoride and ACP work by plugging the open dentinal tubules.

Equip your practice

At PureLife, we carry both in-office and take-home whitening systems, many of them available in several concentrations of hydrogen peroxide and/or carbide peroxide. To help with sensitivity issues, some even contain fluoride.

No matter which type of whitening products you use, there’s no doubt your patients will be asking for bleaching procedures. Having a handle on each specific type can save you money…and help your practice to be more efficient. Happy whitening!