Smile Therapy - teeth whitening procedures

Kiplinger's Personal Finance Magazine, April, 2001 by Christina Ianzito

HEALTH | If Mona had only known what more Americans are discovering about TEETH WHITENING.

IF YOU BELIEVE the advertisements, you're not just whitening your teeth. You're brightening your smile, becoming more attractive, and projecting confidence that can be the key to a more fulfilling life. A video for one take-home bleaching product called Opalescence suggests "lightening up your life." Grinning patients offer testimonials, including a sequined Miss Utah USA who avows that "it really makes you feel more confident about your smile." It's an emotional pitch--smiling equals happiness--and it's working.

Americans, men and women equally, are spending about $1.5 billion a year on dental bleaching products, and that may be the tip of the iceberg: Only about 10% of people claim to be satisfied with the color of their teeth. It seems the passage of time, smoking and coffee drinking--and comparison with the pearly-white choppers on movie stars, models and TV anchors--have managed to make the average enamel look a bit dingy.

That the country now covets a whiter shade of pale is the delight of dentists, whose profits have suffered with the general healthiness of modern, fluoride-fortified teeth. And less-credentialed entrepreneurs are thrilled as well. Some have taken to the Internet or other outlets to hawk their own do-it-yourself systems for the low, low price of $59.95.

Most whitening procedures rely on hydrogen peroxide--the same stuff used to bleach hair--or carbamide peroxide (a more viscous, easier-to-handle form of hydrogen peroxide) to lighten stains and brighten your natural coloring. Generally, the quicker the method of bleaching (some take as little as one hour), the more expensive. Cheaper methods may take weeks to work.

The resulting whiteness can last for years or months, depending on your lifestyle. Routinely eating and drinking foods and liquids that stain tooth enamel will dull the effect more quickly. Regularly using a whitening toothpaste, which has a very small amount of peroxide in it, may help keep teeth bright (or "brite," in marketing parlance) longer.

Lightening fast

A LEADING accelerated method is BriteSmile, which has 17 centers of its own, plus 1,700 dentists who use the BriteSmile technology in their offices around the country for a total of 63,000 whitenings last year. Practitioners charge $500 to $600 for a one-hour treatment that involves gas-plasma light technology developed by a former NASA scientist. A gel of 15% hydrogen peroxide is applied to the teeth, then activated by the light during three back-to-back 20-minute sessions, during which patients can watch TV or quietly contemplate their imminent dental transformation.

BriteSmile promises that "good oral hygiene and regular professional care will help maintain the BriteSmile results for about two years," but clients can also buy into the Smile Assurance program: Purchase two tubes of $15 whitening toothpaste and get two Smile Assurance certificates, each of which is good for a half-price procedure once your grin starts to dim.

Take-home, dentist-supervised treatments are as effective and marginally more affordable, starting as low as $300 (although some dentists will charge up to $700). The most common system involves custom-fitted trays that deliver the bleaching gel over a period of time. The dentist takes an impression of your teeth, from which he or a lab makes a plaster cast and then flexible plastic molds. The molds, or trays, have a thin space for the whitening fluid built in and fit over your teeth like a mildly uncomfortable glove.

The patient then chooses either to wear the trays overnight, which delivers a strong bleach concentration and yields visible results in as few as two applications, or to wear them from one to two hours a day for two weeks. In either case, you simply brush your teeth (ideally, your dentist should have polished your teeth before so the enamel is spotless), fill the plastic trays with the whitener, and squish them onto your upper and lower teeth.

The overnight system is not recommended for light sleepers or anyone anticipating a romantic evening interlude, unless your partner enjoys getting drooled on--especially on the first night, when users tend to overfill their trays with the minty, chalky stuff.

Dentists can choose from a range of whitening systems, but what matters is the percentage of carbamide peroxide in the gel; it varies from 5% to 30%. For example, Colgate's overnight system uses a conservative, 10% carbamide-peroxide gel. A high peroxide level may irritate the gums or make the teeth feel sensitive--sometimes painfully, if your tooth pulp, where the nerve endings lie, is inordinately large or if there are microcracks in a tooth. "Fortunately, if you stop right away, the sensitivity disappears within two days," says Michael Tabacco, a dentist and prosthodontist in Washington, D.C.

Getting in on the act

GIVEN THE dollars spent on whitening, it's no surprise that nondentists are trying to catch the whitening wave. For instance, Sherri Shawgo, a dental technician in Kansas City, has set up a company called Stay White. For $250, she will go to a client's home or office and prepare custom-fabricated trays.