Lighten Up

Consumer demand is on the rise for procedures and products that whiten the teeth.

Focus On Your Smile

April 07, 2002|By Tricia Bishop | Tricia Bishop,Sun Staff

When Maria Sheriff was crowned Miss Maryland U.S.A. in 1998, one of her favorites in the prize package wasn't what you might think.

It was tooth whitening.

"I never thought just doing a little bit to your teeth would be that exciting, but I love it," the 27-year-old Bowie resident says. "It's made me much more confident. I didn't realize it would make that much of a difference."

But whitening isn't just for beauty queens.

According to the American Academy of Cosmetic Dentistry, the procedure is the most requested cosmetic work among all people up to age 50 (It's No. 2 behind crowns and bridges for 50 and older), and requests have increased by more than 300 percent in the last five years.

If the marketplace is evidence, the demand is obvious. You'll see it in your local drugstore's toothpaste aisle. The shelves are lined with every whitening product imaginable: gels and strips, toothpastes, mouthwashes, dental floss and whitening gum -- all claiming to put you on the path to that Hollywood smile.

And dentists have their own bag of whitening tricks: more gels; custom-fit, super-thin mouth trays; and even lasers.

"It comes down to self-image and self-esteem," says Richard Price, an American Dental Association spokesman and a clinical instructor at Boston University's school of dentistry. "People do it to look good, to feel better."

And the more people do it, the more others want it.

So how do you know what works or even where to start?

"Be sure your mouth is healthy before you begin," says Price, who just retired from his own dental practice five months ago. "Visit your dentist first."

The basics

Dentists can diagnose the cause of discoloration and make sure it's due to normal staining or aging (and not decay) and help guide you through the process -- whether you choose to use over-the counter products or the high-powered, doctor-administered stuff.

Here's what you need to know before you get started:

* Whitening does not change the basic tint of your teeth, which is determined by heredity. It lightens them by removing embedded stains. If your teeth are yellow (as most teeth are) or brown or gray by nature, they will still be when you get done.

* Whitening will not affect restorative material: crowns, fillings, veneers. If you lighten your teeth, be prepared to swap your existing dental work for lighter versions, too.

* Your teeth will probably be sensitive to hot and cold during the whitening process, which can take up to several weeks. Price says it goes away in one or two days after stopping. Otherwise, there's no evidence the procedure harms your gums or enamel.

* And finally, there's no telling how well your teeth will respond. Sheriff's Sandy Spring dentist, Linda Steel, says she's had patients with nearly no results and some with tremendous results, and they're all using the same whitening process.

In choosing what type of product to use, price is a big factor. Store-bought kits cost between $8 and $40, and online or phone-based specialty companies can charge up to $150. But those products are generally less effective and contain a smaller concentration of whitener than the ones your dentist uses, which start at about $425 for take-home gels and $700 for in-office laser- and power-bleaching.

Whitening toothpaste, gum and dental floss are too weak for real whitening, Steel says. They're more for smile maintenance and keeping your mouth healthy. Price likens them to wiping the dirt off a white television. Have you really whitened it or just removed the surface stain?

A step up from these are the over-the-counter gel kits from companies including Rembrandt, Natural White and Crest, which offers its gel in coated strips of film.

"They will lighten teeth," Steel says. "The downside is you're not being monitored by a dentist. My best analogy is if you're going to highlight your hair, you can pick up a kit and do it yourself or go to a professional. Which would you choose?"

You pay for the tray

Another problem with the kits is the fit.

"You're using a generic, one-size-fits-all container to hold the gel against the tooth," Steel says. "They are not going to hold the gel there for an extended period of time because they don't fit well."

In fact, it's the fit of the tray you're really paying for with dentist-administered, take-home gels, the favorite whitening method of both Price and Steel. Steel charges $425 for the whitening gel and applicator mouth tray, which should be worn daily over several weeks. (Some are meant for overnight wear and others for day wear.) Of that fee, about $30 goes for the gel.

"The key component is the trays," Steel says. "They're custom-made for each person and made in such a way that there's minimal contact of the gel to the gums. They're very tightly fitted, so you use less gel, which is good because more gel can cause more sensitivity."

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