According to BACD and AACD research teeth whitening is the single most requested cosmetic treatment in dentistry.

before

after

Some practices perform a huge amount of whitening and others do very little. So a common question that arises is: what are the common features of practices that do a lot of whitening and what steps should dentists take in order to develop this service to take advantage of the continuing trend.

In the first in  a series of articles we will look at dentist factors.In the next articles we will look at Practice, Patient, Staff, marketing and clinical factors

There is no doubt that the individual dentist’s approach to his or her patients is highly significant. Even within the same practice one associate will be doing many treatments a week and anther may do none.

The demand for whitening is largely latent. Patients on the whole would like a whiter smile, but the conversation between dentist and patient needs to bring this demand out. 
There does seem to be a direct relationship between the amount of whitening that is done and the frequency that it is offered.  So why are some dentists so confident about offering whitening to large numbers of patients, and others only offer it if a patient expressly asks.

Through many interviews with dentists we have found a major reason some do not like to mention whitening (or any cosmetic treatment) is that they do not want to be seen as salespeople. This fear is grounded in legitimate concerns. The doctor/patient relationship is built on trust and has been nurtured to reassure patients that as dentists we are acting in their best interests. If this is a concern you have consider the last time you bought anything. The person offering it to you may have been a waiter, a travel agent or an architect. Now consider whether some of those interactions were based on high trust and as the expert in their field, how grateful you were to the people who offered a particular product or service to you.

Consider Orthodontics. The health benefits have never been adequately proved. Orthodontics is clearly an elective cosmetic treatment. Does that mean that as dentists we should not offer parents ortho treatment for their kids – in case we are seen as salespeople?  

In fact if you look into the history of dentistry, it soon becomes clear that throughout history in the same way as the smile has always played a major role in human interactions, aesthetics has always played a major role in our profession. So it seems that the dentists who offer whitening more do it precisely because they do believe that they are acting in the best interests of their patients by informing them of the possibilities of improving their smile without doing any harm.

There are of course excellent moments to mention whitening:

1. Before doing any treatment at the front of the mouth – to avoid repeat dentistry if whitening is done later – common phrases used by high performing dentists include:

I want to replace this filling/crown as its leaking – would you like to whiten your smile first so we can match to the new colour – you wont be able to do it later without replacing all this new work

I've got to ask you if you ever want whitening – now is a good time

The great thing is that in this approach the dentist is acting in the patients’ best interest by offering whitening.

2. At examination if no other treatment is necessary

well done, you are brushing well and you definitely don’t need any treatment. You might want to look at whitening the smile. Ive just had it done look at my teeth / we have a summer offer / its really simple / safe / predictable these days

Letting the patient know that they don’t need the treatment, often makes life easier for patient and dentist alike. It gives the patient a really simple way to say “no” without fear of offending the dentist and also makes it easier for the dentist to offer whitening more.

3. Before any major treatment plan

If we are going to do all this work we might aswell whiten first as it is low cost and safe / really predictable these days etc

4. Whitening bundled with contouring , build ups or orthodontics

you are lucky that the basic shape of your smile is good, we can whiten and contour at a fraction of the cost of veneers

I can whiten predictably and build out this one tooth

Whitening is safe, reversible and now predictable with some systems like Enlighten even guaranteeing results. There are very few treatments carried out by dentists which fulfil these criteria. With the public and press interest in whiter smiles, most dentists should have no troube increasing treatments

Payman Langroudi is clinical Director at Enlighten Research Labs. He has been involved in the development of several whitening systems being used by dentists worldwide.
Contact Dr Langroudi
payman@enlightensmiles.com

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