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What to Know About Whitening

Course Number: 491

Non-dental Options

Description: Over the past decade non-dental venues, such as mall kiosks or spas have become popular places for teeth bleaching. These options offer convenience and can provide this service without dental professionals by loading bleach in a tray then allowing individuals to administer the product to themselves. 26It is important to advise patients of the importance of professional dental supervision when bleaching. An issue with non-dental venues is that it may give the appearance of a professional setting, with some employees wearing scrubs or lab coats. However, most do not have the education or training to help someone who may have contraindications to bleaching or experience adverse side effects.3,26,27

Pros: Access, convenience, less expensive than in-office.

Cons: Unsupervised by professionals and unregulated; gives appearance of providing professional treatment. Employees of the kiosks or spas typically do not have the education to determine an individual’s contraindications to bleaching or manage an adverse reaction.

Table 3. Summary of Pros and Cons for 4 Categories of Whitening Options.

Professionally Applied In-office

Pros: Quickest results; professional supervision; gingival protection; safe and effective.

Cons: Most expensive option; may result in more intense sensitivity than other options;7,14 the dentist (not patient) controls the outcome when bleaching is completed in the office; still may require multiple sessions/take-home trays to accomplish desired results;7 the most chairside time at the office.5

Dentist Dispensed Take-home

Pros: The majority of research on bleaching is on this option and shows high degrees of safety; patients can control the results through self-administration and still receive professional supervision; lower cost and less chairside time than in-office procedures with fewer adverse effects.7

Cons: Compliance is necessary; results are not as instantaneous as in-office options; patients can misuse and excessively wear trays leading to sensitivity.5,7

Consumer Purchased OTC

Pros: Least expensive option; easy to access products; high degree of safety; no chairside time required.

Cons: Lack of professional supervision which can result in adverse effects or mismanaged expectations; individuals must be compliant; OTC trays are not custom fit and may be uncomfortable; people with crowded or overlapped teeth may see poor results; compliance is necessary.

Non-Dental Options

Pros: Access; convenience; less expensive than in-office.

Cons: Unsupervised by professionals yet gives the appearance of providing professional treatment; unregulated; employees of the kiosks or spas typically do not have the education to determine an individual’s contraindications to bleaching or manage adverse reactions.5,17