Dr. Linda Greenwall talks to us about teeth whitening and whether or not dentists understand the science behind it.
Tooth color is currently a major concern for many patients, leading to the question of whether teeth whitening is an exact science? And if you understand it? Read on as Dr. Payman Langroudi, marketing expert Prav Solanki, and the legendary Dr. Linda Greenwall discuss this controversial topic.
Dr. Payman Langroudi: What do you say to dentists who say that “whitening is not rocket science and is not a topic that anyone should choose to focus on because it is not real dentistry?”. I mean, I know my answer to that, what's yours?
Dr. Linda Greenwall: The biggest problem I have when teaching dentists is that they never bothered to learn about the science of whitening, not the evidence or the research. They don't know about whitening. They make it up as they go. They make up random facts, a new associate will join the practice, the director hasn't learned about whitening and will give them fake news.
They say: That's how it's done and no one is surprised anymore, and whitening programs aren't successful because they're made up with random nonsense. But there is a lot of scientific evidence regarding whitening and certain protocols that need to be followed.
If dentists take the time to educate themselves properly, they can be better teachers for associates and hygienists and everything else. The biggest problem is that they invent along the way.
Prav Solanki: So it's more than just taking an impression, putting some gel there, and telling the patient to go home. Because I talk to a lot of dentists about different whitening products, especially from a marketing perspective. And it's the same attitude that Payman just mentioned. They don't differentiate between products other than price and they say, "Oh, well, this one does the same thing as that one." All you do is stick bleach on there, send them home, and tell them it's going to do its job, and their results tend to be variable. So that they have some cases that are going really well, usually cases that use Enlighten, from my personal experience.
I just have to wear the aligners for a few nights and my teeth are shining. And that's all I have to do, even though the instructions say 14 nights.
“There is a lot of scientific evidence regarding whitening and certain protocols that need to be followed.”
Dr. Payman Langroudi: What's funny in our industry is that everything is called by percentages.
And a lot of people like to think they know what's going on. And so, they think that Nurofen 200 milligrams is the same thing as Ibuprofen 200 milligrams. But bleaching is so flexible because you have a physical situation with a tray. And then you have a chemical situation with a chemical.
Dr. Linda Greenwall: And you have a patient with anatomy.
Dr. Payman Langroudi: And bruxism. The difference is the physical things that can happen there and a volatile liquid. The idea is that it breaks down and so it's very, very different depending on the patient.
But, to me, when someone says it's not rocket science, generally that guy doesn't know what he's talking about.
Dr. Linda Greenwall: Exact.
Dr. Payman Langroudi: But secondly, we know that Tooth color is the number one concern of our patients. By far, it's much bigger than orthodontics, cavities, etc. It's what concerns them the most.
Dr. Linda Greenwall: Absolute.
Dr. Payman Langroudi: And a lot of times you see these comprehensive exams that offices sell and market. Exams that last an hour and a half, they have two pages on the internet about what's covered, they'll look at ATMs, lymph nodes and manifestations, and all of that is good stuff. And yet, the shadow is not mentioned.
The main concern of our patients from a cultural point of view is not found in our examinations. And it should be. And so, whitening needs to be talked about more, not less.
Obviously I don't have a horse in the game, do I? I'm subjective. But this idea that it's not real dentistry. Well, then you're not treating real patients if you don't think it's real dentistry.
Dr. Linda Greenwall: It's good to listen to all the objections, because by listening to all these things, you can have a strategy to change, to move forward. So here's the thing, we say: number one, take a shade for each patient individually. It's a science actually. And that's part of your exam. It's the first thing.
And we teach the dentist to start with the basic shade, which is called A3. Have lots of A3 shades and measure each patient. The patient wants to know, “Oh, is this a good thing or a bad thing?” That’s how the opening discussion starts. Some dentists say, “Oh, I’m not really, I’m not good at sales, so I can’t sell whitening.” This is not a sales thing. This is a scientific measure.
“Tooth color is the number one concern of our patients”
Dr. Payman Langroudi: It's a work thing.
Dr. Linda Greenwall: It is a service and a scientific measure.
Measure A3, are they lighter or darker? It is recorded. And the patient asks: “"Can I see the shade guide? What's lighter than A3? So my teeth are A3.".
And the dentist says, “Well, 90% of the patients can have this shade.” The patient asks, “What’s lighter?”; “A1″. “Well, that’s a pretty nice shade. Can I have it too? Would it be right for me?”.
And I teach dentists to do an audit. Everyone hates doing radiology audits, which is fine, but do an A3 audit. And you say, For the next hundred patients that come in, we're going to measure the shade and see who gets their teeth whitened. Six months later, the patient comes back and says, "Could you check my shade, because I think my teeth might have gotten darker. Now I'm interested in getting whitened." So that opens up the conversation. It's a scientific measure.
There is now a very good device called VITA Easyshade. I don't know if you've seen it, it's great. And I think, actually, a lot of dentists should have it in their office, because it's a scientific measurement. It's got Bluetooth, it's got an app, and you can measure their whitening percentage and all these things. Dentists love technology, so it's a pretty useful piece of equipment.
But every patient should have their shade measured and they should know their shade. It's not a personal question, it's not an invasive question. It's a scientific measurement.
When they say it’s not rocket science, there’s tons of science behind it. But you have to start with basic communication. For example, if you’re about to start restorative dentistry and you ask Mrs. Jones, “"In the next five years, have you ever thought about whitening your teeth?" Because we were going to put a crown on your front tooth and we need to keep it the same shade as your current teeth. But if you were thinking about whitening, now is the time so we can choose a lighter shade for your crown."”
“There are some basic questions about whitening that we need to ask patients. It’s not a sales technique.”
But we want to educate dentists so they can learn the science to be able to provide the service in addition to which the oral health benefits of whitening are major.
Dr. Payman Langroudi: Do you tell your patients that whitening is good for them?
Dr. Linda Greenwall: I tell them it has oral health benefits. I say it improves gums, reduces swelling, makes your mouth feel cleaner, and plaque doesn't stick to your teeth as much.. So we talk about those benefits. We also talk sometimes about how we need to integrate it into the whole dental process where we'll do the cleaning, we'll start the whitening review and we'll consistently improve their oral health first and then we'll continue with whatever is necessary.
Source: enlightensmiles.com
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