Whitening addiction

The whiter, the better.

That’s how some people feel about their smile. They want their teeth white and bright, even if the white they’re going for doesn’t look natural.

Although it’s rare, there are patients who will go to great lengths to get what they feel is the perfect white smile, from overdoing the whitening strips to over brushing to trying to buy more product from you than they really need. 

“They just want their teeth as white as they can get them,” Dr. Michael Sesemann said. “They’re not even thinking about damage or about being outside the range of natural.”

That’s where you come in. Whether you’re talking about preventing patients from taking it too far or helping patients understand why they need to slow down, it all comes back to you and your staff educating them about what too much whitening can do to their teeth. 

How to spot the problem

If a patient keeps buying more whitening product than you think he or she needs, there’s a good chance that patient has a problem with whitening, said Dr. Sesemann, who is the President of the American Academy of Cosmetic Dentistry. Complaints of sensitivity and teeth that look unnaturally white are also signs that someone is bleaching too much. But it’s important to remember that not every patient who over bleaches can achieve that level of white.

“Sometimes the reason people turn into bleaching addicted patients is because they have a very high translucence to their teeth and the bleaching really has little effect on the whitening objective they’re trying to obtain,” Dr. Sesemann said. “Those folks are buying a lot of product and bleaching a lot, but they’re not getting the results they want.”

And depending on what they’re using and how much, over bleaching can lead to sensitivity, it can weaken enamel or soften composite restorations if the product is too acidic, Dr. Hugh Flax said.  Another fear, although it hasn’t been documented, is bleaching too much may stimulate external root resorption, Dr. Sesemann said.

How to fix it

Patients who are whitening too much may not even realize they have a problem. If you or one of your staff members asks them how frequently they’re whitening, they’ll likely tell you, Dr. Flax said. Simply asking that question can open up a dialogue and create an opportunity to educate that patient.

“It’s all relative to that particular person’s situation,” Dr. Flax said. “When we have people complain about sensitivity or asking unreasonably to improve the color of their teeth when they are as white as they can get without over whitening or over brushing, we have to say ‘hey, we need to take a step back here. You’re getting into an area where you’re not getting any benefits and you’re causing problems for your mouth.’ For some people that’s a wake up call.”

For patients who have translucent teeth, it’s important they understand that no matter how much they whiten it’s not going to make a difference; their teeth aren’t getting any whiter, Sesemann said. They likely will keep trying if they don’t understand this, and that will only lead to problems in the long run.

How to prevent it

If one of your patients is asking about whitening options, take the opportunity to provide some education. Bring out a shade guide and show the patient where the natural shades of teeth were before society decided it was better to go outside that range, Dr. Sesemann said.

“We try to educate them on the particular shades that would look good with their complexion,” Dr. Sesemann said. “And when that shade might be getting hyper white and looking false in appearance when compared with the natural color of teeth.”

When people see the natural shades vs. the hyper white shades and are aware of the harm too much bleaching could cause, they become much less anxious to get that extra bright smile, Dr. Sesemann said.

Make it a team effort

People whiten for different reasons, said Dr. Flax, who is the Vice President of the American Academy of Cosmetic Dentistry. Maybe they’re trying to boost their confidence before a job interview, or maybe they’re trying to attract that special someone. No matter the reason, both you and your staff need to be involved, especially if the bleaching starts to get out of hand. 

Your team members should talk with patients and give them advice about their smiles, Dr. Flax said. It’s important that patients know all of their options; they may decide to go another route cosmetically if whitening isn’t getting them where they want to be.

“We’re here to give them advice and to lead them to better health and a better looking smile,” Dr. Flax said.” “If their smile and their health are going in the wrong direction, it’s our duty to share that with our patients. Of course it’s the patient’s ultimate decision to continue what they’re doing, but sometimes somebody confronting them about it and bringing it up makes them start to think ‘whoa maybe I’m not doing the right thing for myself.’”