If you aren’t a social media addict like so many other millions of people, you may not be aware of the craziness that is being circulated as “DIY this and that” and “life hacks”. For dentists, it’s crucial to be aware of the products and techniques that are currently trending to answer questions about them from patients. As dentists, it is our job to create a relaxed atmosphere where patients want our advice on the “DIY tricks” that they have recently seen on Pinterest.
All too often, there is a temptation that patients have to take matters into their individual hands, and it sometimes gets the better of them when compared to their trust in a dentist’s willingness to communicate openly with them. This temptation is often reinforced by the feeling that a lot of patients have that dentists are more focused on their revenue than the patient’s oral health.
Over the years, apart from the amount of information that has become available to individuals on the internet, the availability of whitening products over the counter has changed drastically. Years ago, you were only able to find one over-the-counter product: Credit WhiteStrips. Now, when you walk into a drug store, there is an ample supply of whitening products to choose from. When you add that to the countless varieties and brands available online, it’s virtually impossible to keep track of all the products on the market.
Abrasivity is what you need to be concerned with. Regardless of the amount of fluoride found in a toothpaste, if there isn’t any enamel left on your teeth to reminerlize, it won’t make a difference. FDA-cleared toothpastes must have a Relative (Radioactive) Dentin Abrasivity (RDA) measurement. This is a measurement of the abrasion that the dentin receives when a certain product is used. The higher the number is, the more abrasive the product.
Generally, you can locate the toothpaste’s RDA easily and quickly via a Google search. However, if you are looking at toothpastes online that aren’t made in the United States, they may not have the RDA measurement. Some companies may have the toothpastes tested by an independent lab, but many companies won’t.
Many popular name brand whitening toothpastes like Colgate and Crest have high RDA’s and are still within the “safe” range. If we’re okay with patients utilizing Crest HD Whitening toothpaste, we shouldn’t recoil at AP24 simply because it is not a name brand in the United States. AP24 is sold here in the U.S., but it is made by a company in Britain. AP 24 has been popular in the States since 2017.
If a patient asks you information about a toothpaste that you haven’t heard of, make sure you are honest with them. Let them know you’ve never heard of it, but that you are willing to read up on it. If you’re able to quickly locate the RDA and it’s less than 250, provide the patient your blessing. If the RDA measurement doesn’t come quickly, let the patient know that you are unable to give you consent at this time because you’re unable to assure its safety.
Overall, are whitening toothpastes safe? Yes. Are whitening toothpastes worth the expensive cost? No.
There is an excess of peroxide gels available on the market today. Similar to the ones in the dental office, there are either carbamide or hydrogen peroxide. The importance white online or over-the-counter whitening gels is making sure that patients are well educated on how to use them properly. Invite patients to bring the carrier they’ll be using to apply the gel for your assessment. The most appropriate adaptation of the tray is far more important than the concentration and brand of the gel.
At Wal-Mart, you can find Plus White 5-Minute Whitening Gel and contains six percent hydrogen peroxide gel. Today, patients can easily get their hands on high-strength whitening gels outside of the office. The one thing that dental professionals are able to offer patients that online and over-the-counter products are unable to is a customized tray with a precise fit, saving gel and money, which keeps the whitening gel isolated to the teeth.
Have you seen the battery-operated lights that have a cheek-retractor-style mouthpiece that the individual bites into in order to keep the light illuminated against the teeth? Some of these lights have a USB cord that plugs directly into your smartphone for power. These lights do not activate gel; instead, they just heat and desiccate your teeth. Make certain that your patients are familiar with these fads and that they shouldn’t waste their money on products that won’t whiten their teeth in the end. Encourage them to invest in a customized tray that will allow more efficient whitening.
Patients don’t understand just how badly acid can actually erode tooth enamel. Dentists must educate patients. Most of the at-home DIY whitening “hacks” utilize fruit juice, fruit peels, fruit flesh, and vinegar, which can be incredibly erosive to the structure of the tooth. Some people tend to believe that anything derived from nature is good for you.
However, rubbing acids of any form (from the banana peel that is mildly acidic at 4.5 to 5.2 pH to strawberries with a pH of 3.0 to the incredibly erosive lemon at 2.0 pH) is harmful. Demineralization of the enamel starts at 5.5 pH, which is higher than the fruits listed here. Patients who try the aforementioned methods because they’re scared of the dentist need to understand the acid erosion will result them in spending more time, rather than less, at the dentist office.
When it comes to coconut oil pulling, there aren’t any significant dangers to the structure of the tooth. However, it won’t whiten your teeth. There isn’t any abrasion to remove surface stains, and there is no peroxide chemical that will bleach the structure of the tooth.
This particular method is trickier than the others since there are multiple forms that patients are able to utilize, all of which are different. Some patients purchase activated charcoal capsules at local healthy food stores and then create their own paste to apply to their teeth. Homemade mixtures like these haven’t been tested or measured for RDA, which means we don’t know whether it is safe. Then, of course, there are the commercial forms of charcoal that can be found in toothpastes, such as My Magic Mud, which was tested independently and measured at 136 RDA—perfectly safe.
The ADA made a response after all the hype surrounding activated charcoal. The ADA said that there is not sufficient research at this time, and as a result, no charcoal products are deemed safe for use on the teeth. With that being said, if the ADA doesn’t approve, we likely shouldn’t either.
The number of tooth whitening products and trends will only increase as the years go by. It is crucial that we, as dentists, have an open-door policy so that patients come to use and ask us which products are safe, which products are worth investing in, and which products to steer clear of. The more informed your patients are, the more likely it is that they will follow your advice when it is given.
If you would like to learn more, contact us at Fountain of Youth Dental.