Your patients are seeing it all over social media, television, and beauty blogs, so no wonder they're demanding whitening treatments that use some kind of light or laser! So, how do you educate them on the reality behind tooth whitening and the effectiveness products that use lights vs. those that do not? The objective of this article is to address just that

We sat down with Ultradent's technical manager over whitening formulations, Peter Allred, to discuss how you can talk to and educate your patients about the pros, cons, and gimmicks when it comes to light/laser used in some whitening systems.

"The first and most important thing to help your patients understand is that the evidence from more than a dozen independent clinical trials shows that tooth whitening using lights or lasers will not improve whitening effect compared to quality whitening systems that don't require expensive additional equipment that add no value and simply increase the time and complexity of the treatment, and that this is a marketing tactic.¹ Patients were introduced to the idea of light used whitening treatments years ago on shows like Extreme Makeover, and this has prevailed and stuck in the minds of patients when in reality, the light creates a very temporary whiter result, and can cause other negative side effects, including oral burns and pulpal stimulation," says Allred. 

He continues, "Walk your patients through the fact that our oral tissues are always in a dark environment with limited light exposure, so when you introduce a continuous stream of very bright, high-intensity light, including UV and heat with some systems for a significant  amount of time, this may not be good for your oral tissues."

How is it bad for oral tissues? Studies like one conducted by a team of doctors led by Dr. Ellen Bruzell of the Nordic Institute of Dental Materials concluded that not only did whitening with a light show no greater long-term whitening effects than without, but that "exposure to UV light created more exposed grooves which made the enamel surface of the teeth more vulnerable to stress and other related damage", adding, "The use of UV light for teeth whitening puts patients at risk of high levels of radiation to sensitive areas. Bleeding gums, sunburn, and severely burnt gums are among the common complaints, not to mention the possibility of getting cataracts, cancer, and other life-threatening illnesses."² 

Secondly, Allred adds, "lights used in many whitening systems simply dehydrate the teeth, which gives them  a temporary whiter appearance. It is not uncommon to find that many of these same patients experience a significant color rebound and in rare cases even return to the pre-treatment shade as their teeth fully rehydrate.  Additionally, dehydration can be a factor in tooth sensitivity so the more dehydrated the patients' teeth are due to light exposure, the more relapse and sensitivity they are likely to experience.

The good news is that there are safe and effective alternatives, without the use of a light. Truly, the only effective way to whiten teeth with the least risk of sensitivity and shade relapse is through prolonged exposure to pH stable and optimized active whitening agents on the tooth's surface. Opalescence^™ Boost^™ in-office whitening system provides brighter, whiter teeth after just about one hour in the chair, without the use of a light. The powerful, 40% hydrogen peroxide gel is chemically activated and contains a high water concentration to provide extra safeguards against dehydration and shade rebound. 

Indeed, Allred says, "We don't recommend light or laser whitening because throughout our years of research, we've found that optimized whitening without lights or lasers is the safest, most effective way to a whiter smile  and doesn't mislead the patient to thinking they ended up with one shade of white, only to experience extreme shade rebound a day or two later. Our products like Opalescence^™ Boost^™ in-office whitening, Opalescence^™ PF take-home whitening, and Opalescence Go^™ whitening trays produce beautiful, honest results that we're proud to stand by." 

References:

1. Maran, M.M., et al (2018). In-office dental bleaching with light vs. without light: A systematic review and meta-analysis. Journal of Dentistry, 70(2018) 1-13.

2. Bruzell, E.M., et al (2009). In vitro efficacy and risk for adverse effects of light-assisted tooth bleaching. Journal of Photochemical & Photobiological Sciences, 2009, 8, 377-385.