Ultrawhite Pearlies
By Cindy LaFavre Yorks

Chicago Sun-Times, Wed. January 2, 1991 Section 2 Page 39

Collagen-injected, perfectly painted lips are the perfect frame for a glistening white smile. So much so that many celebrities frequently shell out thousands of dollars for bonds, caps and veneers to improve less-than-perfect pearlies.

What can less-monied but equally vain individuals do to whiten their teeth? Plenty. Advancements in cosmetic dentistry have made a less expensive method of whitening teeth available to the masses: tooth bleaching.

Although bleaching has been around since the mid 1980s, marketing efforts have increased attention to the procedure in recent months. Dr. Benjamin S. Fiss has been offering bleaching to his patients for about a year and a half, and says more of his Chicago area patients have been asking about bleaching in recent months.

“We’ve had everyone from lawyers to disc jockeys,” Fiss said of the patients who have undergone bleaching recently.

Two methods are available through selected dentists-in-office bleaching ( also called power bleaching ) and supervised outpatient bleaching.

In most cases, bleaching is less expensive than overlay whitening methods, but it isn’t cheap. According to studies conducted by the American Academy of Cosmetic Dentistry in Madison, Wis., national prices range from $175 to $350 per arch–the upper or lower set of teeth–for a mouth whitened by the outpatient. Fiss charged $300 per arch. Nationally, in-office visits range from $120 to $275.00 per visit for an entire month. Dr. William Frericks charges $120 per session for visits in his Chicago office.

Single-tooth bleaching averages, nationally, from $100 to $350. Those prices are a far cry from overlay methods such as bonding, which runs $100 to $400 per tooth. Veneers run patients between $275 and $850 per tooth, while caps cost between $500 and $1,500 per tooth.

Although some bleaching treatments, such as Wonder White, are available over the counter or by phone order without medical supervision, most are offered by cosmetic dentists. They offer consultations with at-home treatments or supervise those done inside their offices.

To facilitate at-home bleaching, a dentist will make a tray (also called a dam) from a mold of the patient’s upper and lower teeth. From that mold, a conforming plastic tray ( similar to a mouth guard used for sports yet only a tenth of a millimeter in thickness ) is created to hold the bleach. Drops or squirts of gel, equivalent to the number of teeth to be bleached, are applied to the tray, which snaps into place. The tray is designed to be virtually invisible and, if necessary, it can be worn out in public or overnight in bed, for up to 20 hours a day.

Dentist office treatments differ. There, the solution is applied directly onto the teeth, which may be wrapped with gauze to protect gum tissue from being damaged. In addition, a rubber apparatus called a dam also is placed over the gums. The dam is outfitted with holes that allow the dull teeth to protrude and take the bleach. A heat source, such as a lamp, activates the whitening process.

Office treatments take between 30 and 60 minutes. The hydrogen peroxide solution used by dentists maybe as much as four times stronger than those provided to patients to be used for home treatments. Desired results from “power bleaching” can be obtained after as few as three or as many as 10 sessions.

Frericks recommends power bleaching four or five times, spaced at 10-day intervals. He then provides a home bleach tray and kit to patients for future use.

Bleaching is especially good for reducing exterior stain problems, says Dr. Jonathan Scharf, vice president of the American Academy of Cosmetic Dentistry. Scharf, a practicing cosmetic dentist who lives near Philadelphia, cites stains caused by coffee, tea, cola, red wine and tobacco as extrinsic stains that usually are intensified with age. The effects of internal stains, such as those caused by drugs such as tetracycline, are more difficult to remove and may require more intensive treatments, Scharf said.

Opinions vary as to how long the treatments last. Scharf said most patients notice some color change, but few ever experience a return to their original shade. Scharf recommends at-home maintenance, when needed, to keep results.

Cynthia Graves, a hand model and hair stylist who lives in Blue Island, first started using the at-home treatments about five months ago. Graves, who was at home recovering from an illness, used the at-home bleaching supervised by Fiss, her dentist. Using the whitener in 17-hour intervals, Graves says she now flashes her pearlies with confidence.

“I noticed a difference right away, but I think one of the reasons I am so happy with the results is because I was quite persistent. You have to use it like you are supposed to,” said Graves, a coffee and tea drinker.

As with many cosmetic procedures, bad habits can mar longevity. Teeth re-exposed to stain-causing beverages will dull at a faster rate that others. But nothing is permanent, dentists said.

“This is the real world-people aren’t likely to stop living. When they want that party smile, I tell them to use { whitening systems } like makeup,” Scharf said. “Re-applied, the white color comes right back.”

Not everyone is gung-ho on bleaching techniques. The American Dental Association’s Council on Therapeutics, which look into whiteners, has yet to give them its seal of approval. They had asked the Food and Drug Administration to investigate whiteners. The FDA has yet to approve dental bleaching solutions to determine whether they should be classified as drugs or cosmetics, said Heinz J. Eirmann, director of color and cosmetics for the FDA.

Although Eirmann said the FDA had no data providing that tooth bleaching procedures were unsafe, he cautioned that hydrogen peroxide, which releases oxygen to promote bleaching, can have a destructive effect. “Just look at the bleached blond,” he said.

Eirmann’s biggest concern is that several applications of bleaching may damage the part of the tooth outside of the root, below the enamel, near the gums.

Frericks sais minor sensitivity to bleach is the only problem he has encountered with has patients. The greatest complications arise, said Scharf, when individuals buy treatments and try to apply them on their own.

“Systems you can buy on television or over the counter at the drugstore can cause problems, but the biggest one is that they simply don’t work.” Scharf said.

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