CATEGORY 22 AUSTRALASIAN DENTIST INNOVATIONS A routine recall appointment finishes. The patient’s oral health is excellent. There are no new carious lesions, no periodontal concerns and nothing requiring treatment. Everything has been examined, discussed and documented – except one thing: their tooth colour. Not because anyone is avoiding the conversation, but because teeth whitening occupies an uncomfortable space in dentistry. Discoloured teeth are not a disease, and many clinicians worry that raising the subject will feel too commercial. As a result, the conversation never begins. Six months later, the patient returns. Their teeth are a little darker, but nothing is said. The assumption is understandable: if patients wanted whiter teeth, they would ask. The reality is that most patients never do. Boutique Whitening commissioned a survey across both private and corporate users and found that 30% of adult patients had concerns about the colour of their teeth (not the industry-published 20%). Very few patients mentioned it, and most had simply accepted the gradual staining as inevitable. Assessment That is why teeth whitening should be approached like every other dental treatment – with a structured clinical workflow. Assessment comes first. What type of staining is present? Is it primarily extrinsic, intrinsic or a combination of both? What result is realistic? Which peroxide concentration and protocol are most appropriate? Without those answers, treatment becomes far less predictable. Sensitivity Patient education is equally important. Sensitivity is one of the biggest reasons If something was wrong, they would have said so patients abandon whitening – not because it is severe, but because nobody warned them it might happen. After a few uncomfortable nights, they stop wearing the trays, assume whitening is not for them and never contact the practice. The practice assumes everything went well. Both sides are left with the wrong conclusion. Tray design and patient technique Tray design and patient technique also influence outcomes. A tray can feel secure yet still allow saliva to enter and gel to escape, reducing the amount of peroxide on the teeth and its effectiveness. Likewise, patients often believe more gel will produce faster whitening. Instead, they irritate the gingiva, waste product and run out of gel early. A simple demonstration showing the correct amount of gel takes minutes but prevents many of these problems. Records Detailed records matter. Before treatment begins, practices should record the starting shade, identify the likely cause of the discolouration, discuss previous sensitivity and whitening history, obtain informed consent and document the prescription. These are not administrative tasks; they are part of good clinical care and become invaluable if expectations are later questioned. Review The final stage is the one most commonly missed: The Review. Too often, the whitening gel is dispensed, and the practice waits for the patient to get in touch. Many never do. Some are delighted, others are disappointed, but most simply accept the outcome. A scheduled review allows the clinician to assess the final shade, manage sensitivity, reinforce maintenance and ensure the patient has achieved the best possible result. Opportunity This also creates opportunity. Once patients see their fresh new smile, they often notice crowding, worn composites, mismatched crowns or ageing restorations. Whitening becomes the beginning of broader conversations about comprehensive care and further cosmetic improvements. For a practice seeing around 65 adult patients each week, the opportunity is significant, the loss greater. Based on national prevalence data and an average take-home whitening fee of $450, the unrealised whitening opportunity alone may exceed $350,000 from existing patients. That figure does not include the restorative or orthodontic treatment that whitening often uncovers. This is not a criticism of dentistry. For years, the profession was given whitening products but very little guidance on how to integrate them into everyday practice. Many clinicians have built their own systems through experience, but experience alone rarely produces consistency. Clinical workflows do. The question is not whether your practice offers whitening. Most already do. The better question is whether your whitening pathway follows the same principles as every other treatment you provide, assess, diagnose, prescribe appropriately, educate, document and review. When those steps become routine, patient outcomes improve, compliance increases and practices discover opportunities that were already sitting in the chair. If you would like to review your current whitening workflow, I offer a complimentary 20–30 minute online Teeth Whitening Assessment and Strategy Review. Together, we can identify practical improvements that make whitening more predictable for your team and deliver better outcomes for your patients. u Stephen Douglas | Teeth Whitening Systems Educator, Boutique Whitening Australia Twenty-two years building teeth whitening systems across the UK and Australia. 0416 629 015 stephen@boutiquewhitening.com.au By Stephen Douglas, Teeth Whitening Systems Educator National Manager, Boutique Whitening Australia Client Testimonial “I learnt more in 90 minutes from the Boutique Whitening Clinical Program than I had in the whole of dental school” Dr Antony Bennedetto – Chairman of the National Dental Care Clinical Advisory Committee. Stephen Douglas
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