Dentists angry about non-dental teeth whitening clinics

If you want white teeth, you face a dilemma. Do you go to a dentist and take advantage of his or her expertise — and pay a little more? Or do you visit a spa, non-dental clinic or even a mall kiosk to get it done at a lower price?

Dentists say only they have the expertise to find problems with your teeth and mouth that could adversely affect the whitening process. Owners of non-dental establishments and the companies that supply them with “laser” lights and bleaching materials say their process is just as safe. In most cases, dentists charge more, but you get their expertise, too.

About 10 states regulate non-dental teeth whitening procedures.

For the rest, it’s the buyer beware.

I don’t know what it says about our culture — I’ll leave that to cultural anthropologists — that Americans feel the need to have the whitest smiles possible. But I do worry that this is a relatively new business that is unstudied, unregulated in most places and, like the Internet, has to be looked at in the coming years.

The sign outside Lottie Holmes' clinic

The sign outside Lottie Holmes' clinic

For help with this, I visited a spa in my neighborhood that has a white banner outside announcing “Laser Teeth Whitening” hanging outside. Owner Lottie Holmes of Lottie’s Skin & Hair Clinic in Watauga, Texas says the banner is working: more customers are coming in to improve their smiles.

For more than a year, she has offered laser teeth-whitening services in her salon, part of a growing, relatively new industry that is stealing business from dentists.

“We jumped on it because it’s painless, noninvasive and safe,” Holmes says.

The service uses a light, not a laser, although most call it that. The staffers who use it receive one day of training.

My home state of Texas has no rules about who can perform laser teeth-whitening. Holmes is a licensed cosmetologist, but she doesn’t need any type of license to operate the light machine.

And because there are no state rules, if anyone complains about teeth-whitening practices at a clinic, spa or any other place (like a mall kiosk), state officials have no choice but to turn them away.

Lisa Jones, director of enforcement for the Texas State Board of Dental Examiners, says, “We do get complaints about these clinics operating, but since we don’t have jurisdiction over them, what we do is refer them to local law enforcement authorities.” Legislation would be needed to regulate teeth-whitening businesses.

Members of the Texas Dental Association say they are frustrated not so much by the independent operators but by the state dental board, which could enforce the state’s dental law more forcefully. Some dentists say they believe these businesses operate an illegal dentistry practice.

Austin dentist Mark Peppard is chairman of an association task force studying the illegal practice of dentistry in Texas, “specifically tooth-whitening,” he says.

Dentists, he says, are concerned that nondentists won’t recognize tooth decay, gum disease or other maladies before applying bleaching agents and what’s called accelerated light to stimulate the chemicals to clean the teeth. Long-term damage is possible, they say.

“It’s simple to say, ‘I drink Coke or coffee.’ But what if disease or a massive cavity is causing a tooth to get darker?” Peppard says.

Nondental technicians, especially those at malls, he says, ask customers to place substances and trays in their own mouth so that the technicians are not actually touching the mouth area — and, technically, not practicing dentistry.

Dentist David Tillman worries that the “caustic chemicals” used in treatments can harm patients if applied by someone other than a trained dentist or dental staffer.

Mary Swift, a dentist at Dallas Laser Dentistry, says dentists are allowed to offer a higher concentration of the bleaching chemical than nondentists. Dentists can offer hydrogen peroxide at 35 percent, but nondentists must offer 10 percent or less.

“Protecting the gums, controlling sensitivity, the concentration of bleach, the type of light source — those are all questions you should ask the guy around the corner,” she says.

Swift charges $600 to $1,000 for teeth-whitening services.

At her clinic, Holmes charges $249, although a follow-up visit, if necessary, may cost an extra $50.

Holmes says that she is well aware of dentists’ concerns but that she knows what she is doing. She protects gums from damage, and her clients don’t suffer from teeth sensitivity problems because of the equipment she uses, she says. Her facility is sanitary, she adds, and she hasn’t heard any complaints.

Lottie Holmes and her laser teeth whitening machine

Lottie Holmes and her laser teeth whitening machine

Tillman says that “until complaints are brought forth, these businesses are probably going to keep going.”

A quick check at the Better Business Bureau found very few complaints, but no specific state agency takes complaints about this.

Joshua Granson, vice president of Beyond Dental & Health, the company that sold Holmes the machine and trained her staff, explains: “We sell to medical spas and salons, people that have training in hygiene. We still want our products represented in an environment that is clean and nice. We don’t want to sell to just anybody.”

Peppard, of the Texas Dental Association, warns: “Just because you see it on TV or in a magazine doesn’t mean it’s safe. It’s not as safe as you think it is. Significant problems can arise from this.

“Instead of just doing something on the spur of the moment, think about how it will affect your teeth. Ask yourself, ‘What should I be worried about? Why shouldn’t I go to a dentist about this?'”

Many customers think about price before anything else, but he figured out a way to combat that argument. He only charges $300.

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