Bright opportunities – Dr Linda Greenwall – The British Dental Conference and Dentistry Show 2019

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  Posted by: The Probe      6th March 2019

Dr Linda Greenwall provides an introduction to the topics she will be discussing within the BDA Theatre at the British Dental Conference and Dentistry Show 2019.

Everyone wants to look younger and healthier, and our appearance-conscious society is driving many people to procedures that will improve their looks. Despite this, there has been a growing trend for non- and minimally invasive methods in which to do this, as more people seek solutions that don’t require going under the knife.

One of the consequences of this has been an exponential growth in tooth whitening around the world. In the US alone, more than 40 million people are predicted to be using tooth whitening products by 2020.[i]There has also been a change in the results people want – the rise of the ‘Love Island White’ smile has been very apparent, though it is rarely a realistic goal.

Some people seek DIY whitening methods, including so-called ‘natural’ remedies. A simple search online will find millions of ways to do this, with suggestions ranging from strawberry paste and banana rub to swilling the mouth with hydrogen peroxide and baking soda paste, and oil pulling.

There are many concerns surrounding some of these techniques, as many DIY methods have no clinical evidence to support their effectiveness. Some home remedies actually pose a threat to people’s safety and do little to complement good oral health in the long-term. Unfortunately, the same can be said of the whitening services provided by beauty salons and therapists, who lack the appropriate medical training and knowledge to successfully improve the colour of the teeth without causing harm to the rest of the mouth.

Comprehensive training

The gold standard tooth whitening procedure has always been and will continue to be that offered by qualified healthcare experts. Dental professionals are perfectly positioned due to their extensive familiarity with the oral cavity and surrounding facial structures.

Even then, however, clinicians should ensure that they are adequately trained to provide whitening. The GDC states that professionals must be fully competent in the skills required to offer such services and therefore able to demonstrate why they believe this to be the case.[ii]

Training should cover how different shades can be achieved in a predictable way, what is possible and how the results can be maintained over time. Clinicians also need to know about the eight available bleaching techniques, including those designed for whitening vital and non-vital teeth. Regarding the former, knowing how to avoid common mistakes – such as inadequate length of whitening treatment – is essential. Some methods such as the inside/outside technique require special attention, as innovative custom bleaching trays can enhance the patient experience and the end result when addressing non-vital teeth.

As sensitivity is the single most common complication of tooth whitening, keeping up-to-date on the latest evidence and concepts to reduce the risks in the area is crucial. The vast majority of patients experience some degree of sensitivity during or after whitening treatment,[iii]so avoiding it in the first place, as well as managing symptoms as they occur, can make a huge difference to a patient’s treatment experience.

Professionals also need to be aware of and confident with the three categories of tooth whitening – basic, intermediate and advanced. The classification depends on the type of discolouration being addressed. It might involve your standard lightening of the tooth shade, or it may require treatment for discolouration caused by one of the many medications routinely taken by patients.

Another area of growing interest is the treatment of white spots, especially as more and more children (around an increase of 20-40%) experience the eruption of teeth with white marks already on them. One of the treatments for this is whitening, so it’s important to be aware of the guidelines for provision of such procedures to patients under the age of 18.

Equally, it is essential to understand why so many children are affected and what the many different causes could be. Among the more than 100 possible causes, MRH (Molar Incisor Hypomineralisation) is becoming one to watch – with an estimated global prevalence of 14%, it most commonly affects those under 10 years old.[iv]As it is often the parents who are quite alarmed by the white and brown spots that appear on their children’s teeth upon eruption, a coherent and evidence-based management strategy is needed to ensure effective treatment.

Exciting opportunities

The benefits of successful whitening are multiple. In my experience, as many as 85% of patients decide to undergo further treatments in order to perfect their smiles after whitening their teeth. Dentists love doing dentistry – especially cosmetic procedures – so the opportunities that whitening can lead to are very exciting. Offering these procedures are also a good way of getting dentists to get out of a rut, as they provide a new field to move into for greater variety in daily practice.

At present, it seems that many individuals don’t embark on specific training in the field, which can prevent them from acting in the best interests of their patients and leave them open to litigation in the event of a complication. Rectifying this is crucial for dental professionals looking to capitalise on the demand for tooth whitening treatment in a safe and ethical way. By learning everything you can in the area, you can gain a huge amount of knowledge that will help you to create beautiful smiles in a conservative way for a large number of your patients.

 

Dr Linda Greenwall will present “White and whiter teeth: success strategies for predictable advanced tooth whitening 2019” in the BDA Theatre on Friday 17thMay. The British Dental Conference and Dentistry Show is free for delegates to attend and passes can be booked online.

 

   

 

The British Dental Conference and Dentistry Show 2019 will be held on Friday 17thand Saturday 18thMay at the Birmingham NEC, co-located with DTS.

 

Visit www.thedentistryshow.co.uk, call 020 7348 5270

or email dentistry@closerstillmedia.com

 

Linda Greenwall

Linda Greenwall is an international lecturer and an authority on tooth whitening, aesthetic dentistry and practice management. As well as running a multidisciplinary private practice in Hampstead, London, where she works with a specialist team in the practice (endodontist, periodontist, implant surgeon, oral surgeon and orthodontist), she is a past Chair for the Alpha Omega Society (2012/13), Editor-in-Chief of the journal Aesthetic Dentistry Today, and is past President of the Metropolitan London Branch of the British Dental Association (2015/2016). In March 2016 she was awarded the FMC Award for Outstanding Contribution to Dentistry.

Her first book, Bleaching Techniques in Restorative Dentistry, won the award for Best New Dental Book in 2001 – the new edition of this book, Tooth Whitening Techniques, was published in May 2017. Her book Success Strategies for the Aesthetic Dental Practice was published by Quintessence in 2011. She has written many papers for scientific journals. In June 2017 she was honoured by the Queen in her birthday honours to receive the British Empire Medal for her Service to Dentistry in the UK and Abroad. The medal ceremony was held on 17 November 2017 at the Tower of London.

In 2011, Dr Greenwall established the Dental Wellness Trust Charity which has the motto “Oral Health through Dental Wellness”. The charity runs innovative oral health programmes to the less fortunate communities and reaches 10,000 children daily in the townships of South Africa.

 

References

[i]Statista. Consumer goods & FMCG. Cosmetics & Personal Care. U.S. population: Usage of tooth whiteners from 2011 to 2010. https://www.statista.com/statistics/287384/usage-of-tooth-whiteners-in-the-us-trend/[Accessed January 2019]

[ii]GDC. Dental team Working. Frequently Asked Questions. May 2010. https://heeoe.hee.nhs.uk/sites/default/files/docustore/1297166724_vrrm_gdc_dental_team_working_-_frequently_asked_questio_2.pdf[Accessed January 2019]

[iii]Carey CM. Tooth whitening: what we now know. J Evid Based Dent Pract. 2014 Jun;14 Suppl:70-6. doi: 10.1016/j.jebdp.2014.02.006. Epub 2014 Feb 13.

[iv]Zhao D, Dong D, Yu D, Ren Q, Sun Y. The prevalence of molar incisor hypomineralization: evidence from 70 studies. International Journal of Paediatric Dentistry. 2018 Mar;28(2):170-179. doi: 10.1111/ipd.12323. Epub 2017 Jul 21.

 


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