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Newsletter – 3rd Quarter 2001

This Issue:

This Issue is 30% – This Whitener focuses on fast, safe, and predictable whitening

  • Making 30% Believers – Top clinicians are choosing 30%
  • Rising Above the Strips – Simply set your Whitening Services high above the professional low-and-slow or OTC Products!
  • Marketing At-Home 30% – New marketing tools set you apart and increase your whitening cases.
  • 30% Patient Testimonial
  • Dual-Arch Whitening – 30% Makes it possible! Here’s how.
  • Patient Compliance – It’s not inexpensive if it doesn’t work.
  • 30% Success Tips – There’s a difference.
  • Sensitivity Dichotomy – Higher Concentration gels mean lower sensitivity due to reduced wear time.
  • At-Home Cleaning & Debriding – An update on the Fight against Gum Disease.
  • Common Sense – Questioning those Whitening Assumptions
  • Community Service Corner

MAKING 30% BELIEVERSTop clinicians are choosing At-Home 30%
Were you a 30% skeptic? You wouldn’t have been alone. To many pros, the use of 30% carbamide peroxide for at-home whitening sounded excessive. However, given the facts and the opportunity to try the product both on themselves and patients, top clinicians are coming to the conclusion that At-Home 30% is the future of whitening. Consider this:* Clinicians started whitening using 10% only because it was originally used to treat gum disease. When treating the gums, 10% (which is Glyoxide Proxi Gel) is still the choice. But, when tooth whitening is the objective, clinicians naturally gravitate toward what works best for patients – higher concentrations for faster results and less wear time. We’ve seen the popularity of percentages move to 15%, then to 20%, and now that it has proven safe and most viable, on to 30%.

* A well-documented 1,400-patient study found an incredibly low 5% rate of pulpal sensitivity using 30% carbamide peroxide for at-home treatment.1 Multiple shade shifts were achieved in 93% to 97% of cases within 7 to 10 days. The 30% carbamide peroxide was tested in-vivo and shown to have no soft tissue aberrations in accordance with the ADA protocol for safety.

* Consider this from the world-class clinician, Bill Strupp, Jr., DDS, who has 31 years of experience, lectures all over the country to thousands of dentists, and publishes the popular Crown & Bridge Update. Over a year ago, Dr. Strupp announced that for months he had been whitening ALL of his patients with Life-Like 30% Carbamide Peroxide. The reason, “We get a better result because we are using 30% c.p. that works faster and consequently patients are more compliant, without any downsides,” explained Dr. Strupp. When asked if he would use 30%, he replied, “That’s the only way I’ll do it, because I can’t stand walking around with that stent in my mouth. I also realize that my patients are no different and deserve the best possible option.”

* Michael Miller, DDS of Reality Magazine spoke out in support of At-Home 30% in a lecture at the Las Vegas Cosmetic Dentistry 2001 conference, February 8-9, 2001. Dr. Miller stated, “…when I first thought of somebody doing home bleaching with a 30% carbamide peroxide I said, ‘You’re out of your mind.’ This’ll never work, it’ll blow out teeth, they’ll be sensitive, it’ll be this, it’ll do that. Well I can t ell you, it doesn’t do that.” Dr. Miller went on to explain, “And, what’s very nice about this product is that you c an have patients wear the tray twice a day for 20 minutes and you can go from a C3 to a C1 in one week – in one week, 20 minutes a day – driving to and from work. So this 30% carbamide peroxide, as long as they keep the wear time down to a minimum and you don’t cover any of the gums, so you scallop the trays very nicely, I am firmly convinced that this is the way that home bleaching is going to go.”1. “1,400-Patient Study Shows 30% Safe for At-Home Use,” Whitener, 2nd Quarter, 2000: 2

RISING ABOVE THE STRIPS
Set Whitening Services high above the Low-and-Slow or OTC Products!

It’s not a problem. It’s an evolution.
The over-the-counter (OTC) Whitest “text/j rofessional whitening towards its inevitable destination – At-Home 30% Carbamide Peroxide.

A May 4, 2001 USA Today article announced that Procter & Gamble plans to spend $100 million on its rollout marketing for their $44 Crest WhitestripsTM kits. That’s more than a gentle push; it’s a shove – for professional whitening to evolve. What does this do to the old 10%, 15%, and even 20% carbamide peroxide whitening market? There are still significant benefits to professional whitening regardless of the percentage used – the supervision, the complete whitening, etc. However, to clearly establish professional whitening as being head-and-shoulders above OTC products, it will take the fast and predictable results of At-Home 30% Carbamide Peroxide.

Natural evolution? Yes. Think how whitening started out with 10% c.p. Life-Like introduced 15% and the dental community was slow to adopt it as safe and more effective. Then Life-Like was again first to introduce 20% that then went through the same slow adoption process. Now it has been over two years since Life-Like was first to introduce 30%. The adopt n.js” type=”text/javascript”> ion rate has been phenomenal. Why? Patients want the product with the fastest, most p redictable results that are safe – and 30% has proven to be the right balance for at-home use, exhibiting a mere 5% rate of pulpal sensitivity.

The extent of the impact of low-cost OTC products remains to be seen. Chances are, it will have the following effects:

Market Expansion – Now whitening will be affordable to thousands of people who would have never considered it before. Whitening will move more into the mainstream beyond the 5% of the population currently whitening their tee th. Proctor & Gamble expects that number to grow to 50%!1

Fall Off – Many of these new whitening cases are sure to trickle back into professional whitening. They are sure to gain a whitening consciousness and they will be dissatisfied with the shortcomings of the one-size-fits-all approach of the strips. Think how many people will use them without regard for existing caps or veneers and end up in your office. Many are going to get “horse-mouth,” and will want distal whitening of all visible tooth surfaces. Many are sure to be frustrated with the long number of days it takes to whiten with the strips.

Need for Speed and the 30% Difference – More dental offices will see the need to set their whitening services above professional low-and-slow or OTC products. Therefore, At-Home 30% Carbamide Peroxide will become the most widely used professional at-home whitener. OTC products will be seen as the budget whitener that can take months. More and more people will be drawn to the faster and more effective professional whitening that takes only 7 to 10 days for both arches. The word will get out as people will struggle with OTC product compliance and likely take months to whiten. They will be walking advertisements for how not to whiten. The fastest at-home whitening solution will be the clear professional distinction over low-and-slow whitening alternatives.

1. Horovitz, Bruce. “Crest Markets White Teeth to the Masses.” USA Today. 4 May, 2001.

MARKETING AT-HOME 30%
New marketing tools set you apart and increase your whitening cases.
Your patients deserve to know. You’ve got a message that needs to be shared. When you offer At-Home 30% Carbamide Peroxide, you offer the fastest, most predictable whitening that requires the least wear time, and has the best patient compliance. Isn’t it a disturbing idea to think that one of your patients could end up using a professional low-and-slow or OTC whitener? Wouldn’t it be sad if a patient didn’t whiten at all because of a common misconception, and because he or she thought the only answer took weeks – or more than a month?

Okay, you don’t have the time to be a marketing guru, nor are you comfortable with the idea of subjecting your patients to a hard sell. What you can do, however, is make it easy for your patients to make an informed decision. Life-Like is trying to help with the right set of marketing tools. Here are some tools and tips:

* New 30% Whitening Brochure – A stack of these compact brochures in your waiting room is a favor to your patients. The brochure is packed with answers to the most common questions about whitening. It provides a clear distinction as to why your professional At-Home 30% whitening will respect the patients’ time and give them the best whitening results. Best of all, the brochures are inexpensive and are often included in Life-Like specials, so you can afford to send every patient home with one to pass on to family and friends.
* Web Page – Want to educate your patients on the benefits of professional whitening and the 30% difference in living, interactive color? You’ll find the Life-Like consumer web page at www.whiterteeth.com. It’s there to support your patients with helpful consumer whitening information. Your patients can learn why your At-Home 30% whitening services are the best possible option. Don’t forget that you and your staff can also go to www.life-like.com for professional whitening information, as well as for all the back issues of the Whitener.
* New Poster – A poster is a great way to get patients asking your staff about whitening. Life-Like polled dental offices to find out what would be most helpful in a poster. The result is a poster that promotes smiling, is attractive, is light hearted, and that includes a before-and-after shot.
* Placards, Buttons, & Statement Stuffers – Subtle but effective marketing tools are a way to open the subject of whitening. The placards are 5” X 8” and can be free-standing on a counter or hang on the wall. The buttons worn by the staff ask the question: “Why go another day?” to initiate a quiet sense of urgency. The statement stuffers are a great way to help patients remember that their dentist is the source for whitening.

To learn more about how you can help your patients make the informed choice and keep your practice a step ahead, visit www.life-like.com/marketing or call (800) 543-3545.
30% PATIENT TESTIMONIAL
Kim Herman of Ventura, California has become a fan of At-Home 30%.
Says Kim about her At-Home 30% whitening experience, “I really like that it takes less time. I haven’t had any sensitivity. I’ve used other whitening products before and I did not see an instant result with them. I didn’t like sleeping with trays in my mouth. I had sensitivity using those other products that took so long, and I didn’t get good results. I like the 30% so much better!”

Kim also liked how the short treatment times allow whitening to fit into her busy life. She explained, “With the Life-Like 30%, I can load bleaching trays and then wear them in the shower and while doing my bathroom routines.”

DUAL-ARCH WHITENING
30% Makes it possible! Here’s how.
In the days of 10%, 15%, and even 20%, dual arch whitening was NOT a good idea. Two stents in the mouth for over 30 minutes was an invitation for patient discomfort and TMJ problems. Whitening over weeks without the contrast of arches is a formula for unhappy patients who can’t perceive the change. The fast whitening and short wear time of 30% changes all that.

Consider this: Dual arch whitening means whitening in just half the time. Consider the difference. Standard 15% carbamide peroxide requires approximately 14 to 21 days per arch. That’s 28 to 42 days to do both arches. That’s a lot of wear time over more than a month’s worth of days. Using 30%, a patient can whiten both arches at once for a total of 7 to 10 days. What is the likelihood of the average patient staying with the whitening regimen for 28 to 42 days with so little reinforcement? Who wouldn’t prefer to whiten in just 7 to 10 days with the instant gratification of fast, predictable results? Which would you choose?

PATIENCE COMPLIANCE
It’s not inexpensive if it doesn’t work.
What good is a cheap over-the-counter (OTC) whitener or the priciest professional whitening treatment if the patient doesn’t stay with the required regimen? The fact is, patient compliance is tantamount to whitening success. However patients choose to whiten their teeth, the value of whitening is tied directly to how easy it is for the patient to fully implement the modality.

The key to patient compliance is TIME. Note how time is at the core of each of these compliance issues and how At-Home 30% Carbamide Peroxide makes the best use of patients’ time:

* Convenience – The shorter the treatment time, the greater the convenience. Using At-Home 30%, the treatments are only 20-30 minutes each. Therefore, whitening can fit into morning and night bathroom routines. Fitting into patients’ busy schedules with a routine makes it so much easier.
* Treatment Days – Studies show most patients lose interest after 10 days. Unlike lower concentrations and OTC products that take 14 – 28 days per arch and beyond, At-Home 30% allows patients to finish both arches in just 7 to 10 days.
* Reality Fudge Factor – Who is perfect? Most patients, in reality, miss a treatment here and miss a day there. The more days required to whiten the more missed treatments there will be. With the shorter number of days required with 30%, this fudge factor is kept to a minimum.
* Treatment Recovery – Lower concentration modalities typically require longer wear times of 1 hour to overnight and keep teeth away from naturally hydrating saliva. Dehydration is one of the leading causes of tooth sensitivity – and pain inhibits patient compliance. The short treatments of 20-30 minutes, using water-based At-Home 30%, allow the teeth to rehydrate quickly.
* Results – Visible results are motivating. Continuing treatment is so much easier when people are complimenting your patients and they are seeing for themselves the dramatic whitening. At-Home 30% simply produces the most visible, dramatic, and predictable at-home whitening results.
* Respect – A modality that shows respect for the patients’ time is more likely to receive the respect of the patients. This respect in turn makes it easier for patients to invest their precious time. At-Home 30% offers this respect and makes the best use of patients’ time.

30% SUCCESS TIPS
There’s a difference.
There’s a difference between working with At-Home 30% Carbamide Peroxide and the lower concentrations. The adjustments to the procedure are small and easy, but the benefits to your patients are big and significant. Here are some important guidelines to keep in mind to insure your patients achieve total whitening success:

* Refrigerate – At-Home 30% should be refrigerated at all times when not in use. Tell your patients to do the same.
* Screen Patients – The patients need to be able to follow dosage control instructions. Overloading the tray will cause mild to severe gum irritation. If you believe the patient cannot follow instructions, perhaps a lower concentration is in order.
* No Reservoirs – Reservoirs sounded like a good idea, but they simply do not help get fresh bleach to the teeth. Reservoirs defeat van der Waal’s Forces and allow bleach to leave the tray. They are ineffective and take unnecessary lab time. In short, they waste busy time, have no benefit, and can cause problems – so skip them.
* Trim Tray Off Soft Tissue – Properly trimmed trays are a must with 30%. The trays should not overlap the gingiva. Pay close attention to the trim and keep the edges smooth and off the soft tissue.
* Short 20-30 Min. Treatments – Each treatment should be 20-30 minutes and no longer. Going beyond that promotes sensitivity from tooth dehydration. Besides, your patients want short wear time and a majority of the active ingredient is expended after the first half hour.
* Patient Instruction – The patient should be shown how to load the tray with the proper dosage. Show the 1/4cc hash marks on the syringe. Demonstrate how small the beads of bleach should be in each tooth indentation, and show the patient how the plunger should only move a total of 1/4cc.
* Manage Expectations – As with any whitening modality, let patients know what to expect. If you are doing dual-arch whitening, let the patients know they won’t have the other arch to compare the contrast. Ask friends to notice. Let the patient know that uneven whitening is common, to stick with it, and that it will whiten and even out quickly.

SENSITIVITY DICHOTOMY
Higher Concentration gels mean lower sensitivity due to reduced wear time.
There is a common notion that higher concentration carbamide peroxide means greater sensitivity. While this is true for soft tissue, it is simply not the case when the objective is to whiten teeth, where higher concentrations can actually help avoid pulpal sensitivity through lower wear time.

There are two types of sensitivity: soft tissue irritation and acute pulpal sensitivity. When using carbamide peroxide to treat gums, a practice that is certain to continue to grow, low concentration (8-10% c.p.) is the choice when putting gel into contact with the soft tissue. When whitening, scalloping the tray makes the soft tissue issue moot. Acute pulpal sensitivity comes from two sources – access to the dentin and/or tooth dehydration.

Contrary to common thought, At-Home 30% fast bleach is the best way to avoid these problems; a small drop of 30% gel will create a smear layer from which maximum oxidation per volume occurs in 20-30 minutes. The tray is removed and the tooth rehydrates, reducing/eliminating hydrostatic pressure imbalance (pain source) in the dentinal tubules. The oxidizing agent enters the dentin via incisal wear, enamel fractures, faulty margins, and insufficient enamel coverage at the C-E junction; scalloping and dosage control keeps the gel off the soft tissue and the C-E junction. In short, less gel and less wear time in higher concentration is best for whitening your patients.

AT-HOME CLEANING & DEBRIDING
An update on the Fight Against Gum Disease.
The response to the previous Whitener articles on periodontal disease and management has been enormous – understandable given that 80% of the population is at risk of periodontal disease which has links to heart disease, stroke, diabetes mellitus, premature births, respiratory ailments, respiratory ailments and hip replacement infections.
The remarkable therapeutic capacity of the topical application of low concentrations of carbamide peroxide is well documented, whose therapeutic significance has been diminished for a decade by its use for cosmetic whitening of teeth and the introduction of costly esoteric drug therapies. The benefits of patient empowered, tray delivered bio-oxidation is well documented for destroying anaerobic bacteria, discouraging plaque formation, reducing bleeding, and foaming away aerobic bacteria, retained food debris, and necrotic tissue.

The use of therapeutic extended bleaching trays is compelling, is covered by most insurances (cat. # 4381), and can be delivered via auxiliary personnel.

Watch for additional information in the Q4-2001 Whitener. Click here to find last quarter’s information on Cleaning & Debriding. Or call 800-543-3545.

30% COMMON SENSE
Questioning those Whitening Assumptions
There are many advertisements claiming fast whitening. But ask yourself this question: how can lower at-home concentrations whiten faster than 30% carbamide peroxide?

* How can a “sustained release formula” help whiten teeth better? How can it help to slow down the chemical reaction that whitens teeth? Is the point to wear a tray for the longest time or is it just difficult to give up the overnight myth?
* Why do we think lower concentrations have less pulpal sensitivity, when extended wear time prevents the natural hydration of the teeth and lower concentrations require more wear time? Doesn’t it make sense to bleach for short sessions with high concentration and then let the teeth rehydrate after 30 minutes?
* Does it make sense to add chemicals to whitening gel to prevent sensitivity when there is the alternative of the shorter wear time patients want anyway?
* Why offer multiple, candy-flavored whitening gels when the patient should not be tasting it in the first place? Isn’t the taste of the gel a warning sign of overfilling the tray? What message are we sending by offering candy flavors?
* Which would you prefer as a patient – the shortest wear time and fastest results with 30% carbamide peroxide – or hours of extended wear time using a low concentration bleaching gel with additives such as potassium nitrate and fluoride?

COMMUNITY SERVICE CORNER
The Life-Like Community Service Whitening program has been met with a great deal of support (whitening fees are donated to charity using free Life-Like kits). For participants looking for the right recipient, we’d like to make a suggestion:

The American Cancer Society is the nationwide voluntary health organization dedicated to eliminating cancer by preventing cancer, saving lives, and diminishing suffering from cancer, through research, edu- cation, advocacy, and service. The American Cancer Society is the largest source of private, nonprofit cancer research funds in the United States.

Contact the American Cancer Society today to arrange forwarding of your contributions. Call 1-800-ACS-2345 or log on to www.cancer.org.

To find out more about the Life-Like Community Service Whitening program, call 800-543-3545 or click here. Write us with the results of your charitable whitening promotions; we’d like to publish your generous work in the Whitener and on the Life-Like web page.