Most of us fear the inevitable reality ofgrowing old and losing our youthfulvivacity. Nowhere is this more appar-

ent than with that infamous demographicgroup, the baby boomers. With the dominanceof this group in the population, the demandhas grown exponentially for all types of cos-metic procedures. Plastic surgery, personaltrainers, hair coloring, and hair transplantsare but a few of the procedures this ravenousgroup demands daily in its search for sus-tained youth.

Baby boomers account for 28% of the USpopulation. Nearly 77 million boomers aregetting older, and approximately every 8.5seconds another boomer turns 50.1 Televisionprograms like Extreme Makeover, The Swan,and Dr. 90210 have not only increased ratingsfor their respective networks but have alsoshown viewers dramatic improvements inpersonal appearance through available andaffordable advancements in medicine and

dentistry. Most boomers are now in their peakearning years. They’ve raised their families,bought their houses and vacation homes, andare now looking for places to put a very highlevel of disposable income. Where better tomake that investment than in improvementsin one’ s appearance, an investment that candeliver returns in self-esteem and the percep-tion of being successful to others?

Boomers are not the only group that cov-ets whiter, brighter teeth. The younger gener-

ations are enthusiastically in pursuit of hand-some smiles. As a result, the market hasbecome flooded with over-the-counter whiten-ing products. Crest Whitestrips (Procter &Gamble) alone have to-date sales of approxi-mately $202 million dollars.2

For many, bright, white teeth is one attrib-ute, if not the most important, of a youthfulimage. Cosmetic smile enhancement hasbecome dentistry’s most requested procedure,with an increase of more than 300% in thelast 5 years.3 In fact, a survey by theAmerican Academy of Cosmetic Dentistryfound that 85% of Americans believe that anunattractive smile makes a person lessappealing to the opposite sex, and 74% believethat an unattractive smile can decrease thechance for career success. People know thatalthough they may not become famous starsor models, they can certainly get their teethas white as those they see in the media by vis-iting the dental office.

Many advancements in tooth whiteninghave been made over the last few years.Dentists have become much more familiarwith the proper protocol for case selection.They can decide which case will be successfuland which will be less than satisfactory.

However, despite the proliferation of den-tal whitening products and improvements intechnology and procedures, one all-too-com-mon problem has been persistent—the issueof tooth sensitivity that many patients sufferwith. Dental professionals have accepted thisas a normal byproduct of bleaching. Somedentists advocate administering anti-inflam-matory drugs such as ibuprofen prior to in-office whitening to help alleviate the uncom-fortable sensitivity many patients experience.Often, dental offices will receive calls frompatients informing them that their teeth areextremely sensitive and their gum tissueshighly irritated. The results are often poorcompliance and loss of trust in the whiteningprocedure specifically, and even the dentist ingeneral. More than once I have heard reports

of a patient suffering sensitivity from ableaching procedure, never to return to thatpractice again.

Reasons cited for sensitivity have includ-ed exposed dentin, excessive dehydration ofteeth, and high temperatures from the in-office whitening light.4 Manufacturers havetried various formulations in an attempt toalleviate sensitivity, but Haywood found thatthe zero sensitivity products he tested werestill causing sensitivity.5 Both increasing anddecreasing the peroxide concentration inbleaching agents has been tried with limitedresults.

This article describes a case report inwhich a proprietary whitening system, whichwas developed to eliminate sensitivity due tobleaching, was used.

MATERIALSThis case uses a new system calledGentleWhite (Innovative Medical and DentalSystems [IMDS]), which recently arrived inthe United States from Europe. The systemincorporates a proprietary chemistry calledExtracted Aqueous Barrier (EAB). The EABformulation reportedly prevents peroxide con-tact with tubules and nerves. Enamel, whichhas low water content, would react very wellto the bleaching agent, but dentin, with itshigher water content, would not allow thebleach to permeate it. The system basically

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Tooth WhiteningAddressing the Sensitivity Problem

AESTHETICS

Peter D.Vastardis, DMD

Many advancements in tooth whitening havebeen made over the last few years... However,despite the proliferation of dental whiteningproducts and improvements in technology andprocedures, one all-too-common problem hasbeen persistent—the issue of tooth sensitivitythat many patients suffer with.

Figure 1. Whitish blistering of tissues traditionally asso-ciated with bleaching was not present with GentleWhite.

% H2O2Concentration

0 10 20 30 40 50 60 70 80 90 100

pH at 25°C 7.0 5.3 4.9 4.7 4.6 4.5 4.5 4.5 4.6 4.9 6.2

DENTISTRY TODAY • MARCH 2006

Table 1. How pH of Unstabilized H2O2 Varies With Concentration.