What about whiteners? Safety concerns explored

Article Abstract:

Consumers, driven by their quest for whiter, more attractive smiles, are currently buying tooth whiteners at a fast clip. These products are undeniably effective for mildly to moderately stained teeth; however, their safety may not receive the same grade-A rating. The majority of whiteners rely on a 10 percent solution of carbamide peroxide, a crystal that reacts with water to release hydrogen peroxide. This, in turn, liberates free oxides. The oxides release free oxygen radicals (oxygen atoms that carry an extra electron), chemicals known to be active in the body. Hydrogen peroxide can interact with carcinogens to enhance their potency and, with chronic use, can alter the balance of normal oral flora (mouth organisms). Enzymes in the teeth may be inhibited and the mouth may become more susceptible to infections such as candida albicans. Scientists at the American Dental Association (ADA) Research Institute's Department of Toxicology are concerned about the long-term effects of whiteners, noting that safety has not been demonstrated. The effect of these products is due to the very chemical that has aroused concern: the free radicals. Some manufacturers are working with the ADA to demonstrate safety. One company supplied results of six long-term clinical studies to support its claims. However, at least one of the studies did not really show long-term effects, although no short-term adverse consequences were seen. The authors are currently evaluating data from people who used the whitener for six months, and report that all seems well. They recommend that whiteners be used only under the supervision of a dentist, and that over-the-counter preparations should be closely monitored. The ADA remains concerned, partly as a result of studies that have shown carcinogenic effects in the mouths of animals from the application of hydrogen peroxide and a carcinogen. One such study tried to simulate the oral environment of a smoker. Hydrogen peroxide alone did not cause cancer, however. ADA scientists believe that ''the jury is still out'' on the safety of tooth whiteners. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Complications and side effects, Teeth, Oral hygiene products, Dentifrices

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Dentistry's public image: does it need a boost?

Article Abstract:

The entertainment media have not shown dentists much respect. Movies, television shows, and books have frequently portrayed dentists as everything from sadistic maniacs to bumbling buffoons. In the novel and movie "Marathon Man", the dentist character is sinister and evil, clearly meant to evoke an association with Josef Mengele, who was known as the Angel of Death at the concentration camp at Auschwitz. The movie "Compromising Positions" involved a dentist who molested his patients, and an episode of the television show "LA Law" showed an obsessive-compulsive woman dentist who had to floss her partner's teeth while making love. Dentists have been portrayed as geeks, according to one professional who works to promote a positive image of dentistry through the news media. In comparison to dentists, other professional groups such as physicians and lawyers tend to get a more balanced press, with roughly equal numbers of unflattering portrayals and heroic roles. The American Dental Association has taken action to enhance the image of the profession by approving an extensive public awareness campaign meant to educate the public about dental health. The theme and logo of the campaign is "Smile America!". Dentists will be shown as caring health professionals who also can offer many advanced and exciting technologies such as lasers, veneering and bonding, and arthroscopic surgery. But not all dentists agree that there is an image problem. Some point out that several public opinion polls have ranked dentists very high in terms of respected professions; one poll put dentists second only to pharmacists on honesty and ethical standards. Other dentists concede that while an image-enhancing campaign may help, the main way that the public forms an opinion on dentistry is from one-to-one interactions with the dentist. The public standing of dentistry may truly hinge on what happens in the dentist's chair and not what is shown on television; if this is the case, quality care and concern for patients is the key to the respect this profession wants. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Dentists, Dentistry, Dental care, Public opinion

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Hygiene enrollments rising: an end to the shortage may be in sight

Article Abstract:

Enrollment in dental hygiene education programs is increasing, perhaps marking an end to a serious problem faced by dentistry. There are 204 accredited dental hygiene programs in the US, and enrollment rose by 7.5 percent in 1989 and additional 3.2 percent in 1990. The total student population in these schools was 5,419, comparable to levels in the early 1980s. However, these levels are far below figures for the late 1970s. For example, there were 8,386 first-year assisting students in 1979. The recent improvement is partly the result of efforts made by practicing dentists who have encouraged young people to consider careers in such fields. Dentists have also supported legislation to encourage enrollment. Mobile units that travel to more remote locations and non-traditional education programs have also helped. The mobile program associated with the University of Kentucky Community College System is described. Such programs allow flexibility in movement to areas where they are most needed. In other areas, community colleges and vocational-technical institutes may join facilities to train dental hygienists. Students may study in the evening and keep regular jobs during the day. Other programs are described. Non-traditional students studying to be dental assistants or dental hygienists are often older than the traditional worker or are from minority groups. More men are also enrolling in this type of training. While the shortage of hygienists continues, such innovative approaches have met with considerable success. (Consumer Summary produced by Reliance Medical Information, Inc.)

Training, Vocational guidance, Dental hygiene, Dental hygienists

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