Tooth whitening in the orthodontic practice: A survey of orthodontists

IntroductionThe demand for tooth whitening has grown almost exponentially in the last 20 years, but there are no published reports regarding how bleaching is used in contemporary orthodontic practices in the United States.MethodsA weighted sample of American Association of Orthodontists members (3601) was surveyed via electronic and paper questionnaires to quantitatively, by logistic regression, and qualitatively assess orthodontists' current practices regarding tooth-whitening procedures.ResultsOf the surveys, 1222 were completed, and 1182 surveys were eligible for analysis. Nationwide, 88.8% of orthodontists had patients who requested tooth whitening, and 76.2% of orthodontists had recently recommended whitening procedures for some patients, typically less than 25% of their total patient population. Approximately a third (32.8%) of orthodontists provided whitening, and nearly two thirds (65.8%) referred whitening procedures to other dental professionals. The geographic region of the country had a statistically significant effect on the proportion of orthodontists who received whitening requests (P = 0.004), recommended whitening procedures (P <0.0006), and provided whitening services in their specialty practices (P <0.0001).ConclusionsAlmost all orthodontists encounter patients who request whitening procedures, and most recommend whitening procedures for a small percentage of their patients. The proportion of orthodontists who refer such procedures to other providers is nearly double the proportion that provides them.