Colgate Simply White Night gel and Crest Whitestrips Supreme

[drPheta]

I just recently scored some Colgate Simply White Night gel from the Yankee Dental Congress. It was free, and I've been beating around the bush about whitening my teeth. So, I figured I'd give these a shot. So far it tastes like nads, but I haven't seen anything yet (only 2 days of a 14 day schedule).

Crest came out with Whitestrips Supreme (which has 14% peroxide), but I'm not ready to shell out a bunch of money for whitening yet (rather use that for the sonicare). I probably won't spend money until I've exhausted the free stuff.

I was wondering, what are your guys' thoughts on these two particular products?

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[aphistis]

I got some Night Effects from P&G when they came for a lunch & learn. Tasted pretty bad, like you say, but I had noticed some change by the end of the 14 days. The P&G lady said the Colgate people had a hard time formulating their whitening gel to stay on your teeth while you slept; but that's one company commenting on its competitor, so take it for what it's worth.

 

[ItsGavinC]

Originally posted by drPheta


I was wondering, what are your guys' thoughts on these two particular products?

Well, not only are those two different products, but they are two different modalities.

The Colgate product you mentioned is put on your teeth and kept on throughout the night, while the Crest product, the Whitestrips, are put on for 30 minutes twice a day.

Crest also has a night gel application called Night Effects (which Bill mentioned), and I think the general concensus is that this product DOES work better than the Colgate counterpart (Simply White).

Whitestrips are an excellent product, and from what I've gathered here, on DentalTown, and with my own experience, most people do see some very noticeable change. The Supreme version that you mentioned is a great product (I use it myself) You can either purchase it from a dentist, or you and several of your classmates can get together and purchase a case.

The Crest website lists 4 boxes for a total of $124, but upon checkout you will find that it is actually 4 boxes for $80 thanks to the student discount. So, if you can find 3 other students that are interested in trying it, you can get a box for only $20. A great price for a great product, in my opinion.

 

[predentchick]

Those strip things are crap. I used them and they left little white dots on my teeth. They are horrible! I followed the directions exactly and the results were bad! I would spring for the trays with the Rembrandt 30%. That stuff works!!

 

[ShawnOne]

After reading predentchicks's post I felt compelled to say that Crest Whitestrips worked WONDERFUL for my fiance and I (especially my fiance). We used the professional strength and couldn't be happier with the results.

Anybody who is thinking about using them should be aware that it does NOT work on bonding or porcelain.

 

[drPheta]

Cool beans guys. No whitening process works on restorations. Well, I'm on the Colgate Simply White Night regimen now. We'll see how that turns up. Eh, it was free, so if it doesn't work no biggie (as long as my teeth don't get sensitive).

If I really want whitening, I may take up Gavin on his mention of how great Crest Whitestrips Supreme are. $20 a box isn't bad at all. I'll just give them as gifts if I don't want all 4 boxes...if I buy them. 😀

 

[scandalouslj]

We had Crest come and talk to us about their products, as well as give all of us a box of the professional strips for free. I used them and they worked great. Although they only whiten the teeth yo can see when you smile and not all of them. They also talked about the simply white and night effects. Bascially the Crest guy told us it was crap. They said Crest came out with them just to compete with Colgate, and since they are so low on peroxide ( I think it was like 4%, if even that much). He said they werent that much better than just the toothpaste, which only polshies the surface stains. I guess they will help a little as they still have the hydrogen.

 

[DrJeff]

Real world data here. At my office, we've been selling them to patients(first the Whitestrip Professional and since its introduction both the Professionals(for the under 15-18 I need my teeth really white before Prom crowd) and the Supreme's for almost 2 years, and at last count over 80 cases of whitestrips, so I'm talking about well over 300 payng customers here. My partner and I tell every patient that buys the kits that if they're not totally satisfied with the kit, bring back the unused strips and we'll refund 100% of their money. To date NOBODY has taken us up on our offer , and when patients buy kits we make a note in their chart, and we'll then ask them the next time they're in. Just about everyone I talk to that's used them is completely satisfied with the product, and in the big scheme of things its been great for dentistry. I'll admit that we hardly ever sell any tray bleaching cases anymore(at about $300 per case), we returned our 1 hour light activated bleaching machine(you get similar results by putting a rubber dam on a tooth and leaving the tooth isolated for an hour, plus there is a reason that Dr. Dorfman and his Discus dental Zoom machine comes with Zoom at home tray bleaching kits to give to the patients after the light treatment), and almost all of our bleaching in the office now is done via Whitestrips at $75 a pop. From the economics of it, its been great. With tray bleaching we'd do about 10 cases per year, thus generating about $3000 in bleaching revenue, and having to use some chairtime for impressions/delivery, thus loosing the other revenue that that chairtime could be used for. With Whitestrips, we've averaged 160 cases/year at $75 per case, so thats roughly an extra $11,500 in bleaching revenue, and no additional chairtime is used for them

Happy patients, more income generated, less chairtime used, win, win, win! My partner and I were talking this past Thursday as we were driving upto Yankee Dental in Boston about the advances in the last 5 years that we couldn't imagine how we practicedwithout them before, and in order our list was #1 Rotary Endo with NiTi files(and we just dropped about $6000 this weekend for 2 of Brasseler's new rotary system that looks like it will take rotary endo files to the next level ) #2 our soft tissue laser(I think we'll be adding a waterlase by years end) #3 Self etching bonding agents #4 Whitestrips and #6 4% Articaine anesthetic. Just missing our list was the electric handpiece and digital radiography

BTW, Dr Pheta, wait till you goto Yankee in a couple of years with the blue "dentist" badge instead of the orange "student" badge, free samples from reps come ALOT easier. And after be "acosted" by the reps on the floor for 30 or so minutes you'll wish that you had a pink "guest" badge so nobody pays attention to you😀 😀

One last thing, if any of you get the chance, goto the Yankee dental meeting in the next 2 years, because after then it's likely to go downhill courtesy of the Massachusetts state gov't. For those that haven't been to Yankee before, it's huge, and it's a blast and a huge part of the reason is the facility where it's held, the Hynes convention center. Sure, it's Boston in January, but because of this great facility you can go 3 days without ever going outside and have all the shopping/dining/"entertainment" that you want. Since the state of Mass wants to turn this convention center into office space starting in about 2 years, the Yankee meeting will have to find a new venue, and plain and simple, there isn't one anything like it in Boston.(this though would be a good thing for my American Express bill from the "damage" that my staff does to it via the bar tabs that we run up as we're "enjoying" Yankee!😀

 

[mmapcpro]

I've been using the Crest Night Effects for the past 8 days. I can tell you that the difference is like night and day. I am VERY pleased with the results I got...and I think I paid about $30 maybe...I can't really remember.

 

[ItsGavinC]

I'm currently using the Whitestrips as well as the Night Effects. I use the Whitestrips every 6 months or so to touch-up, and I've always been very pleased with my results.

Like predentchick said, there are little white spots, but those have always dissappeared after a couple of hours. For the price, especially with the professional discount, and the time that is required, as well as ease of compliance, I don't think a better product exists in this realm.

Dr. Jeff's internal data certainly supports this.

 

[gryffindor]

Originally posted by DrJeff
One last thing, if any of you get the chance, goto the Yankee dental meeting in the next 2 years, because after then it's likely to go downhill courtesy of the Massachusetts state gov't. For those that haven't been to Yankee before, it's huge, and it's a blast and a huge part of the reason is the facility where it's held, the Hynes convention center. Sure, it's Boston in January, but because of this great facility you can go 3 days without ever going outside and have all the shopping/dining/"entertainment" that you want. Since the state of Mass wants to turn this convention center into office space starting in about 2 years, the Yankee meeting will have to find a new venue, and plain and simple, there isn't one anything like it in Boston.(this though would be a good thing for my American Express bill from the "damage" that my staff does to it via the bar tabs that we run up as we're "enjoying" Yankee!😀

Dental conventions are so much fun! I'm gonna get the time off next year to go to this one since I'll be so much closer to Boston, esp. if their gonna get rid of the Hynes convention center.

For those of you interested, Crest provides the Whitestrips even cheaper than $20/box to ASDA chapters to sell as fundraisers. They are a great fundraiser, people love the Professional Whitestrips and really love the Spinbrush inside. I have yet to try them, but I think I will soon.

 

[mmapcpro]

chicago midwinter is right around the corner...it's gonna be a powerful meeting this year.

 

[trypmo]

I've been a little scared to use any whitening products because I don't know how they work. Is it simply a peroxide thing? How sure are we ("we" meaning dental community) that the process doesn't hurt enamel or tooth structure? Someone mentioned increased sensitivity as a potential side effect? What exactly (like down to the molecular level, if anyone knows) do whiteners do?? I'm in need of some enlightenment here!

 

[aphistis]

Originally posted by trypmo
I've been a little scared to use any whitening products because I don't know how they work. Is it simply a peroxide thing? How sure are we ("we" meaning dental community) that the process doesn't hurt enamel or tooth structure? Someone mentioned increased sensitivity as a potential side effect? What exactly (like down to the molecular level, if anyone knows) do whiteners do?? I'm in need of some enlightenment here!

Yeah, it's a peroxide thing. Hydrogen (or carbamide, depending on the product) peroxide is simply a strong oxidant that removes pigmenting agents from the enamel, no differently (although much less harshly) than bleaching laundry. The peroxide simply oxidizes the offending materials into component, uncolored molecules. Temporary sensitivity can occur, but it typically disappears within a few hours or, at the most, days of treatment.

 

[trypmo]

Originally posted by aphistis
Yeah, it's a peroxide thing. Hydrogen (or carbamide, depending on the product) peroxide is simply a strong oxidant that removes pigmenting agents from the enamel, no differently (although much less harshly) than bleaching laundry. The peroxide simply oxidizes the offending materials into component, uncolored molecules. Temporary sensitivity can occur, but it typically disappears within a few hours or, at the most, days of treatment.

Thanks aphistis! BTW, I really like your new sig quote; I actually laughed out loud (which, these days, seems rare)!

This is NOT meant to sound snotty, but is a genuine point of curiosity for me: do you know which molecules are the "offenders," and which other ones they get broken down into? How far does the whitening action need to penetrate (100 molecules deep? 0.1 mm deep? all the way through?) to make teeth appear whiter? And one last annoying question, and I'm probably showing quite a bit of ignorance here: doesn't tooth enamel have a crystalline structure which the breakdown of its component materials would weaken? If it's not the crystal that gets broken down, what is it, and is it simply on the surface of the teeth, or does it get embedded somehow (and thus would make it so hard to get rid of by conventional means)?

Thanks for the enlightenment; please send more! 🙂

 

[ItsGavinC]

Trypmo,

Studies involving 10% carbamide peroxide whiteners have found minimal or no effect on the microhardness or mineral content of tooth enamel surfaces. Scanning electron microscope studies of the enamel of teeth that have been bleached have typically not shown any damage either. In relative terms, studies have shown that exposure to soft drinks and fruit juices cause comparable or greater alteration of tooth enamel than tooth whiteners.

 

[aphistis]

Originally posted by trypmo
Thanks aphistis! BTW, I really like your new sig quote; I actually laughed out loud (which, these days, seems rare)!

This is NOT meant to sound snotty, but is a genuine point of curiosity for me: do you know which molecules are the "offenders," and which other ones they get broken down into? How far does the whitening action need to penetrate (100 molecules deep? 0.1 mm deep? all the way through?) to make teeth appear whiter? And one last annoying question, and I'm probably showing quite a bit of ignorance here: doesn't tooth enamel have a crystalline structure which the breakdown of its component materials would weaken? If it's not the crystal that gets broken down, what is it, and is it simply on the surface of the teeth, or does it get embedded somehow (and thus would make it so hard to get rid of by conventional means)?

Thanks for the enlightenment; please send more! 🙂

I wish I could claim credit for finding the quote in my signature, but I took it from another SDN'er, which makes it (by my count)third-hand plagiarism.

To answer your questions, and they're all perfectly legitimate, the process is actually quite a bit simpler than you're probably making it out to be in your mind 😉 Bear in mind that natural tooth enamel is translucent, so that means there's very little natural color to the teeth in your mouth. Most of the pigmentation present in most everybody's teeth is due to the accumulation of various staining materials. Fortunately, that also makes whitening pretty simple--if a molecule produces color, it needs to be gotten rid of. Precisely what molecules are being attacked by the peroxide, and what they're being broken down to, is completely dependent on the diet of the individual; again, this is why the non-selectivity of the peroxide agent is beneficial.

Also remember that despite the regular crystalline structure of enamel, there's still a lot of empty space sitting between the lattice vertices. Ca10(PO4)6(OH)2, hydroxyapatite, is the primary component of enamel, and the size of the lattice unit leaves a lot of space for contaminants to accumulate. That's why peroxide treatments take time--sitting around with a tray in your mouth for a couple hours, leaving a whitening strip in place all day, etc. That gives the peroxide time to penetrate the enamel's microstructure.

As for the danger of harming enamel, you're absolutely right in observing that's the last thing we want. Conventional whitening treatments are only effective against "extrinsic staining," which is what I've described so far, where external agents become trapped within the enamel and cause discoloration. A second category called "intrinsic staining" also exists, and peroxide whitening treatments are generally ineffective against these discolorations. The two most common examples are fluorosis (excessive fluoride exposure) and tetracycline exposure during formation of the dentition. In those examples, the actual enamel itself is altered, resulting in a coloration that traditional whitening agents can't do anything about.

Sorry for the long response, but hopefully that helps clear things up at least a little for you 😀

 

[trypmo]

Originally posted by aphistis
I wish I could claim credit for finding the quote in my signature, but I took it from another SDN'er, which makes it (by my count)third-hand plagiarism.

To answer your questions, and they're all perfectly legitimate, the process is actually quite a bit simpler than you're probably making it out to be in your mind 😉 Bear in mind that natural tooth enamel is translucent, so that means there's very little natural color to the teeth in your mouth. Most of the pigmentation present in most everybody's teeth is due to the accumulation of various staining materials. Fortunately, that also makes whitening pretty simple--if a molecule produces color, it needs to be gotten rid of. Precisely what molecules are being attacked by the peroxide, and what they're being broken down to, is completely dependent on the diet of the individual; again, this is why the non-selectivity of the peroxide agent is beneficial.

Also remember that despite the regular crystalline structure of enamel, there's still a lot of empty space sitting between the lattice vertices. Ca10(PO4)6(OH)2, hydroxyapatite, is the primary component of enamel, and the size of the lattice unit leaves a lot of space for contaminants to accumulate. That's why peroxide treatments take time--sitting around with a tray in your mouth for a couple hours, leaving a whitening strip in place all day, etc. That gives the peroxide time to penetrate the enamel's microstructure.

OK, let's see if I've got it right. The hydroxyapatite is basically inorganic, crystalline matter, right? Basically, a bunch of calcium with a few phosphates hanging around and a couple of alcohols. I see how food and other nasties could migrate into the lattice, and since we don't need anything besides the lattice to be there, it's okay if those organic trespassers are gotten rid of. However, don't we then have to ask just how far the peroxide passes into the lattice? What makes up the interface between the dentin and the pulp, for example? What would happen if the peroxide got all the way through the crystal and into the organic stuff; wouldn't it then start attacking the pulp? Perhaps this happens in such small amounts, and because the peroxide gets used up in the reaction, it's no biggie.

Are there any data on what happens to the residual material which, I assume, stays in the lattice but is no longer optically active? Is there then a lower probability of accumulation of more nasties because, simply by volume, there's less space in there, or can the residues somehow maliciously recombine with the next wave of food-derived intruders?

As for the danger of harming enamel, you're absolutely right in observing that's the last thing we want. Conventional whitening treatments are only effective against "extrinsic staining," which is what I've described so far, where external agents become trapped within the enamel and cause discoloration. A second category called "intrinsic staining" also exists, and peroxide whitening treatments are generally ineffective against these discolorations. The two most common examples are fluorosis (excessive fluoride exposure) and tetracycline exposure during formation of the dentition. In those examples, the actual enamel itself is altered, resulting in a coloration that traditional whitening agents can't do anything about.

So in these intrinsic cases, the best recommendation would be a veneer or something, right?

I think the thing I'd be most worried about, then, would be the peroxide's effect on the gums! Isn't that an issue?

Sorry for the long response, but hopefully that helps clear things up at least a little for you 😀

I like the long responses (I tend to produce them myself).

Do you know where I could find out more about the crystal structure of enamel and what other components it may have besides hydroxyapatite? I'm getting all these perverse fantasies about filling cavities by epitaxial thin film deposition to ensure a lifetime of maintenance-free fillings.

 

[trypmo]

Originally posted by ItsGavinC
Trypmo,

Studies involving 10% carbamide peroxide whiteners have found minimal or no effect on the microhardness or mineral content of tooth enamel surfaces. Scanning electron microscope studies of the enamel of teeth that have been bleached have typically not shown any damage either. In relative terms, studies have shown that exposure to soft drinks and fruit juices cause comparable or greater alteration of tooth enamel than tooth whiteners.

Huge thanks to you also, Gavin! I had no idea that not even SEM studies could pick up the difference -- that's really saying something!

 

[aphistis]

Originally posted by trypmo
OK, let's see if I've got it right. The hydroxyapatite is basically inorganic, crystalline matter, right? Basically, a bunch of calcium with a few phosphates hanging around and a couple of alcohols. I see how food and other nasties could migrate into the lattice, and since we don't need anything besides the lattice to be there, it's okay if those organic trespassers are gotten rid of. However, don't we then have to ask just how far the peroxide passes into the lattice? What makes up the interface between the dentin and the pulp, for example? What would happen if the peroxide got all the way through the crystal and into the organic stuff; wouldn't it then start attacking the pulp? Perhaps this happens in such small amounts, and because the peroxide gets used up in the reaction, it's no biggie.

The biggest thing to remember here is relative size. It takes a very large number of molecules to accomplish anything of observable significance. To get from tooth surface to pulp you're talking about a distance of up to several millimeters, depending on which surface you're starting from. Given that we're dealing with peroxide molecules measured in angstroms here, that's a migration of well into the hundreds of thousands of multiples of the molecular size. The simple probabilities against any significant number of molecules making that movement are vanishingly small. This does, however, segue into your question about the dentinopulpal interface. This junction is lined by odontoblast cells, whose job is forming and depositing new dentin in response to chemical insult. If any number of peroxide molecules were to leach inward, the odontoblasts likely would deposit reparative dentin to protect the pulp cavity. If you do a Google for "oral histology" you'll probably find everything you wanted to know, and then some.

Are there any data on what happens to the residual material which, I assume, stays in the lattice but is no longer optically active? Is there then a lower probability of accumulation of more nasties because, simply by volume, there's less space in there, or can the residues somehow maliciously recombine with the next wave of food-derived intruders?

They may remain within the enamel structure, but they're colorless so there's no aesthetic trouble. Alternately, they may leach out into the oral cavity at large over time. There's virtually no danger from the residual molecules even if they remain in the tooth structure, however, since the fully oxidized molecules won't be accessible to bacteria for fermentation into cariogenic acids.[/quote]
So in these intrinsic cases, the best recommendation would be a veneer or something, right?[/quote]
This is more for Tom or Andy or any of the other upperclassmen to answer, but I believe the best option for intrinsic staining is operative or prosthodontic treatment, yeah.

I think the thing I'd be most worried about, then, would be the peroxide's effect on the gums! Isn't that an issue?

That's actually a good question. I imagine the keratinization of the gingiva would protect them from peroxide's effects, but that's speculation on my part. Again, any upperclassmen want to chime in?

Do you know where I could find out more about the crystal structure of enamel and what other components it may have besides hydroxyapatite? I'm getting all these perverse fantasies about filling cavities by epitaxial thin film deposition to ensure a lifetime of maintenance-free fillings. [/B]

Again, any oral histology resource is where you'll likely find the answers you're looking for. As for your perverse fantasies, I'm sending you a Playboy in the mail tomorrow to help get your brain out of your teeth and back in the gutter where it belongs. 😉

 

[drPheta]

As far as the gum tissue is concerned, many of the treatments with the mouthguard are done in a way as to keep the gel from contacting the gingiva. I recall being told by my classmate (who had whitening done using the tray) that the tray wasn't molded properly, so her gums were being whitened, too. Needless to say, her gums were irritated for a few days. Not comfy.

This may or may not be the case with other whitening methods, but the Crest strips seem to overlap the gums by about 1mm. This is how I saw it being applied in the animated dramatization during a demo at the Yankee Dental Congress.

 

[DrJeff]

Originally posted by drPheta
This may or may not be the case with other whitening methods, but the Crest strips seem to overlap the gums by about 1mm. This is how I saw it being applied in the animated dramatization during a demo at the Yankee Dental Congress.

I figure with the display that the folks at proctor and gamble had set up to show the whitestrips video demos that there was about 20-25,000 worth of plasma screen up there😍

After "sampling" some of the on floor free beer 😍 😍 and wine on Thursday afternoon, my partner and I thought about asking our whitestrips rep if we could "borrow" 2 or 3 of them to watch the superbowl on. BTW, if you haven't guessed by looking at my avitar I really enjoyed the superbowl, and not just for the Janet Jackson 1/2time festivities

 

[drPheta]

Originally posted by DrJeff
I figure with the display that the folks at proctor and gamble had set up to show the whitestrips video demos that there was about 20-25,000 worth of plasma screen up there😍

After "sampling" some of the on floor free beer 😍 😍 and wine on Thursday afternoon, my partner and I thought about asking our whitestrips rep if we could "borrow" 2 or 3 of them to watch the superbowl on. BTW, if you haven't guessed by looking at my avitar I really enjoyed the superbowl, and not just for the Janet Jackson 1/2time festivities

Oh man. I'm so lucky I did not think of that. I actually had to attempt to study during the super boob...err bowl. That must have been ridiculously sweet watching the game on all those screens...with such a close game.

I didn't even know the congress was still going on during that time.

You lucky bastard!

 

[DrJeff]

Originally posted by drPheta
Oh man. I'm so lucky I did not think of that. I actually had to attempt to study during the super boob...err bowl. That must have been ridiculously sweet watching the game on all those screens...with such a close game.

I didn't even know the congress was still going on during that time.

You lucky bastard!

I was just being a little sarcastic on that one, Yankee did indeed end on Saturday, and I'm sure that the P+G plasmas were packed up and headed to Chicago for the mid winter meeting. I was "forced" to watch on my HD Sony tube while holding my 3 week old daughter all dressed up in her Troy Brown jersey😀 😀

Then I did indeed have to show up at my office yesterday wearing my Patriots golf shirt just to further raz my Jets fan partner If it wasn't for the fact that due to christmas, new years, my daughter's birth, MLK day and Yankee that I haven't worked a full week since mid December I would have been up in Boston today for the parade The best thing though is that all next season at Gillette Stadium I get to hear the announcer saying "and now your WORLD CHAMPION New England Patriots" as they come out of the tunnel and onto the field 😀