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Whitening toothpastes: meeting needs or satisfying demands?

A look at any of the current editions of the dental press reveals that at least four new tooth whitening dentifrices were released onto the market last year. Two products come from established leaders in the United Kingdom toothpaste market, and two from a new company. The packaging, promotional literature and advertisements associated with these new products shows that they are all being sold primarily on the strength of their whitening actions. One would imagine that for this number of new toothpastes to be released at the same time, together with the entry of new comers to the field, the marketing men must have done their homework and identified a substantial gap in the market.

Of course, as clinicians we could have told them this, we were already aware of the demand. These are appearance conscious times. The advertising media tells us that good looks start with a white smile. Patients often come to us requesting whiter teeth and worrying more about the appearance of their teeth than their general oral health. Consequently, any product that appeals to our patients’ vanity should sell and sell well, and as the UK expenditure on toothpaste is currently £250 million a year, this is big business.

But are these new dentifrices purely cosmetics, as were the number of their predecessors? A closer look at the ingredients of these toothpastes, and in one case an oral spray, will tell us that they contain much more than just whitening agents. In fact some of these new products have been formulated as multi-component oral health systems, designed to include ingredients active against plaque, caries, calculus and halitosis amongst others, along with their patented whiteners. The efficiency of these active ingredients has been proven in laboratory research and clinical trials over a number of years and if one was to consider designing a toothpaste to improve total oral health, one would want to include most of these ingredients.

There are already a number of these multi-component toothpaste systems on sale, but what makes these new products different is that they contain whitening agents. As with the other more conventional active ingredients, the inclusion of these novel whiteners is also based on research, admittedly mainly in the laboratory and of a chemical nature, but it would appear that some do work. Indeed, a recent double-blind clinical trial proves intrinsic ‘whitening‘ with one system.1

Is it perhaps still surprising that despite the impressive lists of ingredients present in these products that the marketing men have targeted tooth whitening as the key to their respective campaigns for these new toothpastes and sprays? As a clinicican, I have been impressed with the components that are active against halitosis, as I feel that this is a problem that is only just receiving the scientific attention it has long warranted. I have also been impressed with the oral spray that gives repeated low doses of fluoride and other active ingredients. If used correctly, these will act as a reservoir for the fluoridation and this has the potential for improved caries prevention, particularly for ‘at risk’ patients.

However, it is also probably true that none of these innovative features have the capacity to grab our patients’ attention. Are they really interested in the ability of a dentifrice to reduce calculus and gingival inflammation. How often is our preventive advice given to deaf ears? So who can blame the marketers? We all know how difficult it is to meet our patients’ needs while satisfying their demands. Perhaps here with products such as these we have an example of how the two can be united. Our patients want whiter teeth. We, on the other hand, want improved oral health for our patients. Use of these toothpastes and sprays promises both. The only drawback I can see is the price.

There are times when, as a clinician, I feel I should counsel my patients against buying what I perceive to be expensive toothpaste just because they want whiter teeth. On reflection, though, should we complain that our patients are buying these products? They are buying what they want for their oral health care: whitening action, while the use of such a product provides them with the type of benefits we would want them to have; the potential for improved levels of oral health. Indeed, may we not even recommend such products?

Reference
1 Seymour K G, Morris-Clapp C, Patsias N, Patsias P, Lynch E. Shade modification using a tooth whitening dentifrice over six months. J Dent Res 1996; 74: BSDR abstract no 420.

K G Seymour