Reader’s Forum TO THE EDITOR

I congratulate Dr. Haywood on his article about the bleaching of tetracycline-stained teeth.’ Although it is a single case presentation, he has demonstrated emphatically that less is more and that cooperation and perseverance are paramount in a bleaching procedure. Having spent most of my professional career in Denmark and the past 4 years in England, I have experi- enced first hand the detrimental effects of ridiculous bureaucratic decisions, making it illegal to purchase dental bleaching products for dental bleaching procedures. After years of legal battling and several million dollars in litigation fees, it has finally been made legal to bleach teeth in the United Kingdom, as long as the products are not labeled “for dental bleaching.”

The consequences of years of legal haggling have sometimes been catastrophic. I have seen hundreds of teeth prepared for veneers when bleaching would have met the patient’s needs and expectations. I also have seen too many failures of veneers due to poor preparation or poor laboratory work or just plain poor diagnosing and planning. The patient is then doomed to years of maintenance, replacements, or possible biologic implications due to repeated treat- ments-when a simple, albeit time-consuming, bleaching procedure would have sufficed.

I am tired of being subjected to some of the more exaggerated hype associated with the “need” to invest thousands of dollars in various hi-tech laser equipment to achieve adequate bleaching results. I have actually suggested (with slight tongue in cheek) that when using several of the in-office “power bleaches” available, I can just use the laser pointer that I use for lectures. I can wave it across whichever bleaching gel I have applied, and the patient will receive a state-of-the-art laser bleaching treatment!

I am not against evolutionary developments; usually, I embrace them wholeheartedly. How- ever, when they lead to overtreatment or excessive unnecessary investments, I believe that we are letting our patients down and risk removing ourselves from the category of “health care providers.”

Once again, thanks for showing so clearly that so much can be achieved with “so little.”

David Winkler

R E F E R E N C: E 1. Haywood VB. Greening of the tooth-amalgam interface during extended 10% carbamide peroxide bleaching of

tetracycline-stained teeth: a case report. J Esther Restor Dent 2002; 14:12-17.

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