By Sheri Doniger, DDS, contributing writer

June 5, 2012 -- I received a phone call from a concerned parent the other day. I was seeing his son on Saturday, and he wanted to be clear of his expectations. He said that I had to emphasize the need for perfectly white teeth. He was concerned that his child did not receive the message that both he and his wife were repeating to him about the importance of white teeth.

When the son came into the office with his mom, she repeated the white teeth mantra. By that point, I certainly got it.

The interesting point is that the boy is only 6 years old. Apparently, his parents feel that his primary teeth are not white enough. And the erupting permanent teeth were so much yellower than the primary teeth by comparison. After treating the child, he did have an aversion to tooth brushing evidenced by the heavy volume of plaque and calculus present on the buccals of his posterior molars. By comparison, his anterior teeth were cleaner -- not plaque-free, but less of that sheet of plaque that appeared on the posterior molars.

Sheri B. Doniger, DDS
Sheri B. Doniger, DDS.

I get that the parents are trying to instill a sense of oral health in their children. But has the blinding, overwhitened phenomena reached the kindergarten set? I don't know if this young boy was truly interested in pearly whites, or was just being a kid and not brushing properly, but there was clearly a disconnect between the message at home and the message to be sent.

I am all for outstanding oral hygiene. I believe in giving proper toothbrush and flossing instructions to all my patients (a holdover from my hygiene days). I will sit down with kids of all ages and show them, on a huge typodont, how to brush and floss. I will also give them the brush to do the job themselves. For the most part, kindergarten kids still rely on their parents to enforce oral hygiene. They may still need to floss and brush for them.

But what expectations are we giving our kids by telling them that whiter-than-white teeth, as seen on TV, are the goal, when we know that teeth (especially permanent ones) do not have that shade naturally?

This case was truly a first. It is definitely a teachable moment. I will continue to offer oral hygiene instruction and continue to explain the difference between primary and permanent enamel.

Any comments on how early kids are asking for teeth whitening in your practice? I know this wasn't what the parents requested, but having the parents say they unconditionally expect white teeth may be setting the bar a little too high for some kids.

Sheri B. Doniger, DDS, practices clinical dentistry in Lincolnwood, IL. She has served as an educator in several dental and dental hygiene programs, has been a consultant for a major dental benefits company, and has written for several dental publications. Most recently, she was the editor of Woman Dentist Journal and Woman Dentist eJournal. You can reach her at

The comments and observations expressed herein do not necessarily reflect the opinions of, nor should they be construed as an endorsement or admonishment of any particular idea, vendor, or organization.

Copyright © 2012

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