There used to be a problem with "THE HAMBURGER" we would see on the billboard, and "the hamburger" we would actually get at the fast food restaurant. Twenty to 30 years ago, truth in advertising was a big issue. Now we see a photo of a four-inch-high, stacked burger, and we accept that the reality is a one-inch, foil-wrapped object that a specially trained person flattened just before he or she bagged it.
In my dental practice I expect to see truth in advertising, for my benefit as well as for the benefit of my patients. All of us should expect this, as well as truth in representation of research. Yet, we are often provided with pamphlets for our patients that clearly contain false advertising, and we see false representation in most of our important periodicals and journals, in advertisements, as well as in research results.
What I am referring to are "before-and-after" photos of bleached, and other cosmetically changed, teeth. A prime example is found in a well-written, well-researched article in February JADA, "Light Augments Tooth Whitening With Peroxide," by Dr. J. Max Goodson and colleagues. Any dentist or auxiliary familiar with cosmetics can see a major difference between the before-and-after pictures in Figures 4 and 5. Though I am sure there are differences due to the procedures, I object to the photographically enhanced differences.
Both "before" photos show gingiva that has muted, unnatural color, and both "after" photos show a more normal pink appearance to the gingiva. Different lighting is obvious. The before photos were taken from above, showing little reflection; the after photos were taken straight on to reflect more light, providing a lighter and whiter appearance. They should have been taken in the same light and at the same angle.
I have seen some bleaching advertisements that showed before and after photos that, through stereo imaging, are identical photos, yet one was digitally enhanced to look whiter. Awhile back, I received patient pamphlets from a company selling bleaching products that clearly showed false advertising. Some time after sending a letter stating that I could not hand out these misleading pamphlets, the company sent an apology. They stated that, after having received many complaints from doctors about the unrealistically white teeth advertised, they would reprint the pamphlets with realistic after results.
I am not belittling the extensive research, contesting the results or attacking the article mentioned above, but the photos are not up to par with the quality of the report. My issue? I would simply like to see all dental literature provide us with accurate before-and-after photos so no one is misled.
Bleaching is the No. 1 requested cosmetic procedure. It would be very embarrassing to try to explain to every patient why his or her teeth did not bleach as white as the Kodak 110+ brightness white-paper-shaded teeth shown on our misleading pamphlets, brochures and educational tools. If any readers feel the same, I urge them to contact those companies or journals that continue to show us, and our patients, the big hamburger.
