Illegal tooth whitening putting patients at risk


  Posted by: The Probe      20th March 2020

Sarah Ide, Dental Defence Union (DDU) dento-legal adviser explains what you need to know about tooth whitening.

Recent figures from the General Dental Council (GDC) reported in the media have revealed a marked increase in illegal tooth whitening. Last year 732 cases of illegal-tooth whitening were reported to the GDC, a 26% increase from 582 in 2018 – though the figure was higher in 2016.

According to a BBC report, the GDC said it has launched 126 prosecutions for illegal tooth whitening since 2015.

The GDC regards all tooth whitening procedures, including bleach and laser treatment, as the practice of dentistry.

In our image-conscious society it’s likely that demand for tooth whitening will continue, especially given that the results can boost a patient’s confidence. Dental professionals can offer the treatment without fear of prosecution, provided they act within the legal and ethical parameters. The current legal position is set out by the Cosmetic Products (Safety) (Amendment) Regulations 2012, and the GDC has also issued its own guidance for dental professionals.

So what pitfalls should dental professionals offering whitening treatments be aware of?

Firstly, make sure you do not exceed the legal strength of whitening compound. Those containing or releasing up to 6% hydrogen peroxide can be used or supplied in home-bleaching products, provided necessary conditions are met. If you are using a product which contains zinc peroxide or carbamide peroxide, you may need to contact the manufacturer to confirm that it doesn’t release more than the maximum legal amount of hydrogen peroxide.

Dentist’s supervision

You must be registered with the GDC, trained and competent to carry out the procedure and have the appropriate indemnity, so check with the DDU or your own dental defence organisation.

The first use of a tooth whitening product can only be carried out by a dentist, or under their direct supervision as long as an equivalent level of safety is ensured and the patient has first been examined by a dentist.

If you are providing the patient with a home bleaching kit containing up to 6% hydrogen peroxide, a dentist must have first examined the patient and provided the first application in the cycle of treatment, or this must have been done under the direct supervision of a dentist.

Dentists can delegate treatment to an appropriately trained and indemnified dental hygienist, therapist or clinical dental technician as long as a dentist is on the premises during the first bleaching treatment, and a dentist has already assessed the patient’s suitability for the treatment.

Patient suitability

The DDU advises dentists to exercise caution when considering a patient’s suitability for a cosmetic procedure.

Get the patient’s fully informed consent before you start whitening treatment and make a record of the treatment plan and consent process. You should provide the necessary explanations about benefits and risks, such as sensitivity, and a realistic indication of the cost. It’s important to ensure the patient has enough information and time to ask questions and make a decision. Under the law, patients must be aged 18 or over.

While cosmetic treatments, such as tooth whitening, can occasionally lead to complaints, dental professionals offering this treatment can help to ensure patients are satisfied by managing their expectations and following the legal and ethical rules.

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