The General Dental Council’s Statement on Tooth Whitening
Under the Dentists Act 1984, the practice of dentistry can only be legally undertaken by GDC registrants: dentists, or hygienist or therapists working to a dentist’s prescription. The GDC regards tooth whitening as the practice of dentistry while several companies which produce tooth whitening systems take the diametrically opposed view that, as tooth whitening agents are covered by the European Council Directive on Cosmetic Products 76/68.EEC, their agents are not practising dentistry.
The GDC advises any member of the public wanting tooth whitening to speak to their dentist. A dentist will be able to advise patients whether or not they are suitable for tooth whitening treatment. Dentists, hygienists and therapists will be able to discuss the options available to patients along with an estimation of treatment costs. The treatment options are professional bleaching or laser/halogen light whitening although neither treatment is available on the NHS. There isn’t a set price for private dentists or hygienists or therapists providing tooth whitening treatment therefore patients should request a written estimate.
The most common treatment method is professional bleaching which involves the dentist or hygienist or therapist on prescription putting a rubber shield or gel on the patient’s gums and applying the whitening product to the teeth using a tray that is fitted to the mouth. The active ingredient, usually hydrogen peroxide or carbamide peroxide, is broken down which allows oxygen to get into the tooth enamel thus lightening the teeth. This treatment usually takes between three to four weeks including two or three visits to the dentist or hygienist or therapist and continued treatment at home. Dentists or hygienists or therapists will take impressions at the first appointment to create a mouth guard.
For whitening using a laser or halogen light a rubber dam is put over the patients’ teeth, then a bleaching product is painted on and a light is shone on to the teeth. The light speeds up the chemical reaction and therefore the colour change takes less time.
As tooth whitening involves the use of chemicals it is safer for it to be done by a dentist, or a hygienist or therapist on prescription after a thorough examination and assessment by a dentist. The GDC does not recommend or endorse any tooth whitening product.
The Council has been sent around six hundred complaints in the past three years about this treatment (using hydrogen peroxide, carbamide peroxide or chlorine based products) being carried out in salons and clinics by non-registrants and we are currently exploring different approaches to tackling the issue. The matter is, however, legally complicated and it will be many months before we are sure of the best way forward. When we have the answer, we will publicise it on our website and in the Dental Press. Until then we cannot take any formal action on general complaints about tooth whitening other than writing to the relevant salon giving our position.
The GDC will, of course, continue to investigate allegations of patient harm as a result of tooth whitening and, where we have enough evidence, we will proceed with prosecution. We will also take action against any of our registrants who are carrying out this procedure outside the GDC’s scope of practice guidance.
If you have a complaint which involves:
- documented evidence of patient harm;
- a patient who is, or may be, willing to co-operate with the GDC; or
- an allegation of registrant practice outside the scope of practice guidance
please call us on 0845 222 4141 or email us at illegalpractice@gdc-uk.org