Q. I am a registered dentist during the week but I would like to provide home tooth whitening trays with 16% carbamide peroxide at a local beauty salon at weekends. I envisage taking alginate impressions and decontaminating before sending them to a laboratory. I would not examine the mouth but would rely on the customer to tell me if they had any anterior crowns or veneers or ongoing treatment with their own dentist.

As a GDC registrant you have an obligation to ensure that any dental care you provide for patients is undertaken accordance with GDC guidance; irrespective of where this is carried out.

In relation to medical emergencies, the GDC Scope of Practice reminds us that: ‘A patient could collapse on any premises at any time, whether they have received treatment or not. It is therefore essential that all registrants should be trained in dealing with medical emergencies and be competent to carry out resuscitation.’

This obligation is further expanded in their publication Principles of Dental Team Working at 5.7 that: ‘Medical emergencies can happen at any time in dental practice……. you should make sure that there are arrangements for at least two people available to deal with medical emergencies when treatment is planned to take place.’

The GDC regards tooth whitening as the practice of dentistry. Consequently wherever you provide this service you need to ensure that appropriate support is available to deal with medical emergencies. In order that the patient should not be seen to be disadvantaged in any way by having treatment carried out at a site other than in a dental surgery. A dentist would also need to ensure that appropriate emergency drugs were accessible in order to deal with any medical emergency that might arise when providing dental services. Similarly, appropriate levels of cross-infection control would be required.

In relation to storage of records, you would have a duty to ensure patient records are retained confidentially and would need to ensure compliance with the Data Protection Act.

As part of the consent process, prior to treatment, a patient must be provided with any appropriate alternative treatment options together with their risks and benefits before proceeding with any dental treatment.

The difficulty you would face undertaking treatment in a beauty salon setting would be that you would need to be able to demonstrate that a full examination had been carried out (even if it is not undertaken at the salon) in order to confirm what treatment was necessary and appropriate and naturally this might include a periodontal and radiographic examination.

As I’m sure you will appreciate, the GDC would not be likely to consider that relying on information provided by a patient regarding their understanding of their own dental health would be sufficient to demonstrate that an appropriate assessment and examination had been undertaken. You might find it difficult to defend a subsequent challenge that you had failed to identify a treatment need.

Since diagnostic and screening procedures in relation to dental treatment are now regulated by the CQC; consideration would also need to be made as to whether registration of the premises where you were undertaking tooth whitening would be necessary. Naturally should this be the case, you would then need to ensure that you were fully compliant with all the CQC requirements.

In addition to these issues it still remains illegal in the UK to supply a product for the purpose of tooth whitening, if that product contains or releases more than 0.1% Hydrogen Peroxide. As a result, anybody carrying out tooth whitening using products releasing more than 0.1% may face criminal prosecution which may be instigated by a Trading Standards Officer.

Dental Protection’s advice would then be to avoid advertising the use of tooth whitening products as this may attract unfavourable attention from local Trading Standards Officers.

Whilst the GDC recognises to the whitening as the practice of dentistry it is encouraging the general public to seek treatment in a dental setting rather than a salon. You can read their patient information sheet here in English and in Welsh

Dental Protection’s website does have further information in relation to tooth whitening in its position statement which is available on our website here