Q. My dentist has asked me to undertake tray bleaching for patients and has offered to train me. I haven't attended any courses or studied any theory on the subject. Would the GDC consider me competent?

Setting aside the legal issues in relation to the prescription of hydrogen peroxide, the key element is whether an ‘in-house' course would be considered ‘adequate and appropriate' to provide training for a DCP. Unfortunately the GDC offers no definition in this respect and therefore it is impossible to say whether a particular training course would be considered adequate to comply. It is up to the clinician who provides the training to decide this.

Given the facts outlined in this question, it is perhaps unlikely that the GDC would consider a DCP to be adequately and appropriately trained, (let alone competent) based on this rather brief ‘in-house' training. That is not to say that all ‘in-house' training would be inappropriate. Much would depend on the nature of the training. If it is comprehensive and covers the clinical, theoretical and pharmacological aspects of bleaching, then it may well be sufficient. In reality, reliance on this type of training could be something of a gamble and may best be avoided.

If the DCP wants to undertake this type of treatment for patients they might be best advised to attend a recognised training course organised by an appropriately qualified clinician or the postgraduate deanery. There are a number of these courses around, although they do tend to book up very quickly as demand is high. But, as time goes by, more courses are likely to become available.

Before choosing a course it is best to do a little homework. In particular you need to consider the course content in detail. If you are looking to do in-surgery bleaching for example, it may be helpful if the course offers a practical ‘hands on' component to help you develop some confidence in handling the materials and equipment. In addition, some courses for DCPs will suggest that the delegates keep a logbook of completed cases during the supervision phase. This process allows the DCP to document the learning process and review the outcome or any complications as necessary.

Above all, the course needs to be specifically designed for hygienists and therapists. Bleaching courses for dentists may well assume a degree of knowledge that the DCP simply does not have. Similarly courses run by individual manufacturing companies may focus on their own product(s) and may not deal with the wider aspects of bleaching and the other available methods.

Over the years, many clinicians have found out to their cost that, not obtaining adequate training before adopting new clinical techniques can only lead to difficulties in the future. At the end of the day it is for the individual to make the choice and take responsibility for their decision.