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Bleaching and Tooth Whitening by DCPs
An Update
This Position Statement should be read in conjunction with the previous Position Statement on Tooth Whitening which was updated in March 2008.
On July 11th 2008, the GDC issued a Press Release in the wake of its "Scope of Practice" consultation which took place earlier in 2008. The GDC states:
"Dental hygienists and dental therapists can carry out tooth whitening on the prescription of a dentist, if they have the necessary additional skills. "Taking impressions to a dentist's prescription, and making bleaching trays to a dentist's prescription, are within the scope of additional skills for dental nurses."
The GDC President, Hew Mathewson, is quoted as saying,
"This clarification does not alter the GDC's position that tooth whitening carried out by non dental professionals is illegal"
While the above statement from the GDC President may be factually correct, many members who have contacted Dental Protection's dento-legal helpline have clearly been confused into drawing the conclusion from this, that tooth whitening carried out by registered dental professionals (as distinct from non-professionals) must therefore be legal, and that the longstanding legal obstacles created by the EC Directive and the UK's Cosmetic Products Regulations have been resolved.
This is not the case (please refer to Dental Protection's separate Position Statement on Tooth Whitening for full details of the current position) and it is unfortunate that the GDC's Press Release did not make this clear.
"Tooth whitening" and "Bleaching" are not necessarily interchangeable terms. Their legality (and the other associated dento-legal risks) depends upon the nature and concentration of the products being used. Many tooth whitening products have no bleaching component. As the law presently stands, the main complications arise when supplying products which contain (or release) more than 0.1% hydrogen peroxide. This remains illegal even when carried out by a dentist, hygienist or therapist, despite the GDC's recent statement suggesting otherwise.
Furthermore, it is worth clarifying that a dental nurse who takes impressions and constructs bleaching trays is creating a custom-made device as defined by the Medical Devices Directive, and this activity imposes various legal requirements involving the dental nurse and his/her employer, with regard to registration with the Medical and Healthcare Products Regulatory Agency, and the documentation and quality assurance in relation to each medical device constructed.
Issued 24 July 2008