Whitening confusion ‘threatens patient safety’

Dentists are urgently calling on the government to clear up the confusion over tooth whitening products.

The British Dental Association (BDA) is now seeking an immediate meeting with the Department for Business, Innovation and Skills (BIS) to resolve concerns about the position trading standards officers are adopting in relation to tooth whitening products.

A current investigation by trading standards at Essex County Council is stalling supplies and dentists fear this could impact on patient health if they choose to seek tooth whitening from anyone other than a dental professional.

Dentists claim that the Essex investigation, which took place last month, is having a major impact on the availability of hydrogen peroxide-based whitening products to dentists  – a supply problem that the BDA says may lead to patients seeking ‘illegal and dangerous’ whitening treatments elsewhere.

Stuart Johnston, chair of the BDA’s representative body, says: ‘The recently changed approach to the supply of whitening products – and particularly the impact the investigation being undertaken in Essex – is having a significant concern for patient safety. This must be addressed as a matter of urgency and the previously adopted low-key approach to supply to dental professionals reinstated.

‘A significant body of evidence demonstrates the safety of whitening products when used by trained dental professionals. We urge trading standards officers to adopt a pragmatic approach that recognises this and puts patient safety first.’

The BDA is keen to see the previous low-key approach to enforcement around the supply of whitening products to dental professionals previously advised by Local Government Regulation (formerly LACORS, the Local Authorities Co-ordinators of Regulatory Services) and taken by trading standards re-instated.

The British Dental Bleaching Society (BDBS) has added its voice to this call for government clarification.

It maintains that patient safety is guaranteed when tooth bleaching is carried out by an ‘appropriately trained and qualified dental healthcare professional’.

However, it says any dental professional carrying out the procedure should observe the following guidelines:
• A full examination must take place before any bleaching procedure
• Informed patient consent is paramount and patients must have alternatives and risks thoroughly explained
• ‘Before’ and ‘after’ photos must be taken and retained throughout the course, and following completion of, treatment
• Any products supplied for home use by a dental practice must meet Scientific Committee on Consumer Products (SCCP) guidelines and contain no more than 6% Hydrogen Peroxide
• There should be a commitment by the trade not to supply beauticians or the public direct
The European Union is currently reviewing the EU Cosmetics Directive, which it is hoped will provide a coherent legal framework for the provision of tooth whitening products in the UK.
Meanwhile, dento-legal experts, Dental Protection, which represents more than 56,000 members around the globe, is advising dentists to:
• Take individual therapeutic decisions in respect of each patient
• Avoid advertising the use of tooth whitening products as this may constitute intent to supply the goods beyond an individual therapeutic decision. It is also likely to attract unfavourable attention from local Trading Standards Officers
• Take advice if you have concerns or are approached by a trading standards officer
• If you have concerns about providing tooth whitening products then consider delaying treatment until the legal situation is resolved, rather than proceeding to provide more destructive techniques. Most elective procedures can be deferred
• Ensure that patients are fully informed as to the risks and benefits of both bleaching procedures, and the more interventive alternatives, including a discussion about the current legal status of tooth whitening procedures
• Document all consultations carefully in the patient’s clinical notes – this is essential in order to demonstrate that appropriate discussions have taken place with the patient before the procedure is carried out.

It adds that any member of Dental Protection who is challenged in relation to the use of bleaching techniques in their treatment of patients can look to Dental Protection for advice, assistance and support.

For more guidance from Dental Protection, click here.

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