Here, Dental Protection provides answers to some commonly asked questions about dento-legal issues connected with tooth whitening and DH&Ts
The law relating to tooth whitening will change on 31 October 2012.
The new law increases the percentage of hydrogen peroxide allowed in tooth whitening or bleaching products to 6%, subject to conditions which include first use by a dental practitioner or under their direct supervision. Until 31 October the existing law remains in force and this position statement relates to treatment provided after 31 October 2012.
Dental Protection welcomes the change in the law, which will allow practitioners to act in their patients’ best interests whilst remaining within the law.
The legislation relating to tooth whitening is laid down by the European Union and the change to the law follows many years of lobbying by dental groups.
The new law draws a clear line between the products that can legally be used for tooth whitening by dentists or under their direct supervision and the products that can be purchased by non-dental professionals.
The change follows as an amendment to the EU Directive 76/768/EEC concerning cosmetic products. The amending Council Directive 2011/84/EU was published in September 2011 requiring the UK Government to amend the law. The Cosmetic Products (Safety) (Amendment) Regulations 2012 (The ‘Regulations’) amend the previous regulations relating to tooth whitening. The new Regulations allow the use of hydrogen peroxide and other compounds or mixtures that release hydrogen peroxide, including carbamide peroxide and zinc peroxide to be used for tooth whitening.
The maximum concentration that may be used for tooth whitening under the Regulations is 6% present or released. In very broad terms and as a general guide, a percentage expressed in terms of carbamide peroxide content will release one third of that level of hydrogen peroxide. Thus, the commonly used products containing 16% carbamide peroxide would be permitted under the revised Regulations because they would normally be releasing less than 6% hydrogen peroxide.The Regulations set out that products containing or releasing up to 6% hydrogen peroxide can be used, subject to conditions:
- To only be sold to dental practitioners
- For each cycle of use, first use by a dental practitioner; or
- Under their direct supervision, if an equivalent level of safety is to be ensured.
- Afterwards to be provided to the consumer to complete the cycle of use.
- Not to be used on a person under 18 years of age.
Q. Reading the new tooth whitening regulations I wondered if the referring dentist needs to be in the same room as the hygienist when a new course of tooth whitening has been referred to them? How will beauty therapists stand under the new regulations?
Under the Cosmetic Products (Safety) (Amended) Regulations 2012 that come into force on 31 October 2012, dental hygienists can provide the first application of each cycle of tooth whitening, under the direct supervision of the dentist if an equivalent level of safety is ensured. Whilst the Regulations do not define the term direct supervision there is nothing to suggest that the dentist has to be in the same room as the hygienist when undertaking tooth whitening. The Regulations do not make it clear whether the dentist has to be in the building at the time, although it is apparent that the aim of the requirement is to ensure the same level of safety and an appropriate degree of ‘oversight’ by a registered dentist is maintained. The phrase, “direct supervision’ does mean that a dentist cannot provide a prescription for tooth whitening which the patient can then to take to a registrant working at a different address.
The Regulations set out that the maximum authorised concentration of tooth whitening products is 6% hydrogen peroxide. The Regulations apply equally to products used in the surgery and for home whitening. The Regulations also state that the tooth whitening product can only be sold to dental practitioners.
Beauty therapists who are providing tooth whitening using concentrations of hydrogen peroxide above 0.1% are breaching the Regulations. The Regulations are enforced by Trading Standards Officers and hopefully, the implementation of the new Regulations will give greater clarity so that Trading Standards Officers will prevent non registrants providing tooth whitening.
Q. With direct access will it be possible for patients to go straight to a dental hygienist for tooth whitening?
As tooth-whitening products containing or releasing more than 0.1% hydrogen peroxide can only be sold legally to a dental practitioner, hygienists will not be able to provide this treatment directly if the GDC allows direct access.
The GDC are currently consulting on direct access. You may wish to review the information here on the GDC website for the most up to date position on this proposed change.
• For more, visit www.dentalprotection.org/uk/askdpl/tooth_whitening_faqs