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Chase tattooists, not us
9th Nov 2006
Fears of prosecution for supplying tooth whitening products (TWPs) that contravene cosmetic regulations are causing unprecedented confusion in the profession. This follows the news last month that trading standards officers in England are to tighten up on the law. The Local Authorities Coordinators of Regulatory Services (LACORS) said that the profession might see cases actively pursued, however it is likely the action will be preceded with a written warning. ‘As long as the warning is heeded, there will be no further action,’ said a spokesperson for LACORS. On why the approach has changed, the LACORS spokesperson said: ‘We have had a number of complaints received by local authorities about the activities of non-dental outlets offering consumers tooth-whitening treatments.’ But Dentistry believes that the Trading Standards’ change in stance is being affected by delays in the expected change to European law regarding TWPs. Commenting on the news, Tony Reed, executive director for the British Dental Trade Association (BDTA) said: ‘There have been no recorded complaints from the public concerning adverse reactions to treatment but there have been complaints from dentists. This has caused some derision in Trading Standards circles.’ Unfortunately, the cosmetic regulations make no distinction about who supplies the product, but simply bans the supply of products designed and sold for the purpose of tooth whitening. However, bleaching as a technique remains legal and is far less invasive than many alternatives. In response to Trading Standards’ change in stance, Dentistry’s executive editor, Julian English, commented: ‘Tooth bleaching is a legal, widely accepted (and practised) form of treatment. In these evidence-based times the weight of available scientific evidence clearly favours the use of these bleaching techniques over the various alternatives. ‘Trading Standards officers understand this peculiar legal anomaly and to date have been considerate and I expect they will continue to be. The change in stance is no more than a reaction to the delay in changes in the EU to legislation. Trading Standards could not ignore the law indefinitely. ‘This is not the start of a concerted campaign, but rather a return to the posture held two years ago, and most appropriate for a government body. Dentists should not be overly concerned about this when there are hairdressers, tanning salons and even tattoo parlours performing bleaching, in more dubious surroundings!’ Regarding the EU, Tony Reed said: ‘There is a strong rumour going round saying that the legislation has been amended but this is not true. As far as I am aware, the scientific opinion that supports an increase in the allowable concentration of hydrogen peroxide has been accepted, but I am unable to get a clear statement from anyone about when this opinion might be translated into an amendment to the European Directive.’ The General Dental Council (GDC) has also received numerous concerns from the dental profession. Hew Mathewson, president of the GDC, said: ‘Dentists have contacted the GDC expressing concerns about the safety of non-dentists offering such a service. The GDC’s priority is to protect the public – tooth whitening can be dangerous, particularly in the hands of unregistered professionals.’ Meanwhile, the British Academy of Cosmetic Dentistry (BACD) continues to slam over-the-counter (OTC) tooth whitening kits for causing chemical burns and aggravating gum disease. The kits are seen as a cheaper alternative to in-practice surgical treatments, which can cost between £300 and £1,300. James Goolnik, a BACD board member, said that the kits offer a ‘cheap, quick fix’ and should be used with caution by consumers. He warned that the kit’s poorly fitting mouth guards can lead to hydrogen peroxide leaking into the mouth and damaging gums. ‘If the gel goes on to the gums, it can cause blistering. In someone who has got irritation or decay already, it can accelerate the process.’ In the UK, OTC TWPs cannot contain anymore than 0.1% hydrogen peroxide by law. However, products available online can contain over 250 times the legal amount. Products with higher hydrogen peroxide concentrations are designed to be applied by professional dentists, said Goolnik. ‘We are seeing more and more people coming in with damage caused by whitening kits. They can go to the supermarket and see whitening toothpastes. There is no evidence they can actually whiten teeth and people might not see a difference, so they want the next thing up. At best they get no result, and at worst they get permanent sensitivity. Tamara Morris, 27, one of Dr Goolnik’s patients, suffered painful mouth ulcers when she bought a whitening kit with a gel that had less than a 0.1% concentration of hydrogen peroxide from a high-street chemist. She said: ‘Although it burned my mouth slightly when first I used the gel, I thought this was normal. Afterwards, it hurt when I brushed my teeth, or when I drank anything hot. When I went to the dentist he discovered I had sores on my gums resulting from the treatment.’
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