07th February 2017

Tooth whitening – be aware of the regulations

As Valentine’s Day approaches there is often an increase in the demand for tooth whitening, so this may be a timely reminder of the regulations and the consequences of non-compliance with the general dental council rules.

The law surrounding tooth whitening (the Cosmetic Products Enforcement Regulations 2013) states that it is illegal for tooth whitening products which contain more than 6% hydrogen peroxide or for any associated products which release greater than 6% hydrogen peroxide to be supplied or administered for cosmetic purposes. The EU Cosmetics 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 is 6% present or released. It is generally accepted that 10% carbamide peroxide content would yield a maximum of 3.6% hydrogen peroxide. Thus, the commonly used products containing 16% carbamide peroxide are allowed as they would normally release less than 6% hydrogen peroxide.

Tooth whitening products containing or releasing between 0.1% and 6% hydrogen peroxide can only be sold to dental practitioners. It could be interpreted as a breach of the Regulations if a dentist (or a practice) sold tooth whitening products containing or releasing more than 0.1% hydrogen peroxide to someone other than a patient undergoing a cycle of tooth whitening treatment. For each cycle of use, the first use can only be carried out by dental practitioners or under their direct supervision if an equivalent level of safety is ensured as for example by a trained hygienist, therapist or clinical technician. Clinicians should ensure contemporaneous and accurate records of the initial appointment including details of instructions and consent. After the first cycle of use, the product may be provided by the dental practitioner to the consumer to complete the cycle of use.

Products containing or releasing between 0.1% and 6% hydrogen peroxide cannot be used on any person under 18 years of age except where such use is intended wholly for the purpose of treating or preventing disease. Practitioners need to exercise caution in the rare cases of tooth whitening for under 18’s. Indemnity organisations should be consulted and clear consent and involvement of parents are essential. The maximum penalty for breaching the Regulations is a sentence of imprisonment not exceeding six months.

The General Dental Council’s Position Statement on Tooth Whitening sets out that if it receives information or a complaint that a registrant is using a product in excess of 6%, in breach of the Regulations, the registrant may face fitness to practice proceedings and can expect the matter to be referred to the relevant Trading Standards department.

*All information is correct at the time of publishing

Topics: Dentists

Raj Majithia

Dental Specialist M.Clin.Dent, FFGDP, BDS, LDSRCS, MJDF (UK), DPDS

Raj is in General Dental Practice in London. His other current posts are Associate Dean of Postgraduate Dentistry at Health Education England – London where he is responsible for remediation of dentists in difficulty, quality assurance of Dental Foundation training practices and assessment of Dental Foundation equivalence for overseas qualified dentists. Raj has been the Crisis Management in Medical Emergencies Tutor and Postgraduate Dental Tutor at Northwick Park Dental Education Centre and West Middlesex Hospital.

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