Teeth Whitening & UK Law

This is probably the most confusing and misunderstood aspect for any new entrant into our exciting world of teeth whitening. Don’t worry though, we’re here to help!

Teeth whitening law UK

In recent years UK law has changed a lot with regards to teeth whitening. From 2001 up to 2012 the law had remained pretty stagnant. Tooth whitening products were confirmed as being cosmetics on the 28th June 2001 by the House of Lords ruling in the case of Optident Limited and another V. the Secretary of State for Trade and Industry.

This means that according to teeth whitening law this process falls under the EU Cosmetics Directive (implemented in the UK by the UK Cosmetic Products (Safety) Regulations 1996). In simple terms, the ruling  meant that dentists and non-dentists could both perform teeth whitening treatments without breaking the law.

Further strengthening the case, in 2010 the European Commission classified tooth whiteners as cosmetics.

The House of Lords had ruled on this back in 2001, therefore this ruling confirmed that they should be regulated under the EU Cosmetics Directive.

The decision from the EU Commission not to consider these products as medical devices was based on the fact that the primary claim is aesthetic, and dental curing is secondary or non-existent. As such, these products (with a claim solely of teeth whitening without curing) do not match the definition of a medical device and therefore are not medical devices but cosmetics.

Even with this in force, the General Dental Council (GDC) continuously made quite shocking lies in the press and media which claimed it was illegal for non-dentists to whiten teeth. This desperate action made a lot of people loose respect for such an organisation.

The GDC claims that they have successfully prosecuted 2 tooth-whitening providers. The truth is that these providers were not prosecuted only for doing teeth whitening. One was prosecuted for making false statements in regards to the qualifications of the staff in his clinics (he claimed on his website that they were dental professionals but they were not, which clearly breaches section 38 of the Dentist Act of 1984). The other one was prosecuted on public health grounds.

However this all changed with the 10th May 2013 High Court Ruling which states ‘that teeth whitening treatment comes within the practice of dentistry as identified in section 37 of the Dentists Act 1984.’

The GDC alleged that Lorna Janous had unlawfully practised dentistry, namely tooth whitening, contrary to the Dentists Act 1984. The Act 1984 makes it a criminal offence for anyone other than a registered dental professional to carry out dentistry.

Section 37(1) of the Dentists Act 1984 (the Act)

‘subject to subsection 1A for the purposes of this Act, the practise of dentistry shall be deemed to include the performance of any such operation and the giving of any such treatment, advice or attendance as is usually performed or given by dentists; and any person who performs any operation or gives any treatment, advice or attendance on or to any person as preparatory to or for the purpose of or in connection with the fitting of dentures, artificial teeth or other dental appliances shall be deemed to have practised dentistry within the meaning of this Act.’

Are tooth whitening products illegal?

The same ruling referred to the above House of Lords ruling on the 28th June 2001 in the case of Optident Limited and another Vs. The Secretary of State for Trade and Industry, stated that a cosmetic product cannot release more than 0.1% hydrogen peroxide. On the 15th March 2005 this limit was increased by the European Commission and Scientific Committee on Consumer Products, to products which release more than 6% Hydrogen Peroxide. However has since been reduced to 0.1% for non-dentists.

However this was soon superseded by the ‘The Cosmetic Products (Safety) Amendment Regulations 2012’ (implementing Directive 2011/84 EU which amends Directive 76/768/EEC) which came into force on the 31st October 2012. This stated that:

  • Products containing or releasing between 0.1% and 6% hydrogen peroxide cannot be used on any person under 18 years of age
  • Products containing or releasing less than 0.1% of hydrogen peroxide, including mouth rinse, tooth paste and tooth whitening or bleaching products are safe and will continue to be freely available on the market
  • Tooth whitening or bleaching products containing or releasing between 0.1%-6% of hydrogen peroxide should be used as follows:

1. An appropriate clinical examination is to be carried out in order to ensure that there are no risk factors or any other oral pathology concerns;

2. Exposure to these products should be limited to ensure that the products are only used as intended in terms of frequency and duration of application;

3. The products should not be directly available to the consumer but only through a dentist, dental hygienist or dental therapist;

4. Tooth whitening products containing or releasing between 0.1% and 6% hydrogen peroxide can ONLY be sold to dental practitioners;

5. 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

6. After the first cycle of use, the product may be provided by the dental practitioner to the consumer to complete the cycle of use

  •  Concentrations exceeding 6% of hydrogen peroxide present or released in oral products, including tooth whitening or bleaching products remain prohibited unless wholly for the purpose of the treatment or prevention of disease
  • It is a criminal offence to act in breach of the regulations

Is it safe?

There is nothing illegal or unsafe about the technique of teeth whitening; the safety profile of hydrogen peroxide in these products is well established. The incidence of adverse effects is very low. Hydrogen peroxide is widely used for consumer purposes including hair bleaching, disinfection of eye contact lenses and disinfection of wounds and ulcers. Exposure to hydrogen peroxide from a tooth whitening product would be expected to have a positive effect on oral hygiene and it is effective in reducing the risk of gingivitis.

“Any effects of hydrogen peroxide from the use of tooth whitening products, even over 6 months’ continuous exposure are mild, transient, and involve only gingival irritation and tooth sensitivity both of which resolve within a few days after use of the product is stopped” Professors Philip Larney et al. Canton Health Sciences International, 25th Jan 2005

“The safety profile of hydrogen peroxide in these products is well established the incidence of adverse effects is very low.” UK Department of Health

Are dentists educated in teeth whitening?

Tooth whitening is not part of the syllabus at dental school. Therefore the vast majority of dentists and dental professionals have little to no knowledge about the different gels, the different procedures and the side effects involved.

Many dentists prescribe tooth-whitening kits containing peroxide for home use and recommend to do overnight treatments. How healthy is it to go to bed with a mouth tray full of peroxide gel, having the gums and teeth exposed to that chemical during the whole night, and to do that for a whole week or 14 days in a row?

If whitening products are in the mouth for many hours, the teeth become dehydrated and demineralised increasing the customer’s risk of having severe gum irritation. Moreover, significant amounts of gels are being swallowed during the night, which is not good for the stomach. Could one say that this is good dentist advice? Most dentists would agree with us that this is not in the best interest of the customer from an oral health point of view.

Many dental professionals offering teeth whitening have not received formal training, or they have been trained in the basics by the company who sold them the products. It’s a very superficial training that gives them no insight into the theoretical aspects or the background of tooth whiteners and their side effects.

A simple search for ‘tooth whitening complaints’ on Google gives hundreds of examples where people having experienced excruciating pain on the teeth for a lengthy period of time, or having had severe gum or lip burns after a tooth whitening treatment performed at the dental office.

Dental professionals know a lot about oral health and they are the best ones to do dental procedures which they have been trained for – no one will deny that. But is it safe to let them use peroxide gels when they don´t have the appropriate training?

As opposed to that, most tooth whitening companies selling EU compliant gels in the UK offer their customers (mainly spa and salon owners) complimentary training. This training will cover many aspects of tooth whitening in depth.

The question raised is the following: what poses more risk for the consumer? A dental professional without the appropriate training using a peroxide gel (often in concentrations greater than 6% H2O2, against the provisions of the EU Cosmetics Directive) or a non-dental professional (with or without training) using gels that pose no risk to the health and that can even be used at home without any type of supervision?

THE GDC’S ACTING IS UNLAWFUL

The GDC is openly contradicting the EU Commission’s provisions by harassing and threatening tooth whitening providers while these are doing nothing in breach of EU law or UK law – as long as they are using gels containing or releasing less than 0.1% hp. The EU clearly states that no formal training or background is required in order to use these gels. They can be applied by the consumers themselves, dentists or others.

THE GDC DOESN´T PRIORITIZE CONSUMER SAFETY

Gels containing or releasing less than 0.1% pose no risk to the health of the consumer, according to the SCCP. So why is the GDC against the use of such products in a spa and salon, while the exact same product can be used at home without any type of supervision? If consumer safety is their main concern shouldn’t it be more desirable that these products are used under the supervision of an aesthetician than under no supervision at all?

Is overuse and misuse less likely to happen when the consumer (possibly a minor) is at home without any type of supervision? If they prefer that consumers use it at home with no supervision at all rather than people using the same product in a supervised environment, is their main concern really consumer safety?

Even though non-dental professionals are not regulated by the GDC they get all the negative attention while the actual GDCs registrants’ actions in regards to tooth whitening are not being investigated. Still today, the vast majority of dental professionals offering tooth whitening, use gels containing concentrations greater than 6% H2O2.

If consumer protection was the main priority of the GDC, shouldn’t they devote more time to pursuing and prosecuting the registrants who are breaching the law and pose a risk to the consumer’s health, rather than devote their time to harass tooth whitening providers who are using a product that poses no risk to the health.