Cosmetic dentistry is growing in popularity, but it also raises a number of dento-legal issues.
You must be convinced that the proposed treatment is reasonable, in line with current accepted practice and in the patient's best interest. You should decline to provide treatment if it is not appropriate in your clinical judgement, however persuasive the patient may be.
Make every effort to explain to patients what the proposed treatment involves, the costs, risks, benefits and the alternatives, including delaying or not proceeding with the treatment at all.
The GDC expects dental professionals to provide a written treatment plan, setting out the treatment and cost, which is signed by the patient. But bear in mind that giving and obtaining consent is a process, not a one-off event. A treatment plan is no substitute for ongoing communication.
Training and indemnity
The GDC expects dental professionals to ensure they are appropriately trained and indemnified for any task they undertake.
Tooth whitening is included in our standard subscription rates for dentists, dental hygienists and dental therapists. Dental hygienists and therapists who carry out tooth whitening must work to the prescription of a dentist who has examined the patient and assessed their suitability for the treatment. The first cycle must be under the supervision of a dentist who is on the surgery premises at the time of treatment.
Dental hygienists and therapists wishing to undertake tooth whitening should let us know by calling our membership team on 0800 085 0614 with details for the training they have completed.
Botulinum toxin injections and non-permanent resorbable dermal fillers
We also provide indemnity for suitably trained dentists undertaking botulinum toxin injections and non-permanent resorbable dermal fillers performed to the lips or the face but excluding the neck or any other part of the body.
This indemnity is included in our standard subscription rates for general dental practitioners, although you should still notify the DDU membership team if you are planning to undertake this type of work.
A supplement is applicable for recently qualified dentists and for gross income over £8,000 per year. Dentists wishing to be indemnified for this should call the DDU membership team with details of the training they have completed.
We only indemnify members performing treatments with dermal fillers approved for use by the US Food and Drug Administration (FDA); a list of approved fillers can be found here. Brand names may differ slightly in the UK, but we are happy for DDU members to use the equivalent UK product if the manufacturer and product are the same as the US product listed. Please contact the DDU if you need further clarification on this point.
We do not indemnify DCP groups for facial cosmetic procedures.
Advertising cosmetic treatments
The GDC's guidance on advertising (2013) states that adverts must 'back up claims with facts' and 'avoid statements or claims intended or likely to create an unjustified expectation about the results you can achieve'.
The guidance also explains that if you wish to offer services which your training as a dental professional does not qualify you to provide, you must 'make sure you undertake appropriate additional training to attain the necessary competence. You must not mislead patients into believing that you are trained and competent to provide other services purely by the virtue of your primary qualification as a healthcare professional, but you should make clear that you have undertaken extra training to achieve competence'.
This guidance was correct at publication 16/08/2018. It is intended as general guidance for members only. If you are a member and need specific advice relating to your own circumstances, please contact one of our advisers.