The GDC regards all tooth whitening procedures, including bleach and laser treatment, as the practice of dentistry.
- Anyone carrying out tooth whitening must be registered with the GDC
- All dental professionals involved in tooth whitening must be trained and competent to carry out the procedure and have appropriate indemnity
- The GDC has decided that tooth whitening is the practice of dentistry and can only be safely and legally carried out by registered dental professionals. This position has been confirmed by the High Court in the case of GDC v Jamous.
The concentration of the products used in tooth whitening procedures affects their legal status.
Products containing or releasing between 0.1% and 6% hydrogen peroxide are legal as long as the following conditions are met:
- they are sold to dental practitioners
- for each cycle, the first treatment is administered by a dental practitioner or under their direct supervision (after this it can be completed by the patient)
- the patient is 18 years old or over.
Products containing or releasing more than 6% hydrogen peroxide are illegal, while those containing or releasing less than 0.1% are freely available.
If you're using a product containing carbamide peroxide, contact the manufacturer to check it doesn't release more than the maximum legal amount of hydrogen peroxide.
The supply of any tooth whitening product that does not meet these conditions is prohibited. This includes products administered during a course of treatment taking place entirely within the dental practice.
Breaking these rules could result in a criminal conviction.
Anyone involved in tooth whitening and bleaching must be trained and competent to carry out the procedure, or they risk a fitness to practise investigation.
The first use of tooth whitening products can only be carried out by dental practitioners, or under their direct supervision as long as an equivalent level of safety is ensured.
Dentists cannot supply tooth whitening products without examining the patient first.
Dental hygienists and dental therapists can carry out the first cycle of treatment, as long as:
- a dentist is on the premises during the first bleaching treatment, and
- a dentist has previously assessed the patient's suitability for the treatment.
In-surgery and home bleaching
In terms of the maximum allowed level of hydrogen peroxide, there is no distinction between in-surgery bleaching and home-bleaching products provided by dental professionals.
In our view, the 6% limit applies to any compound that contains or releases hydrogen peroxide, whether used internally or externally on teeth.
Patients under 18
Because they are used for cosmetic purposes, products that breach the 0.1% hydrogen peroxide threshold cannot be used on patients under 18.
Although the GDC makes an exception for higher concentrations than this when used "wholly for the purpose of treating or preventing disease", the DDU cannot envisage any circumstance where this might be the case. Our legal advice is that there are no exceptions to this rule.
Enforcement and disciplinary proceedings
Any prosecutions resulting from a breach of regulations would be brought by Trading Standards.
However, the matter could also be reported to the GDC. A criminal offence is relevant to any assessment of a practitioner's fitness to practise irrespective of whether there has been a prosecution.
If the GDC receives information or a complaint about the illegal use of tooth whitening products, the practitioner concerned may face fitness to practise proceedings. The matter would also likely be referred to the relevant Trading Standards department.
The GDC advises that when providing tooth whitening services, as with any treatment, dental professionals must:
- act in the best interests of the patient in providing a high standard of care
- obtain fully informed consent for treatment, which they must be competent to carry out
- obtain a medical history of the patient before starting treatment
- give necessary explanations about benefits and risks.
When providing tooth bleaching treatment, we advise dental professionals to make a complete, clear and contemporaneous record. This should contain:
- their treatment plan
- the consent process
- any instructions given to the patient (such as how to continue the treatment at home)
- details of any adverse outcome.
This is an important part of effective patient care and can also provide evidence you have complied with the law if your actions are ever questioned.
If you're a DDU member and have any specific queries or concerns about tooth whitening, contact our 24-hour advice helpline on 0800 374 626 to speak to one of our dento-legal advisers.
This page was correct at publication on 15/12/2021. Any guidance 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.