Tooth whitening

  • 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.

Product concentration

Tooth whitening products that contain or release between 0.1% and 6% hydrogen peroxide are legal with the following conditions:

  • 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 are using a product which contains carbamide peroxide, contact the manufacturer to ensure that it does not release more than the maximum legal amount of hydrogen peroxide.

Supply

The supply of any tooth whitening product that does not meet these conditions is prohibited. This includes products administered during a course of treatment that takes place entirely within the dental practice.

The maximum penalties for breaking these rules are six months imprisonment and/or a fine of up to £5,000.

Dental professionals

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.

Internal bleaching

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

The GDC does not bring criminal prosecutions, so 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 have produced a Q&A about this.

General practice

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 that dental professionals should 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)
  • any adverse outcome.

This is an important part of effective patient care and can also provide evidence that you have complied with the law.

DDU members can contact our 24-hour advice helpline on 0800 374 626 with specific queries or concerns about tooth whitening.

This page was correct at publication on 10/08/2015. 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.

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