Cosmetic dentistry may face tighter rules

The world of cosmetic dentistry could come under close government scrutiny following a damning report into the booming multi-million pound cosmetic industry.

An independent review into cosmetic interventions reveals its blueprint for a major overhaul of the industry today (Wednesday).

It suggests that dermal fillers should only be available by prescription and clinicians must be properly registered in order to carry out cosmetic procedures.

The cosmetic industry should also come under the remit of an ombudsman specially for private health care.

Commissioned by the government following the PIP breast implant scandal, it also recommends that ministers should consider a separate review of cosmetic dentistry where similar concerns exist about poor or little regulation.

The report slams the under regulation of a UK cosmetic industry thought to be worth £2.3 billion a year, suggesting that ‘a person having a non-surgical cosmetic intervention has no more protection and redress than someone buying a ballpoint pen or a toothbrush’.

The review looked at products used for surgical and non-surgical procedures, the people who administer them, the way they are advertised and the advice and support patients are given.

Today’s report sets out how the committee would like to see the sector better regulated, practitioners better trained and people having proper redress if things go wrong.

One major area for alarm is dermal fillers, a procedure increasingly carried out by aesthetic dental practices throughout the UK.

The report says: ‘Dermal fillers are a particular cause for concern as anyone can set themselves up as a practitioner, with no requirement for knowledge, training or previous experience. Nor are there sufficient checks in place with regard to product quality – most dermal fillers have no more controls than a bottle of floor cleaner.

‘There has been explosive growth in this market, driven by a combination of high demand and high profits in an era when all other commercial income is stalling.

It adds: ‘It is our view that dermal fillers are a crisis waiting to happen. Previous attempts at self-regulation in the industry have failed, largely because voluntary codes have meant that only the best in this disparate sector commit themselves to better practice, whilst the unscrupulous and unsafe carry on as before.’

If the review’s recommendations are taken on board, people offering injectables such as dermal fillers or Botox will come under closer scrutiny and dermal fillers that currently fall outside of the EU Medical Devices Directive could be classified as medical devices and therefore subject to stringent safety checks.

However, even if these changes to the EU Directive are agreed, they are unlikely to be Review of the Regulation of Cosmetic Interventions 30 implemented before 2018.

The review, led by NHS medical director, Professor Sir Bruce Keogh, has been looking at how to protect patients and tackle unsafe practices in an industry.

He said: ‘At the heart of this report is the person who chooses to have a cosmetic procedure. We have heard terrible reports about people who have trusted a cosmetic practitioner to help them but, when things have gone wrong, they have been left high and dry with no help. These people have not had the safety net that those using the NHS have. This needs to change.

‘We would like to see everyone who chooses to have any cosmetic procedure better protected… ultimately, if someone needs to step in on the side of patients, we think there should be an ombudsman to do that.’

Meanwhile, the British Dental Association (BDA) welcomed the review.

Dr Martin Fallowfield, chair of the BDA’s principal executive committee, said: ‘The BDA welcomes the report of the independent review into cosmetic interventions and the call for the sector to be better regulated in the interests of patient safety.

‘The BDA will be studying the report carefully to consider the findings in detail and how they impact on the dental profession.’

Health minister Dr Dan Poulter said: ‘The independent panel has made some far-reaching recommendations – the principles of which I agree with entirely. We will consider the report carefully and respond in detail in the summer.’ 

The committee found that, historically, the governance of standards of practice in cosmetic surgery has been limited, something it felt applied to cosmetic dentistry, too.

Consequently, it has suggested that Ministers should consider a further review in that area.

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