The whites and wrongs of illegal tooth whitening
With increasing media coverage of the harmful impact of illegal tooth whitening procedures, Michael Farrow says dentists have a duty to raise awareness.
Warnings about the potentially life changing health risks of illegal tooth whitening treatments have now been made by several leading oral health organisations.
Anyone using unqualified dental operators for tooth whitening is ‘gambling with their health,’ according to the British Dental Association (BDA). The BDA spoke out following the recent conviction of a man. He admitted to the use and supply of illegal tooth whitening products. Using the products he was selling would be like ‘brushing your teeth in bleach’, according to the BDA’s statement.
In addition, the Oral Health Foundation has highlighted the serious risks that consumers are taking by opting for illegal and unsafe whitening treatment.
It is clear that there is still work to be done to educate the public into both the legal and health ramifications of having whitening done without the involvement of a qualified dental practitioner to oversee the treatment.
Ignorance of illegal whitening
Oral Health Foundation research found that around one in four people (28%) would rather purchase potentially unsafe home kits over the internet. Or they would visit an unqualified beautician than go to the dentist for their tooth whitening treatment.
Karen Coates, dental adviser at the Oral Health Foundation and coordinator of the Tooth Whitening Information Group (TWIG) has warned about this uninformed thinking.
She said: ‘Twenty million people in the UK are leaving themselves open to illegal and unsafe tooth-whitening, severely harming their health.’
The wrong side of the law
It is illegal for anyone not registered with the General Dental Council (GDC) to perform tooth whitening. However, in 2018 the GDC prosecuted 31 individuals across the UK, including fines and costs of more than £11,000.
More recently was the case of a man who continued to run a teeth whitening clinic in Belfast despite a previous conviction. He avoided going to jail but was sentenced to 12 months on probation and given a £1,500 fine
The man pleaded guilty to charges relating to the use and supply of tooth whitening products. Police found a hydrogen peroxide gel. It was more than 300 times stronger than an unqualified individual would have been allowed to use. The court heard the main risks from using these substances include chemical burns or increased sensitivity of the teeth.
A BDA spokesperson commented on the case. He said: ‘Such high levels of hydrogen peroxide are likely to cause irreparable harm to teeth and gums. This includes blisters and burns to the gum and damage to nerves and tooth enamel.’
The past decade has seen a rise in the development of non-hydrogen peroxide whitening products. This is according to a study published in the British Dental Journal by Greenwall-Cohen and colleagues (2019).
A European directive introduced in 2011 to ensure that bleaching with higher strengths of hydrogen peroxide could only be carried out by dentists has meant that DIY home kits can only contain less than 0.1% hydrogen peroxide, which is too weak to have a significant whitening effect.
To get around the directive, some manufacturers are turning to alternative ingredients. These could be even more damaging for our teeth.
The study raises concerns about the active ingredient sodium chlorite, found in three of the products tested. Researchers found ‘substantial evidence’ of how products seriously damaged the hardness and strength of teeth.
These products also contained a bonding agent called EDTA and citric acid. The study also warned that the UK may start seeing widespread enamel damage as a result.
Greenwall-Cohen J, Francois P, Silikas N, Greenwall L, Le Goff S, Attal JP (2019). The safety and efficacy of ‘over the counter’ bleaching products in the UK. British Dental Journal 226: 271–276
This article first appeared in Aesthetic Dentistry Today magazine.