DENTAL PRACTICE


Whiter than white T


Head of illegal practice prosecutions at the General Dental Council, Shareen Larmour, discusses the latest developments in the regulation of tooth whitening


HERE has been a lot of press coverage about tooth whitening in the last 12 months, some of it positive and


some of it just plain wrong. I would like to state from the outset that the GDC’s stance remains the same: tooth whitening may only lawfully be provided by those who are registered dental professionals. Whether or not it is appropriate for any


particular dental professional to be involved in tooth whitening is set out in our Scope of practice document. Te GDC currently states:


• Dentists can carry out tooth whitening. • Dental hygienists and dental therapists can carry out tooth whitening on the prescription of a dentist as an additional skill.


• Dental nurses can, as an additional skill, take impressions and make bleaching trays to a dentist’s prescription.


Any registrant who undertakes work for


which they are not sufficiently trained and competent risks fitness to practise proceedings, which may affect their registration. Ethical issues arise in treating patients,


whatever the legal position. GDC registrants 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 18 benefits and risks. Tese and similar issues can arise in


connection with any dental treatment proposed or carried out, including treatment designed to improve the appearance such as tooth whitening. Tey apply whether the registrant personally delivers the treatment or gives advice to patients about the use of home kits. It is open to patients to complain to the GDC about these matters, as with any form of care or treatment. I think it’s worth pointing out that the


GDC has been reviewing its Scope of practice document this year. Te guidance was first published in January 2009 and clearly sets out the skills and abilities that each registrant group should have, as well as listing the additional skills registrants may develop aſter registration. In the introductory section of the


guidance it states that the lists will be reviewed regularly to ensure that they are still relevant to the dental team and that is exactly what we’re doing. All the feedback we’ve received this year, including any views regarding tooth whitening, will feed into the development of the formal consultation that we’ll be running in the coming months. Te Scope of Practice Working Group met in October this year and will present proposed changes to the document to Council at its meeting in December. We will then run a consultation on the proposed changes – probably running through until March 2012. Te group will then meet again at the end of March to consider the research, evidence and feedback and make any final changes. Te document will then finally be proposed to


Council in May and hopefully approved at that meeting. Te GDC’s new Scope of practice


document is likely to be published next year and it’s possible some of the currently listed duties for each of our registrant groups will change.


Developments this year So what’s changed in the ever-growing tooth whitening industry this year? Well, in March the GDC successfully


prosecuted a non-registrant for performing tooth whitening. Under the Dentists Act 1984 it is an offence for non-registrants to practise or be prepared to practise dentistry and the GDC’s view is that this includes tooth whitening. Paul William Hill, 48, of Warrington,


Director of PW Healthcare Consulting Limited, pleaded guilty to four offences including practising dentistry while not registered as a dentist or dental care professional between 2 October 2010 and 11 March 2011. Following on from the success of the


prosecution, we launched a new publication entitled Considering tooth whitening? in which we warn the public against tooth whitening conducted illegally by unregulated people. In the leaflet we advise patients to always visit a dentist before having tooth whitening so the dentist can assess whether the treatment would be right for them. In addition we suggest they speak to other patients, get a second opinion and always ask for a written treatment plan and price estimate. We also advise them to carry out their


own research and ask some basic questions. For example:


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