​ Only dentists can prescribe tooth whitening. The first application must be carried out by a dentist or by a dental hygienist, therapist or clinical dental technician working under the dentist’s supervision. After that the toothwhitening treatment can be provided to the patient for them to continue the treatment at home.

You must put your patients’ interests first at all times and always provide treatment that is in their best interests (Standards for the Dental Team 1.4.2). If patients want treatment that is not in their best interests, even after you have explained the risks, benefits and likely outcomes then you are entitled to refuse to provide that treatment.

The Cosmetic Products ((Safety) Amendment) Regulations 2012 (implementing Directive 2011/84 EU which amends Directive 76/768/EEC) came into force on 31 October 2012. This means:

• Toothwhitening products containing or releasing between 0.1% and 6% hydrogen peroxide cannot be used on any person under 18 years of age except where such use is intended wholly for the purpose of treating or preventing disease.
• Toothwhitening products containing or releasing less than 0.1% of hydrogen peroxide, including mouth rinse, tooth paste and tooth whitening or bleaching products are safe and will continue to be freely available on the market.
• Tooth whitening products containing or releasing between 0.1% - 6% of hydrogen peroxide should be used as follows:
  • an appropriate clinical examination is to be carried out in order to ensure that there are not risk factors or any other oral pathology concerns;
  • exposure to these products should be limited to ensure that the products are only used as intended in terms of frequency and duration of application;
  • the products should not be directly available to the consumer, only through a dentist, dental hygienist or dental therapist.

Tooth whitening products containing or releasing between 0.1% to 6% hydrogen peroxide can ONLY be sold to dental practitioners.

For each cycle of use, the first use can ONLY be carried out by dental practitioners or under their direct supervision if an equivalent level of safety is ensured.

After the first cycle of use, the product may be provided by the dental practitioner to the consumer to complete the first cycle of use.

• Concentrations exceeding 6% of hydrogen peroxide present or released in oral products, including tooth whitening or bleaching products, remain prohibited UNLESS wholly for the purpose of the treatment or prevention of disease.
• It is a criminal offence to act in breach of the Regulations.
• GDC registrants need indemnity for any treatment which they provide.
• The GDC does not bring criminal prosecutions of bring criminal prosecutions of breaches of the regulations as this role is undertaken by Trading Standards. However, the GDC is concerned with the fitness to practise of its members. It takes the view that if a practitioner has committed a criminal offence, that must be relevant to any assessment of that practitioner’s fitness to practise irrespective of whether there has been a prosecution. Therefore, if we receive information or a complaint that a registrant is using a product for cosmetic purposes in excess of the 6%, they may face fitness to practise proceedings and can expect to have the matter referred to the relevant Trading Standards department.

Yes. The High Court case of GDC v Jamous confirmed that applying materials and carrying out procedures designed to improve the aesthetic appearance of teeth amounts to the practice of dentistry and is therefore limited to GDC registrants.

Therefore all tooth whitening procedures, including bleach and laser treatment are the practice of dentistry.

The carrying out of dentistry by non-registrants is a criminal offence and the Council can prosecute in appropriate cases.

The GDC expects all registrants to follow the standards and guidance set out in Standards for the Dental Team in whatever area of the profession you work in. This includes all registrants associated with, undertaking or involved in clinical trials and research. Particular relevant standards include:

• putting the patients’ interests first;
• finding out about laws and regulations which may affect your work;
• finding out about current best practice;
• acting honestly and fairly; and
• making sure patients are able to claim compensation.

You need to fully accept and understand your responsibility both to patients participating in clinical trials or research and to professional colleagues whose own clinical decisions will ultimately be shaped by the actions and integrity of those involved in the research itself.

In this situation you should check with your indemnifier to find out if you still need to have indemnity or insurance cover whilst not working, to ensure your patients are covered if they make a claim against you for any previous treatment you have provided.

​Yes, you are able to use the title ‘Dr’ as a courtesy title. However you must make clear the services you are offering and must not imply that you are a medical doctor, unless you are registered with the GMC. It is a good idea to make clear that you are a dentist and not a medical doctor, for example “Dr. A. Smith, Dentist” or “Dr. B. Patel, Dental Surgeon”.

It is your responsibility to make sure that you have appropriate insurance or indemnity in place to make sure your patients can claim any compensation to which they may be entitled. You may not need to have your own indemnity or insurance cover, as your employer may already have arrangements in place but you should not assume this is the case and check with them.

​You will need to check with your defence organisation or other indemnity provider, because different organisations have different rules and policies. Do not assume that you will be covered in respect of the use of controversial bleaching products. If you practise in any field without appropriate indemnity arrangements, your registration will be at risk.

​You will need to check with your defence organisation or other indemnity provider, because different organisations have different rules and policies. If you practise in any field without appropriate indemnity arrangements, your registration will be at risk.

​If you choose to offer Botox or other non-surgical cosmetic procedures the GDC expects the same high standards of you, whatever the type of treatment you are carrying out. In particular, you will need to ensure that you only work within your knowledge and professional competence, adhere to the Council’s standards at all times, and be prepared to back up the decisions you make.

You need to also ensure that you have appropriate indemnity cover. Careful thought also needs to be given to maintaining professional standards in relation to advertising these services.

​Botox is a prescription-only medicine (POM) and therefore must be prescribed by a registered doctor or dentist who has completed a full assessment of the patient.

Injectable dermal fillers are classed as medical devices and therefore do not require a prescription. Any dental professional who chooses to provide these treatments to patients must make sure they are trained, competent and indemnified to do so.

​​No. Work in a patients mouth, the giving of patient-specific advice and carrying out procedures designed to improve the aesthetic appearance of teeth constitutes the practise of dentistry, regardless of the chemicals involved. Therefore anyone carrying out tooth whitening must be a registered dentist, or a dental hygienist, therapist or clinical dental technician working to a dentist’s prescription. If anyone contravenes this, they could be prosecuted in the Magistrates’ Court for illegally practising dentistry under Section 38 of the Dentists Act.

Similarly under Section 41 and 43, the GDC could also prosecute those carrying out the business of dentistry (i.e. making money from dentistry, including tooth whitening) when not registered.

​Yes, although as we do not provide legal advice we would always recommend contacting your defence organisation or indemnity provider for advice on any recent applicable legislation such as the Medicines for Human Use (clinical Trials) Regulations 2004 (amended 2006). These regulations include a requirement to follow the conditions and principles of the EU Directive on Good Clinical Practice.

You also need to make sure that you have the approval of the local ethics committee where required and that you comply with any directions given by them.

Further advice and legislation can also be found on the Medicines and Healthcare products Regulatory Agency (MHRA) website

​You must make sure that any advertising material is accurate, not misleading and complies with our Guidance on ethical advertising (Standards for the Dental Team 1.3.3). There are no specialist lists for dental care professionals. If you are a dental care professional you must ensure that you do not mislead patients by using titles which could imply specialist status, such as ‘Smile specialist’ or ‘Denture specialist’.