A funny thing happened to me this summer when I walked into the Departure area at the Toronto airport — I came upon two dental chairs, complete with a patient in each chair. At first I thought this might be a bad dream — my practice was following me and I would never get away on vacation! But, upon closer examination, I was relieved to see that the patients were not wearing braces. Instead, they were biting down on bleaching trays. Retail bleaching of teeth by unlicensed non-dental professionals has spread to even our Canadian airports.
The issue of non-dental professionals administering tooth whitening procedures in retail settings is a matter of growing concern to dentists and dental hygienists in both the United States and Canada. Tooth whitening/ bleaching services offered by unlicensed and unregulated entrepreneurs is now a common sight in non-dental office settings, such as shopping malls, exhibitions, spas, hair and nail salons, department stores — and now even in airports. I think hat only churches, synagogues and mosques have been left untouched — so far anyway.
Tooth bleaching in Canada is not considered by the government to be a “controlled act” and, as such, it is totally unregulated and “in the public domain.” As a
esult, anybody can do it. No need for a license, no course to take, no exams to pass, no infection control guidelines to follow, no regulatory body to answer to. Just buy some bleaching chemicals, a few bleaching trays and a cash register and you are in business.
Furthermore, tooth bleaching agents, whether hydrogen peroxide,
rbamide peroxide or any other tooth bleaching chemicals, are all classified by Health Canada as “cosmetics” and not as “drugs.” Health Canada does not ‘approve’ any cosmetics, nor does it require the manufacturer of tooth bleaching agents to list the concentration or strength of peroxide on the product packaging.
It also doesn’t restrict the sale of higher strength bleaching agents to only oral healthcare professionals i. e. dentists and dental hygienists. In other words, when it comes to retail tooth bleaching, it is just like the Old Wild West out there — only without any sheriff!
South of the border, however, the bleaching scene is rapidly changing. In the United States, the American Dental Association (ADA), state dental associations and many state legislators have recently taken a very aggressive stand against these unlicensed and unregulated tooth whitening clinics. The ADA, citing safety concerns, has passed a resolution urging all state constituent societies, through legislative or regulatory efforts, to support the ADA position that “the application of any intra-oral chemical for the purpose of whitening or bleaching of teeth constitutes the practice of dentistry and any non-dentists engaging in such activity is committing the unlicensed practice of dentistry (Res. 73 H-2008).”
Consequently, this year a number of state legislatures have either already passed or are currently considering legislation specific to the issue of teeth whitening:
Illinois & Iowa: Legislation would include within the practice of dentistry “one who performs any phase of any operation incident to teeth whitening, including the sale, instruction and application of teeth whitening materials”.
Kansas: The Kansas Dental Board has proposed that “a non-licensed person is illegally practicing dentistry should he or she provide any service or procedure that alters the color or physical condition of teeth.”
Minnesota, Florida & Hawaii: Legislation would include within the practice of dentistry “one who dispenses tooth whitening agents or attempts to bleach or whiten teeth by any means or method.”
Missouri: The Missouri House of Representatives has passed a bill stating that “Any person who performs any part of the teeth whitening process, without being under the supervision of a licensed dentist, will be deemed to be engaging in the practice of dentistry.
Tennessee & The District of Columbia: Each have approved a policy that limits tooth whitening to licensed dentists or dental personnel working under the direct supervision of a licensed dentist.
Alabama: A state court judge recently ruled that “teeth whitening services fall within the scope of the practice of dentistry and, as such, should be subject to regulation by the state dental board.”
Massachusetts, Nevada & New Jersey: All three State Boards of Dentistry have issued statements confirming that tooth whitening is a dental procedure that can only be performed by a licensed dentist.
In England, tooth bleaching clinics are also under attack. Dentistry.co.uk,the leading website for UK dental professionals, recently reported that “the Conservatives in Parliament have demanded that the government clamp down on unqualified ‘cosmetic cowboys’ who carry out potentially harmful tooth-whitening procedures.” They went on to accuse the government of shying away from taking action necessary to stop unqualified ‘rogue beauticians’ from using chemicals to bleach teeth. Both the British Department of Health and the General Dental Council, which regulates the profession, state that, by law, only dentists and dental hygienists are permitted to bleach teeth.
In Canada, a number of commercial bleaching systems are offered on the internet as a franchise opportunity to entrepreneurs who want to start their own tooth bleaching business.
Each offers a ‘junior dentist starter kit’ consisting of dental bibs, a daisy chain, a tooth shade guide, bleaching trays and syringes filled with a special bleaching solution. Unfortunately, the websites do not reveal the formula, the strength or safety of their bleaching solution, usually claiming that this information is “proprietary.” So it can only be guessed that the strength will lie somewhere between ‘Drano’ and tap water.
One of the largest bleaching business websites in Canada explains in detail the revenue possible with their tooth whitening business: if you see just two clients a day at $199 per 12 minute session, your potential yearly income would be $144,872. If you work real hard and see 15 clients a day, you are well over $1,000,000 a year!
Let’s see… cash business, no collection problems, almost no overhead, no license required, no regulator, no expensive mandatory continuing education… Wow! Where did my dental colleagues and I go wrong?
OH
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Tooth bleaching in Canada is like the Old Wild West — only without the sherriff
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It can only be guessed that the strength will lie somewhere between ‘Drano’ and tap water
