Whitening issue heats up in other states ADA urges constituents to act

In addition to the activity in Alabama several ADA constituent dental societies are working on legislation concerning tooth whitening.

Legislation has been introduced this year in Hawaii, Illinois and Missouri and other states are also addressing the issue.

In 2008, the ADA House of Delegates adopted Resolution 73H-2008 dealing with whitening and bleaching treatments and how they may fall within the scope of dental practice. The resolution urges constituent societies “through legislative or regulatory efforts, to support the proposition that the administering or application of any intra-oral chemical for the sole purpose of whitening/bleaching of the teeth by whatever technique, save for the lawfully permitted self application and application by a parent and/or guardian, constitutes the practice of dentistry and any non-dentist engaging in such activity is committing the unlicensed practice of dentistry.”

Res. 73H-2008 also provides that the Association supports educating the public on the importance of consulting a licensed dentist before undergoing whitening/bleaching services and directs that the Association petition the Food and Drug Administration to properly classify tooth whitening and bleaching agents.

The Hawaii legislation as proposed would amend the definition of dentistry to include “tooth whitening services” and the Illinois legislation would include within the practice of dentistry one “who takes the impressions of human teeth or performs any phase of any operation incident to teeth whitening, including, but not limited to, the sale, instruction, and application on site of teeth whitening materials or procedures.”

The Missouri legislation provides in part that “any individual who takes the dental impression of another or who performs any phase of any operation incident to teeth whitening, including but not limited to the instruction or application of on-site teeth-whitening materials or procedures, except with the direct supervision of a licensed dentist, shall be deemed to be engaging in the practice of dentistry.”

Other related state information includes:

• The District of Columbia’s District Government has promulgated rules reserving bleaching to dentists or allied dental personnel with the direct supervision of a dentist.
• The Nevada Dental Practice Act provides that a person is practicing dentistry if the person dispenses certain tooth whitening agents or undertakes to whiten or bleach teeth other than with over-the-counter products. However, a person may engage in such activities without being licensed as a dentist if the person is acting in a manner authorized by the regulations of the board.
• The Tennessee Board of Dentistry has approved policy clarifying its existing tooth whitening rule which reserves tooth whitening to licensed dentists and specified allied personnel with direct supervision. There is also newly adopted policy from the Massachusetts Board of Registration in Dentistry that reads that tooth whitening services “are considered to be the practice of dentistry, and, therefore, must be provided by a dentist who is fully licensed to in the Commonwealth and performed by dental personnel with a licensed dentist’s supervision.”
• The Ohio State Dental Board adopted policy providing in part that “simply providing a consumer with the materials to make a tray and demonstrating to them how to apply materials to their teeth for bleaching purposes is not the practice of dentistry, unless and until someone other than the consumer places their hands in the consumer’s mouth, and/or positions the activation light or similar device on behalf of the consumer.”

Other states with policy or pending policy are Oklahoma, Louisiana, North Carolina and Georgia.

For more information about this issue, contact the ADA Department of State Government Affairs by e-mail at govtpol@ada.org or by calling the ADA toll-free at Ext. 2525. Legal questions may be directed to the ADA Division of Legal Affairs at wilsw@ada.org or Ext. 2542.聽

Dentists who see whitening harm urged to report it
The ADA divisions of Government and Public Affairs and Science recommend that dentists do the following if your office treats a patient harmed through whitening by retail staff:

• Submit the information to the U.S. Food and Drug Administration through MedWatch at www.fda.gov/medwatch;聽
• Encourage the patient to file a complaint with the state dental board;聽
• Contact the ADA Division of Science to report the diagnosed harm. Doing so enables the ADA to gauge the extent of reported harm and thus communicate reliable data and information back to the state dental societies. Call the ADA toll-free number, Ext. 2878, or e-mail science@ada.org.

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