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Wednesday, 4 August, 1999, 10:46 GMT 11:46 UK
Dentists: Legalise teeth whitening
Dental work
Dentists say they should be able to provide a popular service
A warning has gone out to dentists that many treatments to whiten teeth are now illegal.

The British Dental Association, which issued the warning, says the law should be changed so that patients can have cosmetic treatment if they wish.

Teeth whitening techniques such as power bleaching have been used by dentists for many years to give patients instant results.

But on July 1 the Court of Appeal ruled that teeth whitening was a cosmetic procedure, not a medical one.

Under cosmetics regulations, preparations must not contain more than 0.1% of the active ingredient, hydrogen peroxide.

Teeth whitening products can contain 100 times that amount.

Unwhitened teeth
Teeth before they have been whitened
Dentist Dr Jonathan Levy said: "This particular treatment is very effective, very efficient and very comfortable for the patient.

"It is nice to give patients instant results. They come in with a dull smile, and they go out with a bright smile."

Dr Mervyn Druian, of the BDA, said: "It is a safe, effective procedure that we have used with great success for a long time, and it has been taken out of our hands, making it very difficult for patients to have this technology."

"It should be taken out of the cosmetic classification, and put under medical and left for dentists to help their patients."

The Department of Trade and Industry said it strongly believes teeth whitening products are cosmetic.

The best hope for patients is a chance in European Union regulations on the use of hydrogen peroxide, but no move is likely until next year at the earliest.

Techniques for bleaching

Whitened teeth
Teeth after power bleaching
Dentists can bleach or whiten teeth either externally or internally.

Techniques for external bleaching include the nightguard system whereby the dentist makes a tray from an impression taken of the patient's teeth, so that the bleaching gel can be applied very precisely on the teeth needing treatment without touching the gums.

This technique can be carried out at home, under dentist direction.

Another method, used in the dental surgery, involves heating the bleach gel so that it acts more quickly on the discolouring molecules within the tooth.

Where a nerve has died and the tooth has been root filled, a technique can be used to lighten the tooth internally and bring the colour closer to the colour of the surrounding teeth.

Hydrogen peroxide or water mixed with sodium perborate are put inside the tooth, under a temporary dressing.

The bleaching agent remains in the tooth for about a week before being cleaned out so that a white filling can be placed.

Tooth colour is genetically-determined, though teeth do tend to darken with age.

They can also become stained, either superficially by coffee, tea, tobacco and similar substances, or by illness or the use of certain medications while the teeth are forming.

Sometimes teeth become discoloured by the breakdown of tissue inside the root canal when the nerve dies.

Philip Lingard
The BBC's Philip Lingard:"Dentists want teeth whitening classified as a medical procedure"
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