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31 May 2012 | Australasian Dental Practice

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What to do about take home whitening?

By Joseph Allbeury

Teeth whitening products have always been an anomaly in dentistry in Australia. Most everything else that "touches" a patient, from gloves and impression trays to implants and injectable anaesthetics, must be listed on the Australian Register of Therapeutic Goods (ARTG) that is administered by the Therapeutic Goods Admionistration (TGA). Whitening agents, however, have always been noticeably absent.

Any product containing hydrogen peroxide in a concentration in excess of 6% is considered to be a poison and as such, must comply with certain labelling and packaging requirements. Apart from that, however, whitening agents in Australia have essentially been treated as cosmetic in nature and largely unregulated.

This has led to a multitude of products being readily available and readily accessible in various concentrations and delivery systems.

Whether hydrogen peroxide or carbamide peroxide (hydrogen peroxide dissolved in urea crystals) is a therapeutic good or not, it has the potential to cause harm in the wrong hands. Most dentists applying whitening gel to a patient in the chair quickly learn why meticulous gingival masking is a must!

Whilst dental practitioners have the requisite training required to use whitening agents safely and appropriately, there are many others who have seen offering teeth whitening services as a business opportunity and decided to offer this treatment to the public outside the dental practice environment.

The broader debate as to whether or not teeth whitening constitutes "dentistry" continues in the courts around the world, essentially questioning whether beauticians and others should be whitening teeth or should the procedure only be delivered by a dental practitioner. Worse than that, the ready availability of DIY kits sold over the internet with all care and no responsibility somewhere in the finest of fine print is of even greater concern.

Enter the ACCC.

In a move the dental industry was stunned by, the Australian Competition and Consumer Commission has moved to ban the "over the counter" sale of all teeth whitening products in Australia above 6% hydrogen peroxide and the equivalent 18% concentration in carbamide peroxide, whether "professionally" dispensed or otherwise.

"Philips was surprised that the ACCC wrote to the ADA expressing this view of the law," said Muir Keir, Senior Manager Sales & Marketing at Philips Oral Healthcare. "As the new owners of Discus Dental and the Zoom, DayWhite, NiteWhite and Britesmile franchises, we were quite taken aback by this course of action, particularly as it dissuades dentists from prescribing products to their patients that have traditionally been handled in a very safe and effective manner.

"We have stock of NiteWhite at concentrations of 10% and 16% carbamide peroxide and DayWhite at 6% hydrogen peroxide for take home dispensing. We also continue to supply NiteWhite ACP at 22% carbamide and Day White at 7.5% and 9.5% hydrogen peroxide and 38% carbamide peroxide for in-office use which is unaffected by this action."

Mr Keir was quick to point out that whilst the majority of dentists he had spoken with believed that this course of action would negatively impact their practices, there are always two sides to the coin.

"On a positive note, the ACCC's action has the potential to remove a lot of the clutter from the whitening market and effectively return teeth whitening to its rightful home in the dental practice.

"We can see that our customers now have an opportunity to deliver services to patients that otherwise could have been administered at home.

"We would hope that this will finally put an end to cheap whitening treatments offered by beauty salons and elsewhere that often don't deliver results, which subsequently damages the reputation of teeth whitening as an effective treatment; and can damage patients if the products are used irresponsibly, which again, for want of a better word, turns people off whitening in general."

Mr Keir said that the ACCC's actions together with the launch of the new Philips Zoom Whitespeed whitening lamp have seen a renaissance in in-office whitening.

"We're now starting to see sales take off for the new Philips Zoom Whitespeed lamp because smart practices are seeing the opportunity to bring patients in for whitening in the chair.

"Whereas you can still use trays with a high concentration gel in the chair, the results created by using the Philips Zoom Whitespeed whitening lamp in conjunction with the gel add value to the procedure.

"Using Philips Zoom, patients literally walk in and an hour later, walk out saying WOW! If you are going to devote valuable chair time to teeth whitening procedures, then Zoom is all about meeting and exceeding the expectations of your patients in terms of results and reduced sensitivity. Happy patients build practices through word-of-mouth referrals."

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