Teeth whitening: Surging popularity brings issues to resolve

In Australia, as in most wealthy economies, the popularity of teeth whitening is surging, particularly amongst those aged under 35, thanks to a relentless onslaught of social media advertising and celebrity-endorsements directed at the 'selfie' generation. In 2016, competition between over-the-counter and online brands intensified, and in that year, teeth whitening became one of the biggest crazes on Instagram, Pinterest, YouTube and Facebook.

Given this, and frequent emails from members concerned about non-dentist teeth whitening services, the ADA undertook further research into teeth whitening in Australia during 2018. We considered products, services, advertising, and consumer behaviour in Australia, the regulatory environment, and the latest international research on the safety and effectiveness of various teeth whitening methods, ingredients, and products.

What we found was that only 6% of consumers who whiten their teeth are going to non-dentist services to have their teeth whitened. A far higher proportion of consumers (50%) who whiten their teeth are buying whitening do-it-yourself (DIY) products/kits available over-the-counter in pharmacies, and whitening kits sold online.

Young consumers, who are least aware of the risks of teeth whitening, seem most likely to buy whitening kits online, and the comments some are leaving on social media and product review sites suggest that many are applying teeth whitening gels and strips to their teeth on an almost weekly basis, and for longer than recommended durations.

Information provided to the ADA by state poisons centres also suggests that even some patients who obtain home-whitening kits from their dentist are leaving whitening gel on their teeth for longer than instructed.

The ADA's research also confirms that some product manufacturers and some non-dentist teeth whitening services are using statements in their advertising that appear to be misleading, and/or irresponsible. For example, some non-dentist services exaggerate the tooth shade change that can be expected, the 'dental grade' strength or supposed quality of products used, and the training and expertise of the 'professionals' who conduct teeth whitening.

For their part, some DIY teeth whitening product manufacturers are suggesting that their products are 'all-natural' and safer alternatives to peroxide formulations, when in fact their products often contain chemicals like sodium chlorite or sodium perborate.

Furthermore, it seems that some consumer websites and online retail marketplaces that ship to Australian consumers are selling teeth whitening products containing concentrations of whitening agents that exceed legal limits in Australia.

Teeth whitening products are classed as cosmetic, rather than therapeutic goods in Australia, and the ADA is informed that it is the ACCC and its partner state and territory consumer protection agencies that are responsible for monitoring misleading advertising of teeth whitening products and services by product manufacturers, and unregulated service providers. The ACCC and state and territory consumer protection agencies are also responsible for preventing the sale of teeth whitening products that do not meet relevant

Australian laws.

Accordingly, the ADA has documented its concerns about these issues in a submission to the ACCC that will be lodged with that agency and available to read on the ADA website in early June. We are asking the ACCC to act immediately to enforce the law, and to maintain more effective ongoing regulatory oversight of this burgeoning consumer market so as to better protect consumer health and safety. We'll keep you posted on developments.

In the meantime, the ADA and state branches have also done numerous media spots over the past few months warning consumers about the dangers of whitening their teeth without their dentists' advice. We will continue to press this message home during 2019.

DENTIST TEETH WHITENING SERVICES: REGULATORY ISSUES TO BE AWARE OF

Under Australian law and Dental Board of Australia regulations, only dentists can use teeth whitening products containing more than 6% hydrogen peroxide or 18% carbamide peroxide, but it is important to note that under Dental Board requirements, these stronger products can only be used for in-chair whitening procedures.

The Dental Board's Fact sheet: The use of teeth whitening products by dental practitioners, released in mid-2017, makes it clear that dentists must not supply products containing more than 6% hydrogen peroxide or 18% carbamide peroxide to patients for self-administered home-use.

Members who provide teeth whitening services should also be sure that their advertising complies with the advertising requirements of the Australian Consumer Law, and s.133 (1) of the National Law.

Detailed guidance on pitfalls to avoid is provided in the AHPRA Guidelines for Advertising Regulated Health Services. It is als beneficial to read the ADA's latest Policy Statement on Teeth Whitening.

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