Toothwhitening Q&As for Dental Nurses
1. If toothwhitening is a cosmetic procedure, is it really the practice of dentistry?
Yes. In 2013, the High Court ruled that applying materials and carrying out procedures
designed to improve the appearance of teeth is the practice of dentistry.
This means that toothwhitening is a dental treatment and so can only be carried out by a
qualified dental professional who is registered with the GDC.
This includes all toothwhitening procedures including bleach and laser treatment, as well as
giving patients a kit to administer at home themselves.
2. But if someone who is not registered with the GDC just hands a toothwhitening
kit to the patient for them to apply at home themselves, is that still considered
to be dentistry?
Yes. The Dentists Act makes it illegal for anyone who is not registered with the GDC to give
“treatment, advice or attendance” that would usually be given by a GDC registered dental
professional.
Handing someone a tooth whitening tray and advising them on how to apply it would be
considered as giving “advice or attendance” and so is the practice of dentistry.
3. Can a non-registrant do toothwhitening if they do not use hydrogen peroxide?
No. Giving patient-specific advice and carrying out procedures designed to improve the
appearance of teeth is considered to be the practice of dentistry, regardless of the chemicals
involved.
Therefore anyone carrying out toothwhitening must be a registered dentist, or a dental
hygienist, therapist or clinical dental technician working to a dentist’s prescription.
4. So who can actually carry out toothwhitening?
Only dentists can prescribe the gel that is used to whiten teeth. This is set out in EU law. The
law also states that only a dental professional can apply the first use of the toothwhitening
gel in a toothwhitening cycle.
This means that dentists can carry out toothwhitening. Dental hygienists, dental therapists
and clinical dental technicians can be trained in toothwhitening as an additional skill. This
means that they can apply the first use of toothwhitening gel to the patient, but only on
prescription from a dentist and under the supervision of a dentist.
After this, the toothwhitening gel and bleaching trays can be given to the patient so that they
can finish the rest of the cycle at home.
5. What about giving the toothwhitening gel and bleaching trays to the patient?
Who can do that?
Once the dentist, or other relevant dental professional, has completed the first use of the
toothwhitening cycle with the patient, the patient can complete the remainder of the
treatment at home.
A dental nurse could talk through the instructions for completing treatment at home with the
patient, after the first cycle of treatment had been carried out by a dentist, dental hygienist,
dental therapist or clinical dental technician.
They would be able to do this providing they are trained, competent and indemnified to do
so, and follow the instructions provided by the dentist, or dental care professional,
responsible for the treatment.
6. So what can dental nurses do in the practice?
Dental nurses can do the following, on prescription from a dentist, if they are trained,
competent and indemnified:
 Take impressions that will be used to make the bleaching trays;
 Construct bleaching trays;
 Go through instructions with the patient (that have been provided by the dentist) on
how to complete their tooth whitening course of treatment at home.
Dental nurses cannot:
 Apply toothwhitening gel;
 Provide any clinical advice to a patient regarding toothwhitening, for example the
risks and benefits of the treatment or whether the patient is suitable for it;
 Give any toothwhitening materials to a patient unless this is done on prescription
from a dentist.