Vital tooth whitening: the legal and ethical issues

Tooth-whitening procedures have now become commonplace within restorative dentistry as a frontline treatment for the management of discoloured teeth. The use of bleaching has dramatically risen in the last 15 years and there is wide-ranging documented evidence within the dental literature of the efficacy and uses of tooth-whitening procedures (Hasson et al, 2008).

There are now a variety of techniques documented in the dental literature for the management of both vital and non-vital teeth as well many variations in the products that can be used clinically. These include vital bleaching, non-vital whitening and combination techniques such as the ‘inside-out’ technique. The most commonly used method is the tray method of tooth whitening (also known as ‘night-guard’ or ‘at-home’ whitening) where a peroxide-based whitening agent is placed in a custom-made tray that patients can then wear overnight or for a prescribed period of time. This technique uses a form of either carbamide peroxide ranging from 10-22% with the most commonly used agent being 10% carbamide peroxide.