I Got my Teeth Whitened at the Mall

I overheard a lady at a local eatery the other day remarking to another person that she "got her teeth whitened at the mall”. We have all seen the kiosks with salespeople in white coats telling folks how they can whiten their teeth in 30 minutes and touting the special reduced fee.

Dentists across the country probably see this and react differently. Most view this as a clear violation of the Dental Practice Act, specifically, practicing without a license. Others seem to not be as concerned.  Your first thought upon seeing folks lined up in chairs at the mall with a light focused on their teeth is likely, "how do these guys get away with this”?

In 2008, the Panhandle District Dental Society introduced a resolution in an attempt to stem the practice of any tooth-whitening procedure by non-dental persons not properly trained and under the direct supervision of a licensed dentist. Then TDA President, Dr. Hilton Israelson, appointed a "Task Force on Dental Services by Non-Dentists”. Current TDA President, Dr. Matt Roberts re-appointed the task force in May of 2009.

The Task Force discovered that complaints to the Texas State Board of Dental Examiners have proved insufficient to end the practice of tooth whitening in non-dental settings by non-dental retail workers. This is largely due to the fact that the TSBDE has no jurisdiction over anyone except dentists, hygienists, and dental office workers. They are willing to assist District Attorneys’ offices in prosecution however.

Last summer, I walked by a tooth-whitening kiosk in a mall only a few miles from my office. Curiosity got the best of me so I had to do an about face and ask a few questions. The young lady attending the kiosk seemed nice enough so I just came out and told her that I was a dentist here in town and wondered if she would answer a few questions. She immediately told me that, "they never touch the client… that they instruct them on how to bite into a tray and apply the bleaching solution.” I figured that line had to be memorized as a condition for employment. I then asked what solution they use and she told me it was 15% carbimide peroxide.

So I left thinking about what little good one application of carbimide peroxide would do. Not much. So at the discounted rate of $80 that day, I figure about ten more applications and $800 would do the trick!

Certainly, no 35% hydrogen peroxide solutions are being used there or they would have been out of business long ago because we all know that without really good isolation of everything but the teeth, they would all have severely burned tissues.

The kiosk bleaching can hardly be effective but is it legal? Eleven states have ruled that tooth whitening in non-dental settings without dentist supervision is practicing without a license. Those states are: Alabama, Florida, Iowa, Kansas, Massachusetts, Missouri, Nevada, New Jersey, Oklahoma, Tennessee, and the District of Columbia. Legislation is pending in three states: Hawaii, Illinois, and Minnesota. In an interesting departure from most states, the Louisiana Dental Board ruled that using bleaching concentrations equivalent to Crest White Strips and consumers placing their own trays is not a violation of the Louisiana Dental Practice Act.

Your Texas Dental Association is listening to the concerns of the members. The Task Force has looked into the problems of regulation in depth so stay tuned for updates as we hear more news on this topic. You may have other issues that concern you about the state of dentistry. If you do, discuss this with one of your Delegates and action will be taken. If you do not know who your Delegates are, you can give me a call.