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HOD adopts whitening resolution amid safety concerns for patients

San Antonio—Concerns about safety issues regarding unlicensed providers working in teeth-whitening businesses has prompted the ADA House of Delegates to adopt Resolution 73H-2008, which commits the ADA to supporting the education of the public on the importance of consulting a licensed dentist to determine if whitening/bleaching is an appropriate course of treatment.

"The foremost concern is that there may be a chemical or ingredient being used that may be harmful to patients," said Dr. Daniel M. Meyer, ADA senior vice president, science/professional relations.

"Since these products are not regulated by the U.S. Food and Drug Administration, there is no assurance that they are safe or effective.

"Some bleaching materials could be harmful," he continued, "especially if they are not applied carefully or are applied too long. In addition, there are also concerns over infection control and underlying conditions that may require the care of a dentist or physician prior to patients using these products."

The resolution also directs the Association to petition the FDA to properly classify tooth whitening and bleaching agents and directs the ADA Council on Scientific Affairs to compile scientific research to describe treatment considerations for dentists prior to performing these procedures in order to reduce the incidence of adverse outcomes and report these findings to all state dental associations.

The resolution also urges constituent societies, through legislative or regulatory efforts, to support the proposition that the administering or application of any intra-oral chemical for the sole purpose of whitening/bleaching of the teeth by whatever technique, save for the lawfully permitted self application and application by a parent and/or guardian, constitutes the practice of dentistry and any nondentist engaging in such activity is committing the unlicensed practice of dentistry.

"It's important that the FDA get involved in looking at these products," Dr. Meyer said. "We need to have a better understanding of what they are and how they are being used."

Additionally, the ADA Legal Division has conducted a constituent dental society survey on whitening and has offered to assist dental societies with resources that may help in their efforts to lobby their dental boards to take action regarding these whitening clinics.

To see the ADA statement on the safety and effectiveness of tooth-whitening products, please click here.

For more information, call the ADA Division of Science at the ADA toll-free number, Ext. 2878 or the ADA Department of State Government Affairs at Ext. 2525.

Other science-related resolutions adopted at the House are:

Res. 12H-2008, calls for the ADA Policy Statement on Bloodborne Pathogens, Infection Control and the Practice of Dentistry (Trans.1999: 977, 983; 2004:300) to be amended to reflect the ADA position on infection control and the practice of dentistry more generally.

The impetus for this policy amendment was the 2007 report published in the Journal of Infectious Diseases that documented a case of patient-to-patient hepatitis B virus transmission in a dental office, the resolution stated.

Previously, the last paragraph of the policy statement's introduction stated that "since 1987 and the implementation of standard precautions, there have been no documented outbreaks of HBV or HCV associated with the practice of dentistry."

Res. 46H-2008 urges the ADA Board of Trustees to explore negotiations with the Cochrane Collaboration, an international not-for-profit organization providing up-to-date information about the effects of health care, to obtain full access to the Cochrane Library services for all ADA members.