Dentists seek end to loophole in bid to stop cosmetic ‘rivals’

The Dental Association of Malta has said that it is lobbying the government to clarify what constitutes ‘practice of dentistry’ and decide whether cosmetic tooth whitening treatments can be practiced by beauty salons. 

Association vice-president Adam Bartolo told MaltaToday that although it seemed like a statement of fact that any treatment involving someone’s teeth should only be administered by a registered dental practitioner, many argued that teeth whitening procedures were not necessarily the sole remit of qualified dentists.

“The problem is precisely that the Health Professions Act never specifies exactly what constitutes dentistry, it only points out that ‘No person shall practice as a dental surgeon unless he holds a licence for that purpose’,” he said quoting the act. 

The law adds that only people whose name is entered in the register of dental surgeons can in fact apply for the licence.

Bartolo explained that beauty salon operators often made use of this legal loophole both locally and abroad to justify the fact that they offer the treatment, by virtue of it being ‘cosmetic’.

“This argument should be completely closed,” he said. “Compare something like breast implants, which are also in most cases cosmetic treatments, but which obviously should never be attempted by anyone who isn’t fully qualified.”

However, beauty salons use the EU’s manual of dentistry to defend the practice, given that “non-dentists such as beauticians may still carry out tooth whitening, when inspected by health authorities, provided they use products containing less than 0.1% peroxide or they use other bleaching materials,” under the regulation. 

Association president David Muscat explained however, that a truly safe tooth whitening treatment would go beyond simply administering the chemicals.

“When people turn to dentists for their treatments, the condition of their teeth, and even the very quality of the stains on their teeth is established before going on into any particular treatment,” Muscat said, adding that certain stains like those originating from medications, required even more intense treatment.

“The next step after this assessment is to have a full check-up to make sure that the treatment won’t exacerbate already existing issues like gum disease, or cavities and cracks in the teeth,” Bartolo said, adding that this was followed by a routine scale and polish to truly gauge the kind of treatment necessary. 

“If these steps aren’t followed, then one risks seriously damaging one’s teeth,” Bartolo said.

He added that all the aforementioned processes clearly constituted dentistry, which meant that non-dentists were prohibited from doing them.

The association also told the newsroom, that the very chemicals used in the process could also be potentially dangerous, and therefore require professionals to handle them.

“The only scientifically proven whitener, essentially, is peroxide, or peroxide releasing substances. However, the low concentrations that non-dentists are allowed to administer have had negligible results,” Muscat said.

Bartolo explained that essentially, concentrations under 0.1% were so mild that they were safe to purchase over the counter, and that treatments favoured by dentists normally contained something between 0.1% and 6% peroxide concentrations.  

“In the UK, there were various cases where salon treatments were discovered to either contain excessive amounts of peroxide, or potentially toxic, peroxide releasing substances like sodium perborate,” the association pointed out. 

Muscat stressed that such realities therefore threw doubt on the treatments available from non-registered dentists.

“If they are truly effective then the substances in the products used need to be examined closely for safety, and if they are not, these companies might essentially be duping the public,” Muscat explained. 

The association further added that its power was somewhat limited and that it could only flag such issues to the authorities given that it had no executive power itself. 

Meanwhile, asked about tests carried out on such products, the Malta Competition and Consumer Affairs Authority said it had investigated a number of teeth whitening and other cosmetic products to ensure compliance with the EU’s REACH (Registration, Evaluation, Authorisation and Restriction of Chemicals) rules and the Cosmetics Regulations, as required by EU law. 

“Appropriate action, including withdrawals and recalls of products from the market, as well as notification of the Commission as necessary, has been taken whenever such investigations have resulted in products not conforming to requirements,” the authority added.

The MCCAA also said that once a product complied with regulations, it had no power to determine who administers the product. “The MCCAA’s remit is solely to ensure product compliance and safety, so certification of personnel is not the remit of the department.”

Although there are instances where the Cosmetics Regulation specifies that a product is only to be administered by a professional, the level of competence is not specified. “The legislation may state that the product should be administered by a dentist but does not specify what qualifications are required for one to be considered as a dentist.”