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Under 18’s & Teeth Whitening

Dr Rahul Nehra tell us the story of an 11-year-old who was bullied because of the colour of his tooth and how whitening that single tooth transformed his young patients’ life.

17 July, 2019
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Teeth whitening, despite its popularity, is heavily regulated in the UK and only a dentist registered with the GDC can perform teeth whitening on patients. But it is still an illegal procedure for anyone under the age of 18. So, when Dr Rahul Nehra found himself with an interesting case of a bullied child on his hands, he was forced to seek advice from several bodies before being able to give his young patient the most conservative treatment for his particular case.

Read on as Dr Rahul Nehra sits down with Dr Payman Langroudi to tell the whole story.

Payman: I’m here with Rahul Nehra from Smile Gallery in East Grinstead. Rahul recently found himself in an interesting situation where he had a child patient who needed teeth whitening and because of that he found himself on the wrong side of the law.

Maybe you can just elaborate for us Rahul, tell us the full story.

Rahul: So about 18 months ago, an 11-year-old kid fell down at school, as most kids do, but unfortunately the fall devitalised to his upper left tooth. It went completely black.

We had the endodontist carry out a root canal but unfortunately, the child was getting bullied at school and he was finding it very difficult to then go into school. His parents had begun looking into options that were quite extreme like veneers and home schooling.

Before

How Teeth Whitening Became an Option

That’s when we stepped in and told them that there’s easier options and we could simply whiten his tooth inside out. We knew if we used Enlighten it would work so we contacted you guys and got an answer back within a few hours. The parents consented and we spoke to the Dental Defence Union and they were happy for it to go ahead because we were doing something to protect the child and we had the parent’s consent.

The results were incredible.

Payman: Did the parents come to you initially asking for veneers?

Rahul: Yes. We had several consultations where they said they wanted veneers or tooth straightening, anything that would just improve the way the tooth looks. They made it clear that if I wasn’t willing to help then they’d find another dentist. So, I had to explain to them that it’s not down to me alone and the decision comes from somewhere else.

After talking to a few different companies, yourself and then the defence union we were told to go ahead as the results will show for themselves. The parents were over the moon with the results and the child has now integrated back into school.

Payman: So you find yourself in a difficult situation whereby it’s legal for you to go ahead and prep this eleven year old’s teeth but illegal for you to do something as conservative as bleaching.

Rahul: Exactly.

Payman: So how did you feel?

Rahul: Strange, very strange.

It’s one axis cavity, it’s a small axis. And the thing is the axis cavity was already produced by the endodontist. I wasn’t even cutting the tooth away. And the mother was happy to carry out the whitening.
Both sets of parents had individual meetings with me to say you need to protect my son, you need to help him.

Payman: How bad was it?

Rahul: It was bad. He’d come in and even when talking to us as adults he would slowly just quieten down. He wasn’t the same as before.

The Law on Teeth Whitening

Payman: I think the GDC’s now said that if the discoloration is due to a disease process then you’re okay to do what you did. So, I think in the end It’d have been okay, but the situation needed clarification for sure.

And it reminds me of 2001 to 2012 when bleaching was illegal in the UK.  A bunch of us were supplying teeth whitening products to patients and a bunch of us got together; Linda Greenwell, Chris Law, Martin Canada and the idea was that if this goes to court, we’d be willing to stand by it because at the end of the day your number one concern is your patients well-being.  So, I can understand why you went ahead. But the situation needs clarifying and Linda’s doing something about that now, she’s finding twelve situations where it’s okay to bleach the teeth of someone under 18.

Rahul: Something needs to be done. It was such a basic treatment and everyone’s happy. The parents are over the moon the, child is over the moon. He didn’t need to whiten the rest of his teeth, he literally had a tooth whitened and just something so basic and simple has improved his lifestyle.

Payman: I mean you just try to do your best for this patient find yourself in this difficult situation.

Rahul: If it was my 11-year-old I wouldn’t be crowned prepping on him. So why would I crown prep on someone else’s 11-year-old? If it’s as basic as putting a back filling on and a little bit of whitening. You can’t go wrong.

Payman: What steps did you take it before you went ahead?

Rahul: I gave my patient all his options. Both parents were involved in this process. I sent them away with home whitening, the veneer and seeing a specialist option. They decided that the whitening was going to be the option they wanted to go for. They realised it was the most conservative and the results were going to be the best. We gave them that cooling off period sent them away with the literature. I then spoke to the defence union who were happy to go ahead.

Payman: Which defence union was that?

Rahul: The TDS defence union and they were great. They said as long as you’ve done all the right steps. Go ahead.

After that what we did was, send the patient away and let them make their own decision and once it decision was made, I went ahead and did the treatment because my patient’s best interest is all I care about.

The result

Payman: And you got to the result you wanted.

Rahul: I got the result and the patient is over the moon.

Payman: Well hopefully this is going to be one of one of the cases that Linda can use in her campaign, she’s trying to get that law changed so that we can treat people younger than 18 in the right situations because we know it’s completely safe. Whereas the other option would have been completely unsafe.

Rahul: My team went through it as well. Everyone at the smile gallery said this is your best option. We showed them before and after pictures of previous whitening’s we’ve done. And if it works on an adult why wouldn’t it work on a child?

Payman: Brilliant. Thanks a lot for coming in to discuss that with us.

To read more on single dark tooth whitening click here. 

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