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Should under 18s be allowed to whiten their teeth?

Living legend Linda Greenwall talks to us about the controversial topic of teeth whitening for under 18s

19 April, 2024

With teeth whitening now sitting firmly as a part of mainstream dentistry, it’s time to explore if whitening for under 18s should be allowed. And if it is then should it only apply to particular cases? Read on as Dr. Payman Langroudi, clinical director at Enlighten Smiles, and the legendary Dr. Linda Greenwall discuss.  

Dr. Payman Langroudi: Tell me about when you got into whitening, because young dentists now take whitening completely for granted, but when I got into, it was around 2000 and I think you were already an expert at that point. You’d already written your first book. How did you get into whitening? How did you get in touch with the Van Hayward and all that? How did it all come about?

Dr. Linda Greenwall: I was doing this research study. I was in the library, I was looking at some of the journals and I saw the Quintessence cover. The Quintessence covered Van Hayward’s article, which had a picture of the upper teeth white and the low teeth are yellow. And I looked at it and said, “How can that be? What is this? What’s going on?” So I read the article about the whitening and I went to my professor and I said: maybe I should research this.

He glanced at it and said, “Okay, you go girl, you go do it.” So off I went to start on the research study and back then there was very little evidence about whitening. So the first thing we wanted to know is does it actually work? Is it valid? Is it genuine? Is it safe? Those were the key things.

Have the chutzpah to call up who you admire. Go learn from them and continue your quest for knowledge

We looked at all the studies, all the research, all the evidence about whitening, and it was a fascinating subject because it was basically brand new. It had been done for 200 years. It was super popular in the 1860s to have power whitening. But there had been no updates about it. 

I looked at everything, every single thing that came out. In those years it wasn’t a lot but we wanted to understand the mechanisms. And then we discovered there were some basic ways that it works.

I contacted Van Hayward. I believe you should have the chutzpah to meet whoever is the best at what you want to do.

Have the chutzpah to call them up. Go see him. Go learn from him and continue your quest for knowledge. That’s genuine knowledge. Now there’s all this fake news, so you have to be very distinguished as in terms of as a scientist, what’s valid? What’s right?

This is now 1993, I’m in my practice, I’m doing power whitening. I’ve spent 5k on the light and I am not really sure, I thought is it just me, but I can´t see anything happening. So I’d go to these bleaching lectures and I’d ask the lecturers, “Seriously, what really happens? Because I’m not seeing much happen.” And then quietly they would tell me the truth that they also don’t see much happening. But in the lecture they will give me a whole story. And so I was trying to figure out, well who is right? And what is the story? Which continued the quest and then we discovered the whole legal aspect.

At this point I’d been talking about whitening for a long time. Sir Paul Beresford heard me speaking at Queen Elizabeth Hall and he goes: “Linda, I really want to help you. We need to make some changes”, so we set up the British Dental Bleaching Society in 2008 to lobby for change and to make tooth whitening a part of mainstream dentistry, but specifically to get dentists to be able to practice legally, safely, and to have the patient’s best interest at heart.

Dr. Payman Langroudi: And you got it done in 4 years, it was 2012 when it really happened.

Dr. Linda Greenwall: But there is still the issue of the under eighteens.

If the way their teeth look is impacting a child and it’s in the child’s best interest or if they’re being bullied at school, then whitening is absolutely the right thing to do

We are quite advanced in our education process with whitening and aesthetic treatments and the like. But the current concern with under eighteens whitening isn’t really an issue at all. It’s only a classification thing. It’s just that at the time when they made the change in the law, they didn’t think they could change two laws. So they kept it simple. But there’s no reason for it not to be. Clinically it’s perfectly safe.

And that’s why we’re having the conference on the 15th of November. We’re going to lobby and change it and we’ve got an action plan ready to go.

Dr. Payman Langroudi: So where we are at today in July 2019, if a dentist has a child patient who has got a non-vital tooth or if a dentist has a child patient who has particularly dark teeth that they’re being bullied for, should they or shouldn’t they bleach their teeth today?

Dr. Linda Greenwall: It very clearly comes back to the ruling or the guidelines of the General Dental Council. The General Dental Council said, “If whitening is for treatment of disease, then it can be undertaken.”

The main thing is the impact on the child. If it’s impacting the child and it’s in the child’s best interest or if they’re being bullied at school, then it’s absolutely the right thing to do. Not just a random thing cause a child wants the same teeth as someone on Love Island. Now, the problem that we have is that there’s a lot of new diseases in the last 20 years.

We can treat child patients in terms of minimally invasive aesthetics, which makes a huge difference in their lives

Dr. Linda Greenwall: There are new diseases and the environment that we live in causing toxicity on kids’ teeth, which reflects as white spots in their teeth. There’s a 25 to 40% increase in children’s teeth that are erupting with white spots.

A lot of these children who have white spots actually have MIH (Molar incisor hypomineralisation), which is a disease and that causes extreme sensitivity. 

So it needs to be in the patient’s best interest. Especially when children have finished primary school and are about to go to secondary school they want to change their appearance. At the moment we are treating a lot of those children. They have severe discolouration, brown, orange/yellow marks, white discolouration at this time and we are treating them so that when they go into high school in September it isn’t going to be an issue for them.

And the thing with whitening and these minimally invasive treatments is they’re so simple to treat.

The remaining aspect is the mental health issue, which is much more difficult. We can’t treat that but we can treat them in terms of minimally invasive aesthetics which makes a huge difference in their lives.

What are your thoughts on whitening for under 18s? Let us know below in the comments and keep your eyes peeled for part two.  

Next time we’ll be talking to her about why whitening may be one of the neglected disciplines of dentistry.

Don’t want to wait for part 2? Then listen to the full podcast here.


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