Oral hygienists may perform tooth whitening procedures only if they have received adequate education and training on the procedure at an institution accredited by the Professional Board for Dental Therapy and Oral Hygiene (PBDOH).

The Health Professions Council of South Africa (HPCSA) has confirmed the decision by the PBDOH that oral hygienists who have not received training in tooth whitening at undergraduate level or as part of their expanded functions course should not perform the procedure.

On-the-job training or attendance at CPD events or other non-accredited short courses is not enough to satisfy the requirement of adequate education and training.

The PBDOH was recently asked to advise whether oral hygienists may perform tooth whitening procedures or not. It was cognisant of the fact that the regulations defining the scope of practice of oral hygienists specifically state that oral hygienists may perform the procedure. But the PBDOH went further in its enquiry by considering the Ethical and Professional Rules of the HPCSA which serves as a guideline for good practice in all health care professions.

In particular, the PBDOH looked at two of the rules: one is a professional rule specific to oral hygienists, and the other is an ethical rule generally applicable to all health care professionals. The ethical rule states that a health care professional may only perform acts ‘for which he or she is adequately educated, trained and sufficiently experienced’. While the regulations provide that tooth whitening is within the scope of practice of oral hygienists, the PBDOH decision means that the Ethical and Professional Rules restrict oral hygienists’ scope of practice in relation to their training and experience.

On-the-job training or attendance at CPD events is not enough to satisfy the requirement.

Should the same question be posed to the Medical and Dental Professions Board regarding whether all dentists are allowed to perform tooth whitening procedures, a similar answer is likely, because the professional rule specific to dentists is worded almost identically, and the ethical rule is applicable to all health care professionals.

Oral hygienists and dentists who have not received undergraduate education and training in tooth whitening at an institution accredited by the relevant board of the HPCSA, and who wish to perform the procedure, would be best advised to enquire at the HPCSA regarding accredited institutions, and undertake such accredited training before performing tooth whitening on patients.

This is a rare case where regulations improve your smile