The final section of this series examines both the evidence for the safety of external bleaching with hydrogen peroxide and related products and the legal position in the UK with regard to their sale and use in general dental practice. Potential side-effects are examined, including biological effects and dental effects, with a review of the current evidence. The EU Cosmetics and Medical Device Directive are both described and their impact on the provision of tooth bleaching in the UK is explained. The legal position in the UK renders the sale and supply of solutions containing >0.1% peroxide illegal, and practitioners must be aware of the underlying legislation and the basis upon which a prosecution may be pursued.
Clinical relevance: Clinicians considering using hydrogen peroxide products must be aware of the safety issues surrounding their use and be able to explain to patients the nature of the risk and also the likelihood of any given patient experiencing them.