I think if your patient has bought and paid for it twice and it twice didn't work, he/she needs to not buy it a 3rd time! 🙂
There is a whitening station in the mall here in KS near my house and several about town. There was a recent story on the news talking about their false claims - they had one of the reporters undercover and showed the woman at the whitening place talking about how their whitening treatments could fix periodontal disease and all sorts of BS. One of our clinical faculty members was on talking about how it was a crock.
They skirt around the law by having the patient mold their own tray - sort of like making a cheapie football mouthguard. They mold their own tray because "taking an impression" is under the dental scope of practice so the whitening attendant (in their white coat with official-looking certificate hanging on the wall to make them look like they know what they're doing when they don't) can't take the impression for them.
It's a waste of money, it's potentially hazardous and the people that work at that kiosk are... not. too. bright. (When I go to the mall I usually end up stopping by to (harass them) I mean discuss their services and ask a lot of questions about their percentages of carbamide peroxide and ask to see shade guides and ask how many shades I can expect to gain from one treatment and ask about the wavelengths of blue lights on the light thing and if they have any evidence based literature regarding whether or not the blue light actually accellerates the change in shade... then they start catching on and usually ignore me and I move along to Banana Republic.)
Who the heck wants to sit in the middle of the mall with cheek retractors on while all the other shoppers are walking buy anyway? What's wrong with these people?
You can't fix stupid. You can enact all the laws you want to protect the "average consumer". But at the end of the day, you ALWAYS have a RESPONSIBILITY to be your own advocate....unless you're like a minor or such. There's a reason the field of marketing has become so lucrative these days. Some of these places are using close to professional grade products, which can be dangerous. Do you have a right to restrict their business model and regulate how they word their practices? Even if you do that, it wont be easy and it wont be effective. in most previous cases, once enough "problems" arise, the fed ends up "fixing" the problem by regulating the product (making it prescription only), not the practice. Because come on, its much easier and more lucrative to fine a distributor or manufacturer than it is to try to regulate the service provider.
Really though, the average worker at one of these places has no idea that what they're doing is harmful. They FEEL QUALIFIED. And their average customer is not an educated person, its largely people who feel as if they're being cheated by other "overeducated" people. Sure they do it because its cheaper. But the hook line and sinker, the emotional component to this whole business, is the idea that you're superior, know it all, rich dentist is making money off of you....when really, they're not all that superior bc this high school student can do the same thing! They're not going to read any fine print the government forces such stores to put on display. They're not going to heed the warnings. because the FDA or ADA is also superior and know it all and just out to screw over the "Average person".
Theres some brand now that you can get at drug stores (forget the name) that has the "blue light". It says on the FRONT of the box something along the lines of "uses a blue light, just like youre dentist!" and then on the back of the box it says something like "blue color added to light for effect only. blue color does not affect the whitening capability of this product".
and people buy it anyway! and then they go home and tell their friends "I got the blue light one. its the same as my dentist". They LOVE that they one upped their dentist....not necessarily that theyre whitening their teeth (or at least trying to).
Along the same lines, we used to have the same issue with contact lenses. now, ALL contact lenses are by prescription only. But you find that you can get color contact lenses in a lot of ethnic run salons (because they ship them in from other countries without prescription). People dont realize that even if you have no need for vision correction, the damn things go ON your eyes! Youre eyes have a base curve, a diameter, a dryness factor and several other components that have to be taken into consideration. We've had loads of patients come into the OD I used to work for with serious problems because they just go slap on any old pair of color contacts from the asian nail salon on the street corner. They'll get headaches bc they get an 8.6 (or an 8.9 which is custom order in the US but apparently easy to get in asia) when they should be in an 8.2 base curve. Or people who had the nail lady put the contacts in for them (bc it takes sometimes HOURS to teach a new person to put in and take out contacts...which is not lucrative to the whole "selling illegal prescription products" practice) and then have no idea how to take them out and wear them for months (often not even knowing that they arents supposed to!) and then get corneal overgrowth on the contacts.
I mean seriously. it even SAYS prescription only on the contact cases. and on all the commercials on tv.
I'm not actually sure if they already are (somebody else can prob answer that?) but I'm sure certain strength bleaching products are already "prescription only" or otherwise regulated....you can keep tightening that regulation, taking it down a few more percentage points as far as what % peroxide is allowed without prescrption....and these stores will just go 0.1% lower.
My only solution to this is in how we as a profession interact with our patient. Don't be that "superior" person. They already know you have more experience in this particular field than they do! Be the kind of dr. that explains things as thoroughly as your practice permits. They come to your for a full service and experience, not just for the product. If you really explain the risks of bad bleaching practices and inferior products BEFORE you throw the cost of your in office bleaching at them and they STILL go to the mall kiosk, well thats their problem. you presented the facts. you made an effort to make sure they understood the facts at their level. They decided to take a risk. They're entitled to take risks. They'll learn from it and then tell their similar minded friends who will also learn from it.
Regulate it all you want. Somebody will still find a way to offer contacts and bleaching and skin peels and "detox" procedures and all these other lucrative cosmetic procedures on the side. You have to offer more than just the product.
Darwin will take care of the rest.
