Sir, we are writing with regard to Brexit and the implications on clinical dentistry. One piece of legislation of particular interest to paediatric dentistry is the EU Cosmetic Directive 2011/84/EU1 which came into force in the UK in October 2012 and banned the use of products containing >0.1% hydrogen peroxide on persons under 18 years old. Dentists see children with dental anomalies including discoloured teeth; such anomalies have been reported to affect children's psychosocial health;2 tooth whitening in such children and young people is not simply for cosmetic purposes. After much lobbying by UK dentists, including the British Society of Paediatric Dentistry, the General Dental Council amended its guidance and advised that products with ≤6% hydrogen peroxide can be used if 'intended wholly for the purpose of treating or preventing disease'.3

However, the ethical and legal conundrums for the dentist remain. The EU Cosmetic Directive has not changed despite the GDC's statement. The dentist who acts in a child's best interest might still be at risk of legal persecution by the local Trading Standards officers. The maximum penalty of breaching the law is six months imprisonment.

In addition, interpretations of the GDC's guidance have been different. While one major UK defence organisation is supportive of a dentist's decision to provide tooth whitening for those under 18 years of age based on individual assessment,4 another UK defence organisation stated that they 'cannot envisage any circumstance where the product could be used 'wholly for the purpose of treating or preventing disease'.5

Therefore, the dental profession should continue to lobby to ensure that the legislation permits dental professionals to do what is best for their patients without ambiguity.