{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T05:00:00Z","timestamp":1790398800782,"version":"4.1.0"},"reference-count":71,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T00:00:00Z","timestamp":1790294400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T00:00:00Z","timestamp":1790294400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["227544\/Z\/23\/Z"],"award-info":[{"award-number":["227544\/Z\/23\/Z"]}],"id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Comm Dent Oral Epid"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study aimed to demonstrate how power is exercised, and by whom, to expand the practice of teeth whitening in dentistry and the resultant consequences for the public.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Institutional ethnography (IE) conducted in England that included 100\u2009h of observations at cosmetic dentistry conferences, training and treatments; five field\u2010site and eight in\u2010depth interviews with dentists; 16 in\u2010depth and 3 diary interviews with patients\/public. IE analysis identified discourses recurring across field sites and interviews, traced the institutional texts they implied, mapped how institutions activated these texts and generated further texts (work\u2013text\u2013work sequences), then examined disjunctures between institutional discourses and the lived experiences of patients\/public.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Two recurring discourses were identified: teeth whitening by beauticians is a \u201ccrime\u201d and the \u201cpractice of dentistry\u201d, both centred on patient safety. Corporates (Ultradent and Optident) and democratic institutions wielded competing texts (EU Cosmetics Directive and Medical Devices Directive) to promote and resist the sale of higher\u2010peroxide teeth whitening gel in the UK, but corporates failed to secure market entry. Dental institutions used scientific authority to frame teeth whitening as a patient safety issue, opening European markets to higher\u2010concentration products, with dentists as gatekeepers. The Dentists Act 1984 was wielded to exclude competitors such as beauticians. From the patient\/public standpoint, disjunctures revealed lived harms including unaffordable dental care, unsafe healthcare spaces, concerns around bodily autonomy and democratic accountability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Dental institutions and scientific discourse are shaped by power relations, with ethical concepts like safety politically mobilised and functioning as transnational commercial power.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/cdoe.70116","type":"journal-article","created":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T04:30:08Z","timestamp":1790397008000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Institutional Ethnography of Teeth Whitening Industry: How Professional Power Becomes Commercial Power in Dentistry"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5604-967X","authenticated-orcid":false,"given":"Rizwana","family":"Lala","sequence":"first","affiliation":[{"name":"Sheffield Centre for Health &amp; Related Research (SCHARR) School of Medicine &amp; Population Health, University of Sheffield  Sheffield England"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7622-9691","authenticated-orcid":false,"given":"Peter G.","family":"Robinson","sequence":"additional","affiliation":[{"name":"Bristol Dental School University of Bristol  Bristol England"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1413-4950","authenticated-orcid":false,"given":"Barry J.","family":"Gibson","sequence":"additional","affiliation":[{"name":"School of Clinical Dentistry University of Sheffield  Sheffield England"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,25]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jebdp.2014.02.006"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD006202.pub2"},{"key":"e_1_2_11_4_1","unstructured":"Mintel Consulting \u201cBritish Academy of Cosmetic Dentistry Survey. London \u201d(2006)."},{"key":"e_1_2_11_5_1","unstructured":"Dental Council of New Zealand \u201cPractice Statement for Cosmetic Dentistry \u201d(2009) http:\/\/www.dcnz.org.nz\/assets\/Uploads\/Codes\u2010of\u2010practice\/Practice\u2010Statement\u2010for\u2010Cosmetic\u2010Dentistry\u2010Final.pdf."},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdent.2004.06.002"},{"key":"e_1_2_11_7_1","unstructured":"Grand View Research \u201cTeeth Whitening Market (2024\u20132030) [Market Analysis Report GVR\u20104\u201068039\u2010944\u20107] \u201daccessed May 18 2026 https:\/\/www.grandviewresearch.com\/industry\u2010analysis\/teeth\u2010whitening\u2010market\u2010report."},{"key":"e_1_2_11_8_1","unstructured":"Grand View Research \u201cUK Cosmetic Dentistry Market Size & Outlook 2022\u20132030 \u201d(2025) https:\/\/www.grandviewresearch.com\/horizon\/outlook\/cosmetic\u2010dentistry\u2010market\/uk#:~:text=UK%20cosmetic%20dentistry%20market%20highlights cosmetic%20dentistry%20market%20in%202022."},{"key":"e_1_2_11_9_1","unstructured":"Fortune Business Insights \u201cTeeth Whitening Market Size Share & Industry Analysis by Product (Whitening Toothpaste Whitening Gels & Strips and Light Teeth Whitening Devices) by Distribution Channel (Supermarkets\/Hypermarkets Pharmacy Stores Online and Others) and Regional Forecast 2026\u20132034 \u201d(2026) https:\/\/www.fortunebusinessinsights.com\/teeth\u2010whitening\u2010market\u2010110349."},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(23)00013\u20102"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.h81"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(19)31146\u20108"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/2380084420975700"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1308\/rcsfdj.2025.7"},{"key":"e_1_2_11_15_1","unstructured":"European Parliament \u201cRegulation EC No 1223\/2009 of the European Parliament and of the Council of 30th November 2009 on Cosmetic Products (Recast) \u201d(2009) https:\/\/eur\u2010lex.europa.eu\/legal\u2010content\/EN\/TXT\/?uri=CELEX%3A02009R1223\u201020160812."},{"key":"e_1_2_11_16_1","unstructured":"\u201cThe Cosmetic Products Enforcement Regulations 2013 \u201daccessed March 19 2019 http:\/\/www.legislation.gov.uk\/uksi\/2013\/1478\/contents\/made."},{"key":"e_1_2_11_17_1","unstructured":"EU Directive \u201cCOUNCIL DIRECTIVE 2011\/84\/EU of 20 September 2011 Amending Directive 76\/768\/EEC Concerning Cosmetic Products for the Purpose of Adapting Annex III Thereto to Technical Progress \u201d(2011) http:\/\/eur\u2010lex.europa.eu\/legal\u2010content\/EN\/TXT\/?uri=uriserv:OJ.L_.2011.283.01.0036.01.ENG."},{"issue":"4","key":"e_1_2_11_18_1","first-page":"1134","article-title":"A Whiter Shade of Grey: Comparisons of the Legal and Professional Status of Tooth Whitening in Three Jurisdictions","volume":"25","author":"Holden A. 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