Rizwana Lala, Sheffield University
The UK private dental industry is worth £2.4 billion (Office of Fair Trading, 2012). A large proportion of this industry is likely to constitute cosmetic dental procedures. In the earlier part of the decade, it was suggested that there had been a 50% increased demand in cosmetic dentistry over five years (Moyes, William, 2014). Research commissioned by the British Academy of Cosmetic Dentistry (BACD) suggests that over half the adult population (57%) in the UK is concerned with their smile.
But what is cosmetic dentistry? The dental profession often defines cosmetic treatments as elective procedures carried out in the absence of pathology to primarily improve appearance (New Zealand Dental Council, 2009). Thus, beckons the question, to what extent is this aesthetic practice, an appreciation of beauty, healthcare? Understanding cosmetic dentistry in this wider sense, as an aesthetic practice also fails to account for cosmetic dentistry that takes place outside the dental clinic. As an example – and concurrent with whitening treatments at the dentists’ – recent years have seen an increase in the number of teeth whitening products on the market, as home whitening toothpastes, mouthwashes, toothbrushes, and bleaching kits have become staples of dental care in the home (AACD, 2013; Colgate, 2014; Oasis, 2011; BACD, 2007).
Due to its broad definition and wide uptake among social groups, for the purposes of this paper, cosmetic dentistry is regarded as a social and historical activity that has accrued tacit cultural symbolism that is shared across different social groups (Smith, 2005; Bourdieu, 2001). This open, flexible nature of cosmetic dentistry makes it hard to govern which may explain why there are numerous institutions, such as the General Dental Council, Office of Fair Trading, Department of Health, National Health Service, Care Quality Commission involved in its regulation.
Using teeth whitening as a case study, this paper applies institutional ethnography and Steven Lukes (2005) theory of power to empirically investigation and explicate how the practice of cosmetic dentistry is organised in the UK from the standpoint of the consumer. In particular, I focus on how the dominant discourses of crime and safety act as key mechanisms for dentists to position themselves as gatekeepers in the provision and organisation of cosmetic dentistry.
AACD, 2013. Cosmetic dentistry state of the industry survey 2013. American Academy of Cosmetic Dentistry.
BACD, 2007. Official Stats. British Academy of Cosmetic Dentistry.
Bourdieu, P., 2001. Masculine domination, Male domination. Cambridge : Polity, 2001, Cambridge.
Colgate, 2014. Colagte oral and dental care resource [WWW Document]. URL http://www.colgate.co.uk/app/CP/UK/OC/Products/Benefits/Teeth-Whitening.cvsp (accessed 8.26.14).
Lukes, S., 2005. Power : a radical view. Basingstoke : Palgrave Macmillan in association with the British Sociological Society, 2005, Basingstoke Houndmills, Basingstoke, Hampshire : New York.
Moyes, William, 2014. Pendlebury Lecture.
New Zealand Dental Council, 2009. Cosmetic Dentistry Practice Standard. New Zealand Dental Council, Auckland.
Oasis, 2011. Annual national dental health survey. Oasis Dental Care, Bristol.
Office of Fair Trading, 2012. Dentistry – An OFT Market Study.
Smith, D.E., 2005. Institutional Ethnography: A Sociology for People. AltaMira Press, Walnut Creek, CA.