The teeth whitening industry in the U.S. accounts for more than $300 million in annual revenue, according to IBIS World. People use over-the-counter whitening strips, trays, and pens to reverse the appearance of stained and discolored teeth, and also have their teeth bleached professionally.

While many people seek the help of dental professionals, a number of non-dentists offer whitening services, and states are beginning to crack down on these businesses. The Institute for Justice (IJ), a libertarian, public interest law firm, reports that in 25 different states, dental regulators have shut down operations in non-dentist teeth whitening clinics. In addition, another 15 states have passed regulations that preclude anyone without a valid dentist license to offer these services to patients, stating that these procedures can be dangerous without a licensed dentist, hygienist or dental assistant.

A recent case in Georgia lured IJ’s attention, where the state’s Board of Dentistry forced a resident to shut down her teeth whitening business in a medical day spa. The owner claims she never administered the bleaching agents herself, but sold home kits from her clinic, and gave clients advice on teeth whitening.

To retaliate, IJ filed a lawsuit against the Georgia Board of Dentistry. One lawyer from IJ argues that patient safety is not the primary concern for the board, but rather protecting its dentists from competition. The cost of in-office procedures can be hundreds of dollars, and non-dentists often offer these services for a reduced price, according to Fox News.

Litigation is also happening at a national level, as IJ is working with independent businesses across the country in states like Alabama and Connecticut. Similarly, a violation of anti-trust laws by the North Carolina Board of Dental Examiners was brought to the U.S Supreme Court in March by the Federal Trade Commission, because the Board sent letters out to non-dentists to shut down their teeth whitening clinics.

Despite these cases, the American Dental Association was non-committal about its response to cease-and-desist cases, stating that even if patients elected treatment from a non-dentist, they should check with their own dentist to ensure that their teeth and gums are in good health.