Background
Summary of Council decision:
Three issues were investigated, all were Not upheld..
Ad description
A TV and a magazine ad for a mouthwash:
a. A TV ad featured a woman getting ready for a night out. The ad showed her brushing her teeth and then spitting into the sink in which there was then shown a little blood. The voice-over stated "We wouldn't ignore blood from any other part of our body, so why do we ignore it from our gums? If you spit blood when brushing your teeth if could be an early sign of gum disease. A leading cause of tooth loss". On-screen text stated "Corsodyl Mint Mouthwash is a medicine and contains chlorhexidine digluconate. Always read the label" and "Clinically proven to treat gum disease" whilst the voice-over continued, "Corsodyl mint mouth wash. Clinically proven to treat gum disease. Because, after all a missing tooth is harder to ignore. Corsodyl. For people who spit blood when they brush their teeth."
b. A magazine ad featured an image of woman putting on mascara with blood dripping from the corner of her eye next to text which stated "YOU WOULDN'T IGNORE THIS". The ad also featured an image of a small amount of blood and toothpaste in a sink with text alongside stating "SO WHY IGNORE BLOOD WHEN YOU BRUSH YOUR TEETH?". Further text stated "If you split blood when you brush your teeth, it could be an early sign of gum disease, a leading cause of tooth loss. So, if you spit blood in the sink when you brush your teeth, try Corsdoyl [sic] Mint Mouthwash. Nothing is more effective at treating gum disease*" and "CORSODYL CLINICALLY PROVEN FOR PEOPLE WHO SPIT BLOOD WHEN THEY BRUSH THEIR TEETH". Small print at the bottom of the ad which linked to the asterisk stated "*Over the counter medicines only. Corsodyl Mint Mouthwash contains chlorhexidine digluconate. Bleeding gums can be a sign of gum disease and not treating may lead to tooth loss".
Issue
Five complainants, including a dental nurse and a dental hygienist, challenged whether:
1. ads (a) and (b) misleadingly implied that Corsodyl could treat all types of gum disease, including periodontitis; and
2. ads (a) and (b) were irresponsible because they encouraged consumers to self-diagnose and self-medicate rather than advising them to see a dental health professional.
3. One of the complainants also challenged whether ad (a) was irresponsible and misleading because it did not state that the product should only be used for short periods.
Response
1. GlaxoSmithKline UK Ltd (Glaxo) stated that Corsodyl Mint Mouthwash was a licensed medicine containing 0.2% w/v chlorhexidine digluconate as the active ingredient. They said chlorhexidine had been used in dentistry for over three decades and the literature supporting its effective use as an anti-plaque agent was considerable and that it was often considered to be the 'gold standard' ingredient to which all other anti-plaque agents should be compared. They said the product was indicated for inhibition of dental plaque and as an aid in the treatment and prevention of gingivitis and that it could also be used in the maintenance of oral hygiene, particularly in situations where tooth brushing could not be adequately used. They said "Treat and prevent gum disease" was one of the indications approved on the MHRA authorised product label and that the ad clearly identified that the product was for the treatment of "early signs of gum disease" and that the early stages of gum disease referred only to gingivitis and excluded periodontitis.
2. They said that because the early signs of gum disease for which the product could be used (i.e. bleeding gums) were easily identifiable by the consumer, there was no requirement for gum disease to be diagnosed by a healthcare professional. They stated that consumer research carried about by Glaxo demonstrated that many consumers did not associate bleeding gums with gum disease and that one of the intentions of the TV ad was to increase awareness of gum disease by highlighting that one of the most noticeable early signs, bleeding gums, should not be ignored as doing so could lead to the development of periodontitis which could lead to tooth loss if untreated. They believed the ad did not undermine the dentistry profession and stated that the Corsodyl website referred to at the end of the ad included an informative section on gum disease which advised consumers to visit their dentist for advice if they suspected they had gum disease. They said that once a patient had displayed signs of gum disease, a mouthwash such as Corsodyl Mint Mouthwash could be used as an adjunct to daily oral hygiene measures to treat it. They said this approach to improving periodontal health was also recommended by the Department of Health in their publication 'Delivering Better Oral Health - An evidence- based toolkit for prevention'.
3. They believed that, apart from very few exceptions, treatment lengths were not routinely expressed in advertising. They said guidance on the use of the product indicated that for the treatment of gingivitis, a course of about one month was advisable, with some variation expected. They said each pack contained 15 days’ treatment, when used in accordance with the instructions, and that pack information made clear that users should contact their dentist if their symptoms persisted.
Clearcast said the voice-over in the ad made it clear that spitting blood could be an early sign of gum disease, which was a leading cause of tooth loss and believed it did not claim to treat all types of gum disease, just some early signs. They said the product was a licensed product and therefore clinically proven to treat early gum disease and that this claim was therefore permitted. They stated the ad was a story of Corsodyl being effective if used early and that it came across as a cautionary tale. They believed the ad did not state or imply that Corsodyl treated all types of gum disease.
Assessment
1. Not upheld
The ASA understood that bleeding from the gums when brushing was a symptom of a type of gum disease called gingivitis which, if left untreated, could develop into a more severe type of gum disease called periodontitis, which could result in tooth loss. We also understood that it was common for gingivitis to be treated with over the counter mouth washes containing chlorhexidine digluconate and that treatment at this stage could be used to prevent the development of periodontitis. We considered that ads (a) and (b) made clear that the product was for those with bleeding gums (when brushing) and noted it made no reference to the treatment of any other symptoms. Although we considered the voice-over in TV ad (a) and text in magazine ad (b) stated "if you spit blood when you brush your teeth it could be an early sign of gum disease, a leading cause of tooth loss" over-simplified the links between early gum disease and tooth loss, we noted it explained the potential outcome from not acting on bleeding gums (when brushing). Although we understood the complainants believed the ads implied that the product treated all gum disease, including periodontitis, we considered that within the context of the ads in their entirety, the claim "Clinically proven to treat gum disease" in ad (a) and the claim "Nothing is more effective at treating gum disease" in ad (b) would be understood to mean that the product could be used to treat the bleeding gums symptom associated with early gum disease and that this early treatment could prevent more advanced gum disease which could result in tooth loss. We therefore concluded that ads (a) and (b) were not misleading.
On this point we investigated ad (a) under BCAP Code rules
3.1
3.1
Advertisements must not materially mislead or be likely to do so.
3.2
3.2
Advertisements must not mislead consumers by omitting material information. They must not mislead by hiding material information or presenting it in an unclear, unintelligible, ambiguous or untimely manner.
Material information is information that consumers need in context to make informed decisions about whether or how to buy a product or service. Whether the omission or presentation of material information is likely to mislead consumers depends on the context, the medium and, if the medium of the advertisement is constrained by time or space, the measures that the advertiser takes to make that information available to consumers by other means.
(Misleading advertising),
3.9
3.9
Broadcasters must hold documentary evidence to prove claims that the audience is likely to regard as objective and that are capable of objective substantiation. The ASA may regard claims as misleading in the absence of adequate substantiation.
(Substantiation),
3.10
3.10
Advertisements must state significant limitations and qualifications. Qualifications may clarify but must not contradict the claims that they qualify.
(Qualification) and ad (b) under CAP Code (Edition 12) rules
3.1
3.1
Advertisements must not materially mislead or be likely to do so.
3.3
3.3
Marketing communications must not mislead the consumer by omitting material information. They must not mislead by hiding material information or presenting it in an unclear, unintelligible, ambiguous or untimely manner.
Material information is information that the consumer needs to make informed decisions in relation to a product. Whether the omission or presentation of material information is likely to mislead the consumer depends on the context, the medium and, if the medium of the marketing communication is constrained by time or space, the measures that the marketer takes to make that information available to the consumer by other means.
(Misleading advertising),
3.7
3.7
Before distributing or submitting a marketing communication for publication, marketers must hold documentary evidence to prove claims that consumers are likely to regard as objective and that are capable of objective substantiation. The ASA may regard claims as misleading in the absence of adequate substantiation.
(Substantiation) and
3.9
3.9
Broadcasters must hold documentary evidence to prove claims that the audience is likely to regard as objective and that are capable of objective substantiation. The ASA may regard claims as misleading in the absence of adequate substantiation.
(Qualification) but did not find them in breach.
2. Not upheld
We considered that ads (a) and (b) made clear that the product was only suitable for the use of individuals who had blood in their spit when brushing and noted this was a symptom of gingivitis, a gum disease which the product was licensed to treat. Although we noted some of the complainants (a dental nurse and hygienist) were concerned that consumers delayed visits to their dentist surgery because they self-medicated with the product for more serious symptoms associated with advanced gum disease, we considered the ads made clear that the product was for the treatment of that specific symptom and did not state or imply that the product was suitable for any further symptoms associated with early or advanced gum disease. Furthermore, both ads contained the text "Always read the label" and we noted product labelling made clear that if the symptoms persisted beyond the recommended treatment time, consumers should consult their dentist. We therefore considered that the suggestion that consumers self-diagnose and self-medicate for the specific symptom referred to was not irresponsible and concluded that ads (a) and (b) did not breach the Code.
On this point we investigated TV ad (a) under
1.2
1.2
Advertisements must be prepared with a sense of responsibility to the audience and to society.
(Social responsibility)
3.1
3.1
Advertisements must not materially mislead or be likely to do so.
3.2
3.2
Advertisements must not mislead consumers by omitting material information. They must not mislead by hiding material information or presenting it in an unclear, unintelligible, ambiguous or untimely manner.
Material information is information that consumers need in context to make informed decisions about whether or how to buy a product or service. Whether the omission or presentation of material information is likely to mislead consumers depends on the context, the medium and, if the medium of the advertisement is constrained by time or space, the measures that the advertiser takes to make that information available to consumers by other means.
(Misleading advertising) and ad (b) under CAP Code (Edition 12) rules 1.3 (Social responsibility) and
3.1
3.1
Advertisements must not materially mislead or be likely to do so.
3.3
3.3
Marketing communications must not mislead the consumer by omitting material information. They must not mislead by hiding material information or presenting it in an unclear, unintelligible, ambiguous or untimely manner.
Material information is information that the consumer needs to make informed decisions in relation to a product. Whether the omission or presentation of material information is likely to mislead the consumer depends on the context, the medium and, if the medium of the marketing communication is constrained by time or space, the measures that the marketer takes to make that information available to the consumer by other means.
(Misleading advertising) but did not find them in breach.
3. Not upheld
We understood that, as with any medicine, continued use beyond the recommended treatment time had the potential to cause harm. However, we noted information in relation to the recommended use of the product and the time period over which it should be used was included on the label and noted on-screen text specifically stated "Always read the label". We did not consider the duration of treatment was a piece of information that was necessary to be included in the ad and therefore concluded that its omission was not irresponsible.
On this point we investigated TV ad (a) under BCAP Code rule 3.1 3.1 Advertisements must not materially mislead or be likely to do so. (Social responsibility) but did not find it breach.
Action
No further action necessary.
BCAP Code
1.2 11.19 11.2 11.2 11.29 11.3 11.3 3.1 3.10 3.2 3.9
CAP Code (Edition 12)
12.1 12.11 12.2 12.5 3.1 3.3 3.7 3.9
