ADA discourages DIY orthodontics through resolution
November 10, 2017
— The ADA "strongly discourages" the practice of do-it-yourself orthodontics because of the potential for harm to patients, according to a new policy passed by the 2017 ADA House of Delegates.
"Patients are being inundated with direct marketing campaigns encouraging them to initiate and manage their own orthodontic treatment. These campaigns are operating in multiple media outlets, including online, billboards and television ads," said Dr. Craig Ratner, chair of the ADA Council on Dental Practice.
Dr. Ratner continued: "This year's ADA House of Delegates recognized the need for the ADA, as America's leading advocate for oral health, to take steps to educate patients about the potential pitfalls of self-managed orthodontic treatment. This new policy supports the importance of dentists being in charge of diagnosing and treating patients to ensure the safe delivery of appropriate care."
The Michigan Dental Association transmitted Resolution 50H-2017 to the House. The state society's executive director and CEO, Karen Burgess, told the ADA News that members brought the topic to the association's attention. Some research found that there was no policy addressing the issue.
The resolution states that the Association "believes that supervision by a licensed dentist is necessary for all phase of orthodontic treatment including oral examinations, periodontal examinations, radiographic examinations, study models of scans of the mouth, treatment planning and prescriptions, periodic progress assessments and final assessments with stabilizing measures."
The American Association of Orthodontists was not involved in the creation of the resolution, but has been cautioning consumers about the dangers of DIY orthodontics in the past year.
In a survey conducted among its members, according to a news release on the AAO website, the AAO reported that nearly 13 percent of its member orthodontists are seeing patients who have tried do-it-yourself teeth straightening, with some of those attempts causing irreparable damage.
In response, the AAO issued a "consumer alert" on the home page of its website, stating: "The American Association of Orthodontists is urging consumers to beware of Internet videos and websites which encourage people to try and straighten their own teeth. Moving teeth is a medical procedure and needs personal supervision by an orthodontist. Please be wary of any suggestions to move teeth with rubber bands, dental floss or other objects ordered on the Internet. Moving teeth without a thorough examination of the overall health of the teeth and gums could result in the permanent loss of teeth, which may result in expensive and lifelong dental problems. Orthodontists receive two to three years of specialized education beyond dental school and are specialists in straightening teeth and aligning the bite."
Kevin Dillard, AAO general counsel, told the ADA News that the AAO has filed complaints with dental boards and attorneys general in 36 states regarding companies providing aligners through an online service. In addition, he said, at least three dental boards — in Alaska, California and West Virginia — have opened investigations into one of the companies, SmileDirectClub. In August, Alaska's board voted to ask the state's licensing division to send a cease-and-desist letter barring SmileDirectClub from selling there, Mr. Dillard said.
Mr. Dillard said the complaints allege that SmileDirectClub is violating laws that exist to protect the public. The AAO complaints argue that these companies are performing medical work that many state laws reserve for licensed professionals, such as taking bite casts and delivering dental appliances to patients.
Some of the businesses, such as SmileDirectClub, contend that they function as a marketing company for dentists, connecting them to customers, Mr. Dillard said. He said that claim is difficult to accept. Part of their marketing, he said, is that people can skip going to the dentist.
On Oct. 26, attorneys for SmileDirectClub filed suit against the Michigan Dental Association in the U.S. District Court for the Western District of Michigan for "false light" and "trade libel" with regard to an August 2017 article published by the MDA in the Journal of the Michigan Dental Association.
SmileDirectClub did not respond to attempts to reach it by ADA News, but in a SmileDirectClub news release, Alex Fenkell, SmileDirectClub co-founder, said, "The inaccuracies and misrepresentations in the MDA article are egregious. We're committed to fighting back against this type of anti-competitive activity because we believe people deserve an accessible and affordable option for obtaining a better and healthier smile."
In the same release, co-founder Jordan Katzman added, "The medical industry has been here before. Products like hearing aids, contact lenses, and dialysis supplies faced resistance at first too. We are confident in our product, as well as our process and independent providers, and will not let the opposition keep us from providing more accessible and affordable services."
"The Michigan Dental Association is dedicated to upholding the highest standards of practice for the residents of Michigan so that they receive the best oral care in compliance with the laws of the state of Michigan," the MDA said in its official statement. "MDA denies the allegations contained in the complaint filed by SmileDirectClub, and in that company's recent press release. The MDA sent a letter to SmileDirectClub seeking information to confirm it was complying with the Michigan laws governing dental practice when providing services to patients in the state. SmileDirectClub's response failed to support its representations that it was in compliance with Michigan law. The article published in the August MDA Journal simply informed MDA members of these facts. The MDA stands by the accuracy of the article. The claims made by SmileDirectClub are without merit. If served with the complaint, MDA will vigorously defend itself in court."