Policy Resources
Protecting the health and well-being of orthodontic patients is one of the highest priorities of the CAO. The following resources are provided to facilitate a deeper understanding of the most significant issues facing orthodontic patients.
CAO Position on DTC Orthodontics
The CAO has significant concerns about certain components that are common to direct-to-consumer orthodontic treatment, such as the patient never being seen in-person and the absence of x-rays prior to beginning treatment. These concerns are based on reliable, peer-reviewed scientific evidence, and are focused on protecting the health and well-being of the patient.
- Patients never being seen in-person
- Absence of x-rays prior to beginning treatment
- Lack of comprehensive oral health assessment
- Limited emergency care and follow-up
CAO Recommendation for Diagnostic Records
Assessing patients properly before beginning treatment is essential to patient safety and effective treatment planning. This begins with collecting basic but critical information about the patient’s oral health through a variety of records.
Essential Diagnostic Records
Clinical Records
- Comprehensive oral examination
- Medical and dental history
- Clinical photographs
- Periodontal assessment
Diagnostic Imaging
- Panoramic radiographs
- Cephalometric radiographs
- Intraoral radiographs
- 3D imaging when indicated
The Importance of In-person Examinations
An in-person examination by a dentist or orthodontist prior to beginning orthodontic treatment is essential. The CAO joins our national organization, the AAO in advocating for laws that require an in-person examination prior to orthodontic treatment, based on reliable scientific evidence.
Why In-Person Examinations Matter
- Detection of underlying oral health issues
- Assessment of bite and jaw function
- Evaluation of gum and bone health
- Proper treatment planning and case complexity assessment
The Importance of Radiographic Imaging
Radiographic imaging (x-rays and other types) is an essential component of the evaluation and diagnosis that must occur prior to beginning orthodontic treatment. The CAO advocates for laws that require radiographic imaging prior to orthodontic treatment, based on reliable scientific evidence.
Critical Imaging Information
Diagnostic Benefits
- Root position and development
- Bone density and health
- Hidden pathology detection
- Impacted teeth identification
Treatment Planning
- Tooth movement limitations
- Anchorage considerations
- Risk assessment
- Treatment complexity evaluation
Teledentistry Catch-22
Dental boards and state legislatures have expressed concern that patients who elect to receive orthodontic treatment through mail-order are not being adequately protected. Mail-order orthodontic companies are using a catch-22 hoping to prevent legislators and dental boards from codifying, in statute or regulation, a standard of care that would protect these patients.
The Regulatory Challenge
The Problem
Mail-order companies claim they cannot meet standard care requirements while simultaneously arguing that requiring such standards would be unfair regulation.
Patient Impact
This regulatory gap leaves patients without adequate protections and recourse when treatment goes wrong.
The Problem
Mail-order companies claim they cannot meet standard care requirements while simultaneously arguing that requiring such standards would be unfair regulation.
Policy Focus Areas
DTC Orthodontics
Patient safety concerns and regulatory gaps
Diagnostic Standards
Required records and examinations
In-Person Care
Importance of physical examinations
Imaging Requirements
X-rays and diagnostic imaging
Regulatory Issues
Teledentistry compliance challenges
Evidence-Based Advocacy
Peer-Reviewed Research
All CAO positions based on reliable scientific evidence
Professional Standards
Aligned with AAO and dental board guidelines
Patient Safety
Primary focus on patient health and wellbeing