The American Association of Orthodontists provides Clinical Practice Guidelines (CPG) as a complete overview of the orthodontic clinical process from diagnosis to completion of treatment. These Guidelines are not put forth as standards of treatment.

Every two years the Guidelines are reviewed to evolve with the changing practice landscape. Any proposed changes to the Guidelines must be approved by the AAO House of Delegates, the association’s primary governance body.

This year’s House addressed some previous revisions to the Guidelines. The previous revisions included changes to prescriptive language that had been historically included in the document as must or shall, changing that phasing to suggestive language (should). This change came in recognition that the Guidelines do not “set” the standard of care, which is instead established by a judge in each case according to community practice standards. Passage of this change in prescriptive language resulted in some unintended consequences.

After these changes were made, opposition parties to the AAO’s mail-order orthodontic advocacy efforts misinterpreted or misrepresented the Guidelines. The implication was that the wording change from must to should indicated the AAO no longer believed in-person exams and/or radiographs were essential prior to all orthodontic treatment. The new version of the CPGs, approved by the House of Delegates on April 24, 2023, changes the suggestive should language back to prescriptive must language in order to eliminate this misinterpretation by opposition to AAO advocacy efforts.

The Guidelines state, ” Where limited orthodontic procedures are anticipated, diagnostic records may vary from those associated with comprehensive care.”

Additional updates on 2023 House of Delegates actions will be available on May 12.

View the Clinical Practice Guidelines