Workforce Challenges, Overburdensome Regulations, Mail-Order Orthodontic Concerns, and Student Loan Debt Remain Top Issues of Interest

The annual AAO Public Policy Survey is an opportunity for AAO members to share feedback on key issues, workforce challenges, grassroots actions, and more. The results provide crucial insight into the top advocacy issues and challenges facing orthodontists.

Thank you to all AAO members who completed the 4th annual AAO Public Policy Survey (open November 26, 2024 – January 13, 2025). Your feedback is important and is used to inform AAO data-driven policy priorities in Washington, DC and across the United States and Canada. The 2025 survey results show that the majority of AAO respondents are concerned about overburdensome regulations, mail-order orthodontic patient health and safety and workforce shortage issues.

Challenges associated with private equity-based consolidation of healthcare practices also surfaced as a new priority issue on the survey this year and the AAO is closely monitoring policy action on this topic across the United States.

AAO members continue to rank mail-order orthodontic patient health and safety issues as a top priority at both the state and federal levels. In 2023 Nevada became the first state to require an in-person examination prior to orthodontic treatment. Since then, AAO Advocacy efforts for patient health and safety have continued and in-person examination requirements are now required in Nevada, Florida, Illinois, Utah and West Virginia, while in Georgia a bill is awaiting the Governor’s signature.

At the federal level, following a meeting in July in Washington D.C. between AAO members, AAO staff, and key leaders at the U.S. Food and Drug Administration (FDA), AAO members shared clinical stories about risks and harms related to direct-to-consumer (DTC) clear aligners with the FDA team, which included dentists. The FDA expressed interest in learning more from AAO members about their experiences with patients requiring retreatment from mail-order orthodontic treatment models without an initial in-person examination.

To accurately depict how widely the issue impacts orthodontic patients, the AAO introduced a petition for members to sign attesting they have seen patients in need of retreatment. The petition has garnered over 1,700 signatures. 

Workforce Shortage Impacts More than 50% of 2025 Respondents
Additionally, over half of all survey respondents reported at least one workforce challenge impacting their practice and staffing, with lack of available dental assistants, attrition due to wage competition, and overly restrictive dental regulations being primary challenges. The AAO continues to advocate for solutions to workforce challenges.* Efforts have successfully concluded or are ongoing in Michigan, California, Maryland, North Dakota, and Ontario.

Orthodontic residents and recent graduates prioritized student loan debt as a top priority. The AAO recently launched the AAO Student Loan Debt Resources website, created specifically to support orthodontic residents and early-career orthodontists as they navigate the challenges of student loan debt and evaluate options for repayment. Visit AAOinfo.org/StudentDebt to learn more.

The AAO continues to grow its advocacy innovation and influence on a range of policy issues at the federal and state levels. The Public Policy Survey helps AAO Advocacy anticipate future work – and positions on relevant, timely issues that could impact AAO members as we move through the 119th Congress and state legislative sessions.

The AAO is deeply committed to patient health and safety through orthodontic care provided by qualified specialists. Our mission – to advance the art and science of orthodontics through education, advocacy, and research — has never been more important. 

Please help support AAO Advocacy priorities now by making your gift celebrating 125 years of AAO in 2025. It only takes a few minutes to complete your contribution now at AAOPAC.org, using your e-mail address associated with your AAO membership (All U.S Citizens and permanent residents are eligible).

Our AAOPAC Pillars of Giving are working and the AAO’s bipartisan advocacy influence continues to grow through member grassroots engagement. Your grassroots voice and AAOPAC support make all the difference!

* The AAO has also offers resources for hiring, onboarding and training of new team members.
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