Wide-ranging AAO state regulatory offense and defense will carry into the new year.
The AAO continues to prioritize work with state dental boards on a wide range of evidence-based issues our AAO members care most about. Those issues include specialty advertising, addressing workforce challenges, and teledentistry patient protections related to mail-order orthodontic treatment models.
In 2025, the AAO Advocacy team, with support from the AAO Component Legal Support Fund, has been active in over 20 states and Ontario, Canada on AAO priority issues. We have seen success on our issues where there has been strong support and grassroots engagement from AAO members.
You may know that the AAO has been leading on successful passage of state laws requiring an in-person examination prior to orthodontic treatment. To date, eight states have passed these in-person examination requirements for patient health and safety: Nevada (2023), Florida and Illinois (2024), and Utah, West Virginia, Georgia, Oklahoma and Texas (2025).
When these laws are passed, the AAO’s advocacy work is not done. Implementation and enforcement of the laws are the true key to patient protections. This means that the AAO Advocacy team works closely with AAO grassroots leadership — including the AAO National Advocacy Network — on rules and regulatory language through state dental boards for more specific policy language to implement the laws. This work can and does require years of effort.
As an example, the Nevada in-person examination law that passed in 2023 is still working through the regulatory process with the Nevada State Board of Dental Examiners and has not yet been finalized.
The AAO has actively worked since 2023 with AAO grassroots leaders in Nevada to defend against regulatory language proposed and advocated for by opposition groups interested in weakening the teledentistry law to create ambiguity and loopholes. These loophole tactics are meant to allow virtual companies to continue operating without the necessary patient health and safety guardrails included in the teledentistry legislation signed into law by the Nevada Governor.
Similar to Nevada, other states, including Illinois, Utah, Georgia and West Virginia, have not yet finalized their regulatory policy associated with new teledentistry laws. AAO Vice President of Advocacy Nathan Mick noted, “The AAO will remain actively engaged across state regulatory efforts to ensure that these laws are implemented and enforced in ways that best protect patient health and safety.”
Regulatory Advocacy Also Includes Workforce, Specialty Advertising Issues
AAO advocacy work and priority on regulatory changes at the state level make a difference for AAO members and patients. For example, Dr. Daniel Keith is currently the only orthodontist Medicaid provider in North Dakota and a strong grassroots advocacy leader for AAO in the state. Following the implementation of updated regulations over the past year expanding the scope of practice for Qualified Dental Assistants (QDAs), Dr. Keith shared the following feedback with AAO:
“The expanded duties for QDAs have been, and will likely remain, the single most impactful change of my career. I am extremely grateful for AAO Advocacy’s leadership on this issue. These workforce regulatory updates in North Dakota have clearly expanded access to care and resolved a significant orthodontic staffing challenge. Previously, orthodontic assistants were required to complete nearly two years of on-the-job training before being permitted to perform even basic tasks such as removing an O-tie—an inefficiency that is difficult to justify in hindsight. I am grateful for AAO’s continued advocacy in North Dakota and for helping bring our state closer to parity with neighboring states.”
The following list provides a sample of places where we have either seen success through offense or defense on state regulatory issues or highlights the ongoing work the AAO will continue to pursue in the new year.
CALIFORNIA: AAO and California Association of Orthodontists continue to successfully address ongoing workforce changes and challenges working with the Dental Board of California on education and training pathways for orthodontic assistants.
COLORADO: The Colorado Dental Board is reviewing its Dental Practice Act, including its teledentistry and specialty advertising regulations. The AAO has been involved in stakeholder meetings and submitted public comments on the proposed draft to ensure rules are in the best interest of patient health and safety.
MARYLAND: AAO is monitoring new hands-on hours requirements for Expanded Functions Dental Assistants (EFDA) to complement virtual training opportunities based on a new law passed by the Maryland state legislature last spring and approved by the Maryland Governor.
NEVADA: The AAO Advocacy team identified weak points in Nevada teledentistry regulation that would allow mail-order orthodontic treatment models to circumvent the “bona fide relationship” requirements within the law that was passed and the AAO led on in 2023. Advocacy efforts resulted in the Nevada State Board of Dental Examiners tabling the vote to review the regulation language and the AAO will continue to advocate on this issue.
NORTH DAKOTA: AAO submitted comments on the proposed rules in support of appropriate increased delegation to dental assistants to help expand workforce opportunities and access to care. The rules will be considered by the full Board in January 2026.
OHIO: The AAO continues to successfully defend against changes to the specialty advertisement law as opposition works to make that law weaker. Grassroots engagement by AAO members continues to be the key to our success on this issue, especially during the 3rd annual Ohio State Lobby Day in Columbus in November 2025.
ONTARIO: Over 250 orthodontists and dentists in Ontario signed a public letter requesting that Ontario’s Ministry of Health formally endorse and implement changes to allow Level II dental assistants, under direct supervision, to perform certain orthodontic tasks that assistants are trained to perform and are allowed in the other Canadian provinces.
SOUTH DAKOTA: The AAO played successful short-term defense by submitting comments to the South Dakota State Board of Dentistry on proposed teledentistry rules we opposed and were not in the best interest for patient health and safety. Rather than approve of the proposed changes opposed by the AAO, the Board passed a motion to “solicit additional information and data from national organizations relative to teledentistry.” The AAO will continue to work with the Board on this issue and advocate for patient health and safety.
TEXAS: The AAO and the Texas Association of Orthodontists worked together closely to ensure that the final rules and informed consent language associated with the clear aligner law that took effect in September 2025 promote access to care, while maintaining the same professional and ethical standards that govern in-person treatment. The Texas State Board of Dental Examiners unanimously adopted AAO’s proposed amendment regarding informed consent and patient protections.
UTAH: The AAO continues to engage with the Utah Association of Orthodontists (UAO) on rulemaking related to amendments to the Utah Dental Practice Act that became law in 2025. Discussions at the Utah Dental Board are ongoing regarding proposed language that would allow Expanded Functions Dental Assistants to perform coronal adhesive removal. The AAO will continue working closely with UAO to advocate for policy language that protects patients and complies with the new law.
WEST VIRGINIA: AAO submitted comments in support of the West Virginia Dental Board’s proposed rules related to the implementation of SB 710, which established standards for teledentistry, including a requirement for an in-person examination before orthodontic treatment.
WISCONSIN: There is a push to ease specialty advertising restrictions in Wisconsin led by a common opponent of any advertising restrictions. Opposition has gone so far as threaten the Wisconsin Dentistry Examining Board with litigation, prompting the AAO Advocacy team to engage and play defense with other specialty groups as we have done in other states.
Three Important Ways You Can Make an Impact for AAO Advocacy Before Year-End
1. Make Your 2025 AAOPAC Contribution (Deadline: December 31)
If you have not yet made your 2025 AAOPAC contribution, we encourage you to do so before December 31. AAOPAC plays a vital role in supporting lawmakers who understand and champion issues important to orthodontists and their patients.
Contribute at: www.AAOPAC.org
You will also find on AAOPAC.org the 2025 AAOPAC contributors and giving levels. We hope you’ll be on the list — and maybe even spot friends and colleagues. The full recognition list will be published in the Orthodontic Advocate and on the AAOPAC website after year-end.
2. Complete the 5th Annual AAO Public Policy Survey
Your voice matters. The AAO Public Policy Survey directly informs and shapes our legislative priorities and ensures our advocacy remains aligned with the needs of AAO members and the patients they serve.
Survey link: https://tinyurl.com/mvafryra
Please consider completing the survey before the end of the year and sharing the link with other AAO members.
3. Plan Ahead for the 2026 Professional Advocacy Conference- NEW Reimbursement Policy *
The 2026 Professional Advocacy Conference will take place in Washington, D.C. on March 17–18 (Tuesday/Wednesday). This conference offers an invaluable opportunity for leaders to:
- Engage in federal and state policy discussions
- Sharpen advocacy skills
- Collaborate on advancing AAO strategic goals
- Visit Members of Congress and their staff on Capitol Hill
* AAO covers hotel and meal expenses. Participants who attend and complete the conference receive a $400 travel stipend, and new this year, an additional $350 may be available for those with limited flight options and pricing. Invitations are sent on a rolling basis as members make their 2025 AAOPAC contribution.
