Landmark Federal legislation builds on years of successful AAO advocacy to advance patient health and safety standards for teledentistry 

A major AAO advocacy priority has reached Congress with the introduction of the Oversight of Responsible Teledentistry for Healthy Outcomes (ORTHO) Act (H.R. 9829).

Introduced on July 23, 2026, by Congressman Brian Babin, DDS (R-Texas), the AAO-supported legislation would establish baseline federal patient health and safety standards for orthodontic treatment delivered through teledentistry while preserving appropriate access to virtual care. 

The bill represents an important milestone in AAO’s longstanding work to ensure that new technologies and treatment models evolve in ways that protect patients and maintain professional accountability. Developed with the support of the AAO, the ORTHO Act reflects years of collaboration among AAO volunteer leaders, members, advocacy staff, and congressional champions. 

“Teledentistry and artificial intelligence are transforming the delivery of health care and can expand access to care when deployed in ways that preserve patient safety and professional accountability,” said AAO President Dr. Mike Durbin. “By providing a clear framework for the responsible use of teledentistry, the legislation promotes responsible innovation while helping protect patients nationwide.” 

AAO Vice President of Advocacy Nathan Mick added, “Introduction of the ORTHO Act represents an important first step in the legislative process. While much work remains, this milestone demonstrates that AAO is helping shape public policy rather than simply responding to it. 

The ORTHO Act would: 

  • Require an in-person dental examination before most dental treatment is provided through teledentistry;  
  • Allow appropriate exceptions for emergencies, public health programs, and initial orthodontic screenings;  
  • Require in-person confirmation and review of appropriate diagnostic records, including X-rays, before orthodontic treatment begins;  
  • Authorize enforcement by the Federal Trade Commission and state attorneys general; and  
  • Allow patients to seek damages for willful violations.  

Congressman Babin, who practiced dentistry for more than four decades, emphasized that the legislation is intended to balance access and innovation with appropriate clinical safeguards. 

“Patients deserve the confidence of knowing their treatment decisions are based on an in-person evaluation, appropriate diagnostic records, and sound clinical judgment—not solely on an online interaction,” Congressman Babin said. “The ORTHO Act strikes the right balance by preserving access to teledentistry while ensuring commonsense safeguards are in place to protect patients.” 

Building on a Decade of AAO Advocacy 

The ORTHO Act represents the latest milestone in nearly a decade of AAO efforts to strengthen oversight of direct-to-consumer orthodontics and promote the responsible use of teledentistry. Working alongside AAO members, state dental associations, AAO Component and Constituent organizations, and policymakers and regulators, the AAO has pursued patient protections through multiple avenues.

Examples of this work include: 

  • Elevating concerns before state regulators. Beginning as early as 2017, the AAO and members submitted complaints and comments to state dental boards regarding direct-to-consumer orthodontic models and the importance of applying existing standards governing the practice of dentistry.  
  • Defending state oversight authority. The AAO supported state dental boards facing legal challenges to their regulation of direct-to-consumer orthodontic companies. In 2019, a federal court dismissed the majority of SmileDirectClub’s claims challenging the Alabama Board of Dental Examiners, and upheld the Board’s authority to regulate digital dental scans under Alabama law.   
  • Pressing for greater federal oversight. The AAO worked with a bipartisan group of 21 members of Congress to request a Government Accountability Office review of federal oversight of direct-to-consumer advertising for medical devices. The AAO was subsequently selected as one of 11 stakeholder groups interviewed for the report submitted to Congress in 2023.  
  • Bringing patient-safety concerns directly to federal agencies. In response to an FDA request for information on at-home medical technologies, the AAO highlighted the risks of orthodontic treatment provided without direct doctor-patient interaction, an in-person examination or appropriate diagnostic records.  
  • Challenging practices that limited patients’ voices. The AAO also advocated for greater transparency regarding SmileDirectClub’s use of restrictive nondisclosure agreements. A 2023 settlement with the District of Columbia attorney general required the company to release more than 17,000 consumers nationwide from provisions that prevented them from publicly discussing their experiences.  
  • Educating patients and gathering evidence. Through OrthoFacts.org, consumer alerts, member surveys and its Prior Mail-Order Orthodontic Customer Form, the AAO has helped patients understand potential risks while collecting information to support advocacy and regulatory engagement.  

Together, these efforts laid the groundwork for state-level progress and the introduction of a federal framework through the ORTHO Act 

Bringing State-Level Progress to Congress 

The ORTHO Act takes patient health and safety protections successfully advanced through AAO advocacy in individual states to the federal level. 

Nevada became the first state to enact an AAO-supported in-person examination requirement in 2023. Florida and Illinois followed in 2024, with the AAO and its state partners helping advance legislation requiring an in-person examination and review of diagnostic records before teeth are moved. 

Momentum accelerated in 2025, when Utah, West Virginia, Georgia, Oklahoma and Texas enacted similar patient protections. In May 2026, South Carolina became the ninth state to require an in-person examination before orthodontic treatment following six years of sustained advocacy by the AAO, the South Carolina Association of Orthodontists, the South Carolina Dental Association and AAO members. 

The AAO’s work continues after legislation is signed. The Advocacy team and AAO grassroots leaders remain engaged with state dental boards during the rulemaking and implementation process to help ensure new laws are enforced as intended and do not contain loopholes that could weaken patient protections. 

The introduction of the ORTHO Act now provides an opportunity to build on this bipartisan state momentum by advancing consistent patient safety principles nationwide. 

Ask Congress to Support the ORTHO Act 

Introduction is only the first step in the federal legislative process. AAO members are encouraged to contact their representatives and ask them to support the ORTHO Act. Member advocacy will be critical to building bipartisan support and moving the legislation forward in Congress. 

Take Action: Ask Your Representative to Support the ORTHO Act 

And don’t forget- the new AAO fiscal year 2026-2027 began June 1. Make your FY26-27 AAOPAC contribution today at AAOPAC.org using your AAO member email address to log in.  

AAOPAC is the only political action committee dedicated exclusively to representing orthodontists and their patients. Through its bipartisan approach, AAOPAC builds and strengthens relationships with cCongressional champions who understand the AAO’s priorities and can help introduce, support and advance legislation such as the ORTHO Act. 

Members contributing $250 or more will receive an invitation this October to join the AAO in Washington, D.C., for the Professional Advocacy Conference, March 8–9, 2027, where they can advocate directly for AAO policy priorities, including the ORTHO Act, in the 120th Congress.