As previously reported, in conjunction with World Orthodontic Health Day, on May 12, 2022 the AAO issued a press release regarding a survey of its members on mail-order orthodontic treatment issues. A copy of the AAO’s prior news story on that press release can be viewed here. As reported in the press release, a recent survey of AAO members showed that 77% reported having seen patients for retreatment after receiving direct-to-consumer or mail-order orthodontic treatment, with 61% reporting seeing such patients at least once per quarter.

Now, the AAO has received a cease-and-desist letter from attorneys for SmileDirectClub, demanding that the AAO retract the press release and otherwise “immediately cease” any further references to the survey. The letter further claimed that the press release falsely implied that mail-order orthodontic treatment has a higher rate of retreatment or relapse than in-person treatment. A copy of the letter can be viewed here.

The AAO disagrees with every contention raised in SDC’s letter and will not comply with any of the demands set out in the letter. The AAO’s attorneys have communicated this to SDC in a response letter; and AAO has no intention of retracting the press release. It is of the highest priority to the AAO to take all advocacy and education efforts necessary to protect patients from risks of orthodontic treatment that do not include necessary components such as in-person examinations or x-rays prior to treatment. The scientific evidence supporting those concerns is set out more fully in the Position Paper and other resources located at

The AAO will continue to update members on this situation as further events develop.