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Just the facts.
Protecting the health and well-being of orthodontic patients is of paramount importance to the American Association of Orthodontists (AAO). The AAO has particular concerns about some common practices and policies within the mail-order orthodontic field. These concerns are based on reliable, peer-reviewed scientific evidence, unlike information from some who advocate for DTC companies. The AAO provides the following resources to support laws and regulations that best protect patients.
For more information or questions, you can contact the AAO Advocacy team at [email protected].

AAO Recognizes World Orthodontic Health Day
Survey Findings Highlight Risks of Mail-Order Orthodontics
Health and Financial Risks of Mail-Order Orthodontics
Mail-order orthodontic treatment often leads to in-office retreatment.
AAO Position Paper on DTC Orthodontics
Scientific evidence raises concerns about direct-to-consumer orthodontic treatment.
The Importance of In-Person Examinations
Get evaluated by a dentist or orthodontist before starting orthodontic treatment.
The Importance of Radiographic Imaging
Evaluation and diagnosis, including X-rays, are crucial before starting orthodontic treatment.
Concerns about Patient Consent in DTC Orthodontic Treatment
The problem with providers only offering teledentistry services without face-to-face consultations.
A Former DTC Doctor Speaks Out
In a class action lawsuit involving a direct-to-consumer orthodontic company, testimony by a dentist who formerly worked for the company was recently made public.
AAO Teledentistry Parameters
The AAO advocates in legislative and regulatory settings throughout the United States for laws that require protection for patient health and well-being.
AAO Clinical Practice Guidelines
In 2023, the AAO’s House of Delegates approved revisions to the AAO’s Clinical Practice Guidelines.
Access to Care
Making orthodontic treatment accessible while maintaining the highest standard of care to protect patients doesn’t need to come at the cost of patient safety.
Teledentistry Catch-22
Dental boards and state legislatures throughout the United States have expressed concern that patients who elect to receive orthodontic treatment through mail-order are not being adequately protected. The scientific evidence overwhelmingly demonstrates that an in-person examination and x-rays prior to orthodontic treatment are essential to the standard of care for safe and effective treatment.
Myths vs Facts
It sounds almost too good to be true: the convenience of orthodontic treatment without ever having to leave your home or seeing an orthodontist or dentist in person (meaning no office visits); and, it sounds considerably cheaper than in-person orthodontic treatment. What’s not to like?
Self-service Healthcare
Mail-order orthodontic providers claim to offer “doctor directed” orthodontic treatment. A statement by one of their own allies in advocacy efforts, TechNet, reveals the truth about their vision for orthodontic care—“self-service healthcare.”
What You Need to Know Before Participating in a Partner Program
Many clear aligner companies offer “partner programs” or “partner networks” for dentists and orthodontists. Promises of company-generated leads and increased income for your practice may make these programs sound tempting.
But, there may be risks and other complications that are not obvious when first considering these options.
Educating Patients about Mail Order Orthodontic Treatment
You probably have serious concerns about mail-order orthodontic treatment and want to protect your patients and the public by providing them information on the topic. But the stories of orthodontists and dentists getting sued or encountering other problems when they speak out on the topic understandably cause concern.
AAO Concerns about the American Teledentistry Association and its Positions:
The American Teledentistry Association has been active advocating throughout the United States against regulations on teledentistry. Specifically, the ATDA argues that in-person examinations and x-rays should not be required prior to beginning orthodontic treatment. The AAO has serious concerns about the lack of evidence-based support for the ATDA’s positions, as well as concerns about whose interests the ATDA represents.

AAO Analysis of ATDA White Paper on In-person Examinations
The AAO believes that the ATDA’s arguments against requiring in-person examinations prior to beginning orthodontic treatment are not supported by credible scientific evidence. An examination of the ATDA’s argument against requiring in-person examinations, and the lack of credible scientific evidence in support, can be found below.

AAO Analysis of ATDA White Paper on Radiography
The AAO believes that the ATDA’s arguments against requiring x-rays prior to beginning orthodontic treatment are not supported by credible scientific evidence. An examination of the ATDA’s argument against requiring x-rays, and the lack of credible scientific evidence in support, can be found below.

Who is the ATDA?
The AAO has serious concerns about the ATDA’s close affiliation with certain direct-to-consumer orthodontic companies, as well as contradictions in the ATDA’s current advocacy messages. Its executive director makes arguments today that directly conflict with statements he made in his academic publications prior to forming the ATDA. A summary can be found below.