An assessment of the treatment information contained within the websites of direct-to-consumer orthodontic aligner providers

User Experience, Satisfaction, and Complications of Direct-to-Consumer Orthodontics in Spain: A Cross-Sectional Study

Background/Objectives: Direct-to-Consumer Orthodontics (DTCO) has gained popularity through social media, offering clear aligner treatments without in-person supervision. However, there is limited research on the related user experiences, satisfaction, and complications, particularly in Spain. This study aimed to evaluate user experiences, satisfaction levels, and complications associated with DTCO in a sample of Spanish consumers. Additionally, differences among major DTCO providers were analyzed. Methods: A cross-sectional online survey was conducted over one year. This questionnaire, adapted from previous studies and reviewed by certified orthodontists, assessed user awareness, reasons for treatment selection, communication with providers, discomfort, complications, and satisfaction. A total of 101 valid responses were analyzed using statistical means. Results: The majority of respondents reported that their expectations were not met, and they would not recommend DTCO. Cost was the primary motivation for treatment selection, followed by convenience. Many users experienced complications, leading to dental consultations. While overall satisfaction levels did not significantly differ among providers, variations were observed in discomfort levels, in-person care availability, and the need for additional consultations. Conclusions: DTCO offers affordability and convenience but raises concerns regarding treatment quality and supervision. In most cases, users' expectations were not met, highlighting the need for greater patient education and regulatory oversight.

Quality and content assessment of internet information on nasoalveolar molding

BACKGROUND

To evaluate the quality and content of websites related to nasoalveolar molding (NAM).

METHODS

A systematic Internet search was conducted using the keywords "nasoalveolar molding" and "presurgical nasoalveolar molding" determined through Google Trends and popular search engines: GoogleTM, YAHOO!® and Yandex®. The top 50 websites were evaluated for each keyword and search engine. Repetitive websites, advertisements, scientific articles, and irrelevant websites were excluded from the study. The remaining 40 websites were evaluated using JAMA benchmarks, HON criteria, DISCERN, and EQIP tools.

RESULTS

75% of websites were created for informational purposes, and the remaining websites were created for clinical promotion and advertising. According to DISCERN, only 2.5% of the sites were classified as excellent (63 points): 7.5% very weak (16-26 points), 22.5% weak (27-38 points), 40% moderate (39-50 points), and 27.5% good (51 points-62 points).

CONCLUSIONS

Internet information on NAM was generally at a moderate to poor level in terms of quality and content. In this regard, patients should be informed about the limits of their Internet information, and the Internet content that patients can obtain information should be increased.

To assess the knowledge, awareness, and perception of non-dentists offering orthodontic treatment among the Malaysian young adult population

BACKGROUND

The increasing number of young adults seeking cheaper and easily accessible orthodontic treatment from unlicensed practitioners in Malaysia poses significant risks to patients. Therefore, it is essential to evaluate their motivations and awareness regarding such practices. The objective of our study was to assess the knowledge, awareness, and perceptions of non-dentists offering orthodontic treatment among the Malaysian young adult population.

METHODS

This was a cross-sectional study. An online self-administered questionnaire was distributed to Malaysian citizens aged 18-37 years. The questionnaire consisted of 11 questions that investigated their awareness of non-dentists offering orthodontic treatment, the harmful effects of braces fitted by non-dentists, and potential strategies to mitigate this phenomenon.

RESULTS

The study was completed by 426 participants, predominantly Malay, with a mean age of 22.9 years. A total of 76.1% reported awareness of braces fixed by non-dentists, primarily through social media platforms such as Instagram and Facebook. Lower cost emerged as the predominant motive (83.6%) for opting for non-dentist orthodontic treatment, followed by no waiting list (48.8%). Notably, the majority of participants acknowledged the illegality (70%) and potential harm (77%) associated with non-dentists providing orthodontic treatment. Legal enforcement (53.1%) was identified as the preferred method for mitigating this practice. Occupation significantly influenced knowledge of illegal orthodontic treatment (p < 0.05), however no significant association was found for gender and level of education (p > 0.05).

CONCLUSION

The survey revealed that young adults are aware of and informed about non-dentists offering orthodontic treatment. While they identified cost as the primary reason for seeking such services, they also recognized legislation and public awareness through campaigns and social media as effective strategies to address this issue. Additionally, significant differences in legal awareness were observed among different occupational levels.

The quality of Web-based orthodontic information: A scoping review

INTRODUCTION

Patients seeking health information on the Internet is commonplace. This scoping review aimed to collate and synthesize the evidence regarding the quality of Web-based orthodontic information.

METHODS

A systematic search and independent screening process was conducted by 2 independent reviewers across 4 databases. The review was conducted in alignment with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines.

RESULTS

Of 661 records identified, 30 publications satisfied the inclusion criteria. Reviewed studies included those related to the information contained within Web sites regarding dental and orthodontist practices, orthodontic interventions, appliances and auxiliaries, orthodontic conditions commonly requiring orthodontic therapy, issues related to patient experience, and advice during orthodontic treatment. A total of 5 quality of information (QOI) instruments and 3 readability tools were employed, with the University of Oxford, United Kingdom (DISCERN) instrument and the Flesch Reading Ease Score tool being the most frequently used. Most studies determined that the QOI contained within evaluated Web sites was poor and provided suboptimal information related to treatment risks and Web site reliability. Most studies indicated that the information was more difficult to read than recommended by guidelines.

CONCLUSIONS

The QOI of orthodontic information available on Web sites was low to moderate, with the readability of content at a level that was considered challenging for many readers to understand. A recommendation for greater involvement of the dental and orthodontic specialty in Web site development was commonplace. Research is required for the development of validated tools that can determine the accuracy of information in addition to Web site reliability.

Clear aligner therapy informed consent forms: A quality and readability evaluation

OBJECTIVE

The aim of the present study was to evaluate the quality and readability of content contained within clear aligner therapy (CAT) informed consent forms.

METHODS

CAT informed consent forms were identified via an online search. The presence of details related to CAT-related processes, risks, benefits and alternatives in each form was recorded. A 4-point Likert type scale was used to determine the quality of content (QOC). The readability of content was evaluated with the Simple Measure of Gobbledegook (SMOG) and Flesch Reading Ease Score (FRES).

RESULTS

A total of 42 forms satisfied selection criteria. Nineteen (45.2%) were authored by companies who provided aligners to patients via clinicians. The QOC regarding CAT-related treatment processes [median 2.0; IQR 0, 2] and benefits [median 2.0; IQR 1, 2] was adequate. The QOC scores regarding treatment alternatives, consequences of no treatment and relapse were poor. There was no difference (P=0.59) in the median (IQR) QOC of the informed consent forms provided by direct-to-consumer (DTC) aligner providers [10 (8.25, 16.25)] and non-DTC aligner providers [12 (10, 14)]. The median (IQR) SMOG score was 12.1 (10.9, 12.7) and FRES was 39.0 (36.0, 44.25).

CONCLUSIONS

The QOC of the evaluated forms was incomplete and poor. The content was difficult to read and failed to reach recommended readability standards. Consent is unlikely to be valid if it is based solely on the content of the forms. Clinicians need to be aware of the limitations of informed consent forms for CAT particularly in relation to alternatives, prognosis, risks, and the need for long-term maintenance of results.

Assessment of the quality and accuracy of information contained within the websites of marketed orthodontic products: a cross-sectional investigation

OBJECTIVES

To assess the quality and accuracy of information contained within the websites of providers of marketed orthodontic products.

MATERIALS AND METHODS

Twenty-one websites of orthodontic appliance and adjunct (product) providers were identified. The website content was assessed via two validated quality-of-information instruments (DISCERN and the Journal of the American Medical Association [JAMA] benchmarks) and an accuracy-of-information instrument. Website content was qualitatively analyzed for themes and subthemes.

RESULTS

More than half (n = 11; 52.3%) of the assessed websites contained clinician testimonials. The mean (SD) DISCERN score was 33.14 (5.44). No website recorded the minimum of three JAMA benchmarks required to indicate reliability. The most common content themes related to quality-of-life impact and treatment duration. Just 8% of the statements within the websites were objectively true. The Pearson correlation coefficient indicated that the DISCERN scores were correlated with the accuracy-of-information scores (r = .83; P < .001).

CONCLUSIONS

The quality and accuracy of information contained within the websites of the providers of marketed orthodontic products was poor. The combined use of DISCERN and the accuracy-of-information instrument may help overcome the shortcomings of each. Clinicians should check the accuracy of information on orthodontic product provider websites before adding links to those websites on their own sites.

Ethical issues in direct-to-consumer healthcare: A scoping review

An increasing number of health products and services are being offered on a direct-to-consumer (DTC) basis. To date, however, scholarship on DTC healthcare products and services has largely proceeded in a domain-specific fashion, with discussions of relevant ethical challenges occurring within specific medical specialties. The present study therefore aimed to provide a scoping review of ethical issues raised in the academic literature across types of DTC healthcare products and services. A systematic search for relevant publications between 2011-2021 was conducted on PubMed and Google Scholar using iteratively developed search terms. The final sample included 86 publications that discussed ethical issues related to DTC healthcare products and services. All publications were coded for ethical issues mentioned, primary DTC product or service discussed, type of study, year of publication, and geographical context. We found that the types of DTC healthcare products and services mentioned in our sample spanned six categories: neurotechnology (34%), testing (20%), in-person services (17%), digital health tools (14%), telemedicine (13%), and physical interventions (2%). Ethical arguments in favor of DTC healthcare included improved access (e.g., financial, geographical; 31%), increased autonomy (29%), and enhanced convenience (16%). Commonly raised ethical concerns included insufficient regulation (72%), questionable efficacy and quality (70%), safety and physical harms (66%), misleading advertising claims (56%), and privacy (34%). Other frequently occurring ethical concerns pertained to financial costs, targeting vulnerable groups, informed consent, and potential burdens on healthcare providers, the healthcare system, and society. Our findings offer insights into the cross-cutting ethical issues associated with DTC healthcare and underscore the need for increased interdisciplinary communication to address the challenges they raise.

The quality and content of websites in the UK advertising aligner therapy: are standards being met?

Aims To evaluate the quality of information and compliance with General Dental Council (GDC) ethical advertising guidelines for English-language orthodontic websites providing orthodontic treatment with aligners in the United Kingdom (UK).Materials and methods The term 'orthodontic aligners or braces' was entered into the Google online search engine. The first 100 English language orthodontic websites (practice or company) were pooled. Both the quality (DISCERN instrument) and compliance with GDC ethical advertising guidelines were assessed. Frequency distributions and the overall summative DISCERN score for each website were calculated.Results The overall mean DISCERN score was 42.9 (SD = 9.4). The quality of information was only rated as good-excellent for 16% of websites and only 11% of websites showed full compliance with GDC guidelines on ethical advertising. A link to the GDC/authority website (75%), the date when the website was last updated (72%), and the practice complaints policy (66%) were not commonly provided. The country of qualification, a statement of whether practices provide NHS or private treatment or a combination of both, and the date when the website was last updated, were significant predictors for the overall quality based on DISCERN score.Conclusions The quality of information provided on websites providing aligner therapy and their compliance with GDC guidelines on ethical advertising was suboptimal. An improvement in both areas is required.

Direct-to-consumer orthodontics: Exploring laypeople's perception of orthodontic treatment complexity

BACKGROUND

The authors aimed to explore the treatment preferences of laypeople regarding direct-to-consumer (DTC) orthodontics and to identify whether case complexity, as perceived by laypeople, is one of the factors influencing interest in DTC orthodontics.

METHODS

An online cross-sectional survey was conducted. Data analysis was performed using logistic regression models.

RESULTS

A total of 1,362 surveys were completed. A significant inverse association was identified between the complexity of an orthodontic case, as measured using the American Board of Orthodontics' discrepancy index (DI) score, and the likelihood of choosing DTC treatment over an orthodontist. Participants were 3.53 times more likely to choose DTC treatment for a mild case (DI score, 0-10) compared with a complex case (DI score, > 20), although the likelihood of choosing DTC treatment for a moderate case (DI score, 11-20) was only 1.79 times higher than for a complex case.

CONCLUSIONS

When laypeople were asked to consider each case as if it were their own dentition, there was a significant inverse association between the complexity of an orthodontic case, as measured using the DI score, and the likelihood of choosing DTC treatment over an orthodontist. Laypeople were seemingly more likely to choose DTC orthodontics for dentitions that did not appear crowded and were well aligned within the arches. Laypeople seemed to have an understanding that there are some limitations to DTC orthodontics.

PRACTICAL IMPLICATIONS

Orthodontists should better understand the factors influencing consumers' decisions to select DTC orthodontics and dental organizations should focus their educational campaigns on these factors.

Quality assessment of online information on orthodontic Web sites in the United States

INTRODUCTION

The objective of this study was to assess the quality of online information on orthodontic treatment provided by orthodontic Web sites in the United States and investigate their claims.

METHODS

Three hundred and one American orthodontic Web sites were identified after an advanced Google search. Data collection included: the location of the clinic, treatment options offered, quality-of-information assessment using the DISCERN tool, and finally, claims when promoting 1 treatment option against another, as well as the presence of information on relapse risk and retention needs.

RESULTS

All Web sites belonged to private clinics, with more than half (60.5%) in a single location. Invisalign (Align Technology, Santa Clara, Calif) was the most commonly promoted treatment option (94%), followed by the full fixed appliance (FFA) (92%). The mean DISCERN total score was poor (36.78 out of 80.00), whereas the mean reliability (questions 1-8) and quality-of-information (questions 9-15) scores were 17.06 out of 40.00 and 16.85 out of 35.00, respectively. Almost one-third (28%) of the Web sites compared aligners to FFA, whereas 25% claimed that aligners are less painful than FFA, faster than FFA (14%), or give better results than FFA (1%). Almost half of the Web sites (47%) failed to display information on relapse risk and retention needs after orthodontic treatment (41%). The Web sites that displayed such info had higher DISCERN total scores (P <0.001).

CONCLUSIONS

Invisalign seems to be the treatment modality most commonly mentioned online. According to DISCERN, U.S. orthodontic Web sites display poor or fair quality information. On many Web sites, aligner treatment was compared with FFA, with some stating that aligners cause less pain than FFA or are more efficient/faster than FFA. Moreover, almost half of the American orthodontic Web sites failed to display information on the relapse risk or retention need. Display of such information can be an indicator of better-quality Web sites. There is ample room for improvement in the online information American orthodontists provide to potential patients.

Public perception of Invisalign® clear aligner treatment: A cross-sectional survey-based study

Objectives:

The demand for clear aligner treatment has increased in recent years. Thus, this study investigated public knowledge regarding Invisalign clear aligner treatment.

Material and Methods:

A web-based survey was administered through different social media platforms covering different aspects of Invisalign treatment, namely: Treatment efficiency, patient discomfort, appliance esthetic attractiveness, oral hygiene maintenance, and treatment aesthetic results. Participants were also asked to outline their perception of Invisalign treatment cost. A Likert-type scale was used to rank the participant responses. Data were analyzed with the Chi-square test and Bonferroni correction for multiple comparisons.

Results:

Out of 934 eligible adult participants, 19.6% were aware of Invisalign. Most of the Invisalign-familiar respondents were unaware of its cost (27.9%) but agree it is generally better (49.7%), requires fewer visits (38.2%), results in shorter treatment duration (39.4%) and reduced teeth discomfort (35%), more esthetically attractive (64%), yields easier oral hygiene maintenance (55.2%), and produces superior esthetic results (43.7%) than traditional braces. In addition, males and average-income participants were more likely to believe that Invisalign treatment produces superior esthetic results than traditional braces (P = 0.0002 and P = 0.002, respectively). Average-income participants also believed that Invisalign treatment was generally better (P < 0.0001). While participants in the age-range 55–64 years strongly believe, it is cheaper (P < 0.0001) than traditional braces.

Conclusion:

This study highlighted the lack of public knowledge about Invisalign treatment. The results also indicated the importance of ensuring public access to reliable information backed up by high-quality evidence.

The reach, influence and tenor of professional orthodontic societies on social media: A cross-sectional content analysis

BACKGROUND AND OBJECTIVES

Orthodontic societies should support the profession and improve patient awareness. We aimed to investigate the scope and influence of orthodontic societies on social media.

METHOD

A total of 120 orthodontic societies were identified on the World Federation of Orthodontists (WFO) affiliates list. Presence of orthodontic societies on Instagram, Facebook and Twitter was ascertained. All societies with Instagram accounts were included for further analysis of the nature and content of posts as well as user engagement. Pilot coding and thematic analysis were undertaken (n=200 posts). The most recent 20% of the total number of posts for each account were then analysed for content.

RESULTS

Only 10 (8.3%), 34 (28.3%) and 52 (43.3%) orthodontic societies had accounts on Twitter, Instagram and Facebook, respectively. A total of 2124 Instagram posts were analysed. On average, 318 posts were identified per account (range=1 to 1901). The average number of followers was 2337 (range=85 to 11,400) with average user engagement of 1.25% (range=0.0%-7.17%). A total of 6 themes (subthemes; n=28) were identified including "announcements on professional events" (51.6%), "patient education, enlightenment and commendation" (26%), "running and operation of the society" (9.1%), "highlighting research and evidence" (3.1%), "COVID-related advice and updates" (4%) and "observance and commemoration" (10.4%). The posts targeting patients were limited (18.7%).

CONCLUSIONS

The limited reach of the accounts of international orthodontic societies highlights the need to develop a more effective and influential social media presence. Orthodontic societies should involve members, providers and patients in developing more effective social media resources.

The World Wide Web of orthodontics- A comprehensive narrative on teledentistry pertaining to the orthodontics of the 21st century

Teledentistry has proven effective in practically all dental fields. It also allows access to inaccessible and underdeveloped locations. Better treatment outcomes were documented in patients treated by an orthodontist supervised by teledentistry than by a general dentist with minimal orthodontic experience alone. It may also help to focus referrals to specialists and weed out those who do not need them. But, on a critical note, a doctor-patient relationship is much more than a business transaction. A face-to-face initial consultation instills trust that a remote session cannot. Teledentistry includes professional networking of doctors. This contact includes digital information exchange, CPD programs, case discussions, and analysis that bring dentists from all around the world together to improve patient care. Teledentistry has not only spanned the distance between dentists worldwide, but has also served as a conduit between customer (patient) and manufacturer. This spawned Direct to Consumer (DTC) dentistry, sparking substantial debate among dentists worldwide. In DTC dentistry, inadequately trained customers conduct complex procedures on themselves with minimal guidance of a dentist. One of the major issues today is the general availability of clear aligners to patients without the requirement for an intermediary skilled orthodontist. The American Association of Orthodontists (AAO) has publicly questioned the validity of Smile Direct Club, a private firm that dominates the DTC industry. European Federation of Orthodontic Specialists Association, on the other hand, has sponsored a joint declaration with the representative orthodontic associations in Europe to highlight and alert patients about the potential risks of DTC products. Unfortunately, public shaming hasn't slowed commercialization of DTC firms. Teledentistry has been a boon for healthcare, but a nightmare for our profession, raising fundamental questions like what is the difference between a customer and a patient? Is dentistry a just another discipline of cosmetics? Is teledentistry making us less connected with our patients?

The quality and readability of online molar incisor hypomineralisation patient education materials: a systematic analysis

Background

Molar incisor hypomineralization (MIH) is estimated to affect 14% of children worldwide. It is crucial that patients and their families have access to easily comprehensible and reliable MIH‐relevant information. This study aims to determine the quality, reliability and readability of online patient education materials about MIH.

Methods

A systematic search strategy was adopted. Five validated tools were used to assess the content of the 21 websites that satisfied inclusion/exclusion criteria. Data analyses were applied via GraphPad Prism software version 9 (GraphPad Software, San Diego, CA, USA).

Results

Five (23.8%) websites only satisfied the criteria for understandability and two (9.5%) websites satisfied the criteria for actionability using the Patient Education Materials Assessment Tool (PEMAT). No website contained the Health on the Net (HON)Code Seal and the mean (SD) Journal of theAmerican Medical Association number of benchmarks per website was 1.33/4 (1.02). All websites failed to reach recommended minimum readability levels. Higher PEMAT scores were associated with ‘easier’ readability.

Conclusions

Online patient education materials related to MIH are lacking in quality and reliability, and are too difficult for most to read easily. The authors of MIH‐related online content should consider reference to quality of information tools when developing patient education materials.

The nature and accuracy of Instagram posts concerning marketed orthodontic products: A cross-sectional analysis

OBJECTIVES

To scrutinize claims contained within Instagram posts related to six popular marketed orthodontic products.

MATERIALS AND METHODS

Three hundred publicly available Instagram posts were identified using the following Instagram hashtags: #carrieremotion, #damonbraces, #invisalign, #acceledent, #propelorthodontics, and #myobrace. Pilot coding was undertaken on a subset of claims (n = 50) and a coding guide was developed. The associated claims were categorized under 24 recognized themes and their accuracy assessed on a five-point scale.

RESULTS

Of 1730 posts screened, 300 were included for analysis. The majority of posts were based on photographs (n = 244, 81.3%) with the remainder (n = 56, 18.7%) including videos. Half of the posts involved a picture of the product in isolation (n = 150, 50%), with clinical cases presented in a minority (n = 99, 33%). Overall, 472 claims were included with treatment duration being the most frequent theme (n = 125, 26.5%). In terms of accuracy, most of the claims were judged to be "false" (n = 283, 60%) with less than 2% considered "objectively true."

CONCLUSIONS

Most of the claims relating to six popular marketed orthodontic products concerned treatment duration. The vast majority of these claims were not supported by evidence and were judged to be false. Efforts should be made to promote the provision of accurate orthodontic information and to verify marketing claims on social media platforms.

Medication-related osteonecrosis of the jaw: A cross-sectional survey assessing the quality of information on the Internet

OBJECTIVE

The objective of this study was to evaluate the quality of information and readability of online content regarding medication-related osteonecrosis of the jaw (MRONJ).

STUDY DESIGN

Three search engines were used to identify websites containing information regarding MRONJ. The content was assessed with 5 quality of information and readability tools. Statistical analyses were performed via GraphPad Software (GraphPad Software Inc., La Jolla, Calif, United States).

RESULTS

The Health on the Net (HONcode) seal was present in 2 of the 21 websites that satisfied inclusion/exclusion criteria. The mean JAMA (Journal of the American Medical Association) benchmark satisfied per website was 1.619 out of 4 (standard deviation [SD] = 1.2; 95% confidence interval [CI], 1.07-2.17). The mean overall Quality Evaluation Scoring Tool score was 15.29 out of a maximum 28 (SD = 6.174; 95% CI, 12.48-18.1). The Quality Evaluation Scoring Tool scores of those websites that satisfied ≥3 JAMA criteria were significantly higher than those that did not (P = .01; 95% CI, -11.41 to -1.79). The readability levels of all content ranged from fairly difficult to very difficult.

CONCLUSIONS

The information related to MRONJ on the Internet is unreliable and too difficult for the general public to read. Authors of online MRONJ information should consider use of quality of information and readability tools to ensure that reliable information is understood by those with poor health literacy skills.

Information on the Internet about clear aligner treatment-an assessment of content, quality, and readability

Purpose

The goal was to evaluate the content, quality, and readability of the information available about clear aligner treatment on the Internet.

Materials and methods

The search terms “aligner,” “clear aligner,” and “Invisalign” (Align Technology, Tempe, AZ, USA) were analyzed in three search engines (Google [Google LLC, Mountain View, CA, USA], Bing [Microsoft, Redmond, WA, USA], and Yahoo [Yahoo, Sunnyvale, CA, USA]). The first 50 websites for each keyword in each search engine were screened. Duplicate websites, advertisements, links to scientific articles, videos, and other irrelevant websites were excluded. The quality of the remaining websites was analyzed using the DISCERN and Journal of American Medical Association (JAMA) benchmark instruments together with the Health on the Net code (HONcode, Health On the Net Foundation, Geneva, Switzerland). The readability of the websites was evaluated by the Flesch Reading Ease Score (FRES) and Flesch–Kincaid Grade Level (FKGL). Statistical analyses were performed by one-way analysis of variance, Kruskal–Wallis and Fischer’s exact tests, with p < 0.05 accepted to be statistically significant.

Results

Among 111 evaluated websites, most belonged to multidisciplinary dental clinics (n = 49; 44.2%), followed by aligner companies (n = 26; 23.4%), orthodontists (n = 26; 23.4%), and professional organizations (n = 10; 9%). The mean DISCERN score (sections 1 and 2) for all websites was 29.95/75. The average FRES and FKGL were 55.77 and 9.74, respectively. Professional organization websites had significantly higher DISCERN scores than others (p < 0.001), and together with multidisciplinary dental clinic websites, they showed better compliance with JAMA benchmark criteria. Professional organization websites’ FRES and FKGL were also higher than other websites (p > 0.05).

Conclusions

Overall, the quality of web-based information about clear aligners was poor and the readability of the data was insufficient. Websites presenting high-quality data with better readability are needed for potential aligner patients.

Availability of 'Do-It-Yourself' orthodontics in the United Kingdom

Objective:

To identify the number of companies providing Do-It-Yourself (DIY) orthodontics and explore information available on websites for DIY brace providers operating in the UK.

Design:

Web search and review of websites providing DIY braces.

Setting:

Leeds, UK.

Methods:

A Web search was completed in November 2020 and April 2021 of all companies providing DIY braces for UK consumers. Each website was evaluated, and the following data collected: name; year started operating; costs; process; involvement of a dental professional; average ‘treatment’ length; retention; consent process; information on risks and benefits; aligner material; social media presence; age suitability; and consumer ratings on Trustpilot. Quality of website information was assessed via the DISCERN tool.

Results:

Seven DIY orthodontic companies were operating in the UK. Websites reviewed revealed the following: product costs were in the range of £799–£1599, ‘treatment’ length quotes were in the range of 4–12 months; Trustpilot reviews were in the range of 1.6–4.8 stars; and websites claimed their aligners were suitable for individuals with an age range of 12–18 years. Quality of content regarding risks described on websites varied, and there was limited information regarding involvement of a dental professional. Quality of websites information scored ‘poor’ or ‘very poor’ on the DISCERN scoring.

Conclusions:

There has been an increase in the number of DIY orthodontic companies operating in the UK over the last three years. There is a need to determine whether these products constitute dental treatment in their own right. If so, it is crucial to ensure these are regulated appropriately with adequate information available to satisfy informed consent and have greater transparency over dental professional involvement to safeguard the public.