The straight and narrow – new GDC guidance on direct-to-consumer orthodontics

the straight and narrowEmma Laing considers the latest GDC guidance on direct-to-consumer orthodontics and what it means for dentistry.

In my column last month, I discussed direct-to-consumer braces. We’ve seen the 2021 ‘Zoom boom’ demand for Orthodontics, coupled with a shift to online purchasing for just about everything since the pandemic.

Yet this worrying trend to purchasing clinical treatment online, often with home impressions has sparked huge worry amongst clinicians. The market is staggering, the leading company have now made aligners for one million people. Close to half a million are following them on Instagram, plus being promoted by social media influencers to their vast number of followers.

In a really positive step for our profession, a few weeks after my article went live this month, the General Dental Council (GDC) published new guidance. It is entitled ‘an updated statement in relation to direct-to-consumer orthodontics’ and also published:

  • ‘Information for dental professionals to support professional judgement’
  • ‘Information for patients to support informed decision making about treatment’.

Close links to patients

A ‘direct-to-consumer orthodontics – social media toolkit’ can now be downloaded from the GDC website. This provides some images and I felt, really useful suggested words that clinicians can use to ‘reach out to your patients about direct-to-consumer orthodontics through your social media channels’.

The GDC makes an important point that dental practices have close links with their patients. Therefore they are best placed to highlight things for patients to consider about whether treatment is right and safe for them to undergo. Given that patients are seeking the treatments online, often through social media, this is really on point to ensure we broadcast the right message through the relevant means.

The GDC’s stance is a really encouraging step in terms of patient safety, recognising the issues raised, and to support us as clinicians with advice from our professional body. In 2020 so many concerns were raised by both dentists and patients.

Examples cited included aligners being used in undiagnosed periodontal cases, with no detailed assessment of the gingival health nor supporting bone levels prior to commencing treatment. The GDC at this time said they ‘were concerned about a number of consumer reviews brought to their attention’.

This month their ‘updated statement in relation to direct-to-consumer orthodontics’ includes three main points, summarised here:

  1. Before prescribing aligners, there must be an assessment of the patient’s oral health. There is no substitute for a clinical examination in person
  2. For valid, informed consent, there must be a direct interaction between patient and practitioner. This is so that patients can ask questions and fully understand the proposed treatment
  3. Patients must know the name of the dental professional responsible for their treatment and be able to contact them directly.

Patient safety first

As clearly shown on the GDC’s website, clear aligners that are direct-to-consumer fall within the legal definition of dentistry. So they can only be performed by dentists and dental care professionals registered with the GDC.

The treating clinician is responsible for ensuring they have met all of the ‘GDC Standards for the Dental Team.’ Some elements of the aligner treatment process can be performed safely on a remote platform whilst complying with the Standards. But for other aspects a clinical assessment in person is required for patient safety.

I feel this is a great support for us as dental professionals. I welcome the recognition of the issue and some useful information that we can pass on to our patients.


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Catch up with previous Straight and narrow columns:

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