The British Dental Association (BDA) has warned that the collapse of the remote-orthodontic service SmileDirectClub will not close the door on the clear risks to patients presented by remote orthodontics.
The business model - offering patients plastic aligners based on a 3D scan of their mouths or via an impression taken from at-home moulding kits – can lead to fundamental changes to a patient’s mouth that may be irreversible.
The BDA has regularly raised concerns directly with regulators – the Care Quality Commission and General Dental Council (GDC) – about this practice since 2019. The professional body warns that the bankruptcy of the market leader should not be viewed as a substitute for meaningful regulation to protect patients.
In 2021, the GDC published guidelines stressing that orthodontic patients need to be fully assessed by a dentist, that direct dentist-to-patient interaction – the basis for informed consent - is essential, and that patients must know the name and registration number of the dentist responsible for their care. However, the BDA says it did not offer clarity on what sanctions it might utilise and how the regulator backed up that such models of care are "safe for many people.”
The BDA says it has seen cases of patients with advanced gum disease that have been provided with these aligners, potentially leading to tooth loss.
In 2020, an investigation into the provider by U.S. network NBC revealed a wide range of complaints on treatment outcomes. Patients were not required to have any in-person assessment with a dentist, and unhappy customers were made to sign non-disclosure agreements.
Eddie Crouch, British Dental Association chair, said, “Dentists are left to pick up the pieces when these providers offer wholly inappropriate treatment.
“It shouldn’t have taken a bankruptcy to protect patients from harm. It requires decent laws and effective regulation.
“Sooner or later, someone will find a way to make remote orthodontics turn a profit. Before that time, proper safeguards must be in place.”