Activities Regarding Direct-To-Consumer Orthodontics
The AAO’s efforts regarding Direct-To-Consumer Orthodontics has taken a broad approach, as we strive to protect the health and safety of orthodontic patients, both current and prospective.
*Consumer Alert from the AAO – Questions to Consider When Researching Direct-To-Consumer Orthodontic Companies (like SmileDirectClub, Candid Co., Smilelove, SnapCorrect, Orthly, Etc.)
Release: California Passes Dental Law Regarding Self-Applied Orthodontic Treatments
On October 13, 2019, California Governor Gavin Newsom signed Assembly Bill 1519 into law, granting the California Dental Board continued authority to oversee and regulate dental services in the state. As Governor Newsom noted in his signing statement, “The bill includes significant policy changes related to the regulation of self-applied orthodontic treatments administered via telehealth and other technological platforms.”
AAO Addresses SmileDirectClub in Arizona
AAO Attorney Andrew Wiltsch presented the AAO’s position that the taking of an intraoral digital scan constitutes the practice of dentistry and, therefore, must be performed by licensed dentists or individuals operating under the appropriate level of supervision by a licensed dentist.
AAO Weighs In - BBC: SmileDirect Club, the $8bn braces firm boosted by selfies
“It has also come under fire from the medical community, who say the lack of in-person oversight of orthodontic treatment violates local laws and puts users at risk, since moving teeth improperly can lead to changed bites, gum loss and other problems. The American Association of Orthodontists has lodged complaints with dental boards and regulatory authorities in 36 states.”
Membership Update on SDC IPO
“At the AAO, we have long held the position that orthodontic treatment is a complex medical process and that it is in the best, and safest, interest of the public to have that treatment conducted under the direct and ongoing supervision of a licensed orthodontist.”
AAO Weighs In - Forbes: "What Investors Need to Know About SmileDirectClub’s (SDC) IPO"
“According to the AAO, however, activities such as taking bite casts constitute medical work that is reserved for licensed medical professionals. In both Georgia and Alabama, the state boards of dentistry have required that a licensed dentist be present for all oral-imaging services.”
AAO Weighs In - KOB Albuquerque: "4 Investigates: State leaders weigh legality of do-it-yourself teeth straightening"
“The American Association of Orthodontists has lodged complaints with 36 state dental boards, including New Mexico. An attorney from the association — Andrew Wiltsch — spoke up at the most recent dental board meeting in Albuquerque, claiming companies like Smile Direct Club are operating illegally in New Mexico.”
AAO Weighs In - Bloomberg BusinessWeek: "A Tooth-Straightening Startup Runs Into Resistance"
“The orthodontist association has made formal complaints in 36 states, demanding they enforce their laws against practicing dentistry without a license.”
Release: SmileDirectClub Surpasses 1,000 “Customer Complaints” on Better Business Bureau’s Website
The AAO believes it is in the best interest of patients to have orthodontic treatment conducted under the direct and ongoing, in-person supervision of a licensed orthodontist.
AAO Weighs In - TechCrunch: "SmileDirectClub files to go public amid concerns from dental associations"
“Though, members of the American Association of Orthodontists have taken issue with SmileDirectClub, previously asserting that SmileDirectClub violates the law because its methods of allowing people to skip in-person visits and X-rays is “illegal and creates medical risks.”
AAO Weighs In - Fortune: "Brace Yourself: SmileDirectClub Is the Latest Unicorn to File for an IPO"
“The American Association of Orthodontists has taken issue with SmileDirectClub because of a key feature that has made the company so attractive to consumers: The ability to skip in-person meetings with an Orthodontists. The AAO argues that without a medical professional, consumers are endangering themselves.”
Release: AAO Addresses Direct-To-Consumer Orthodontics
PR Newswire: American Association of Orthodontists Discusses Patient Health And Safety Information Regarding Direct-To-Consumer Orthodontics
AAO President, Dr. Brent Larson, Addresses At-Home Aligners
Larson says people should know that teeth straightening is not “something that just changes your look. It’s actually a very complicated biological procedure.”
AAO Weighs In - CBS: "CVS Expanding Services to Include Teeth-Straightening"
The American Association of Orthodontists has criticized the service, warning that in-person visits are important in this type of care. Dentists can spot gum disease during these visits, and X-rays can detect bone loss not seen in a photo, Sean Murphy said.
Federal Court Throws Out Over Half of SmileDirectClub’s Counts Against the Alabama Dental Board
On April 17, 2019, the Court entered an order on the Alabama Board’s Motion to Dismiss, and threw out six of SmileDirectClub’s counts against the Board.
Federal Court Dismisses a Majority of SmileDirectClub’s Claims, and Finds that SmileDirectClub’s Digital Scans Constitute the “Practice of Dentistry”
On May 8, 2019, the Court entered an Order dismissing a majority of SmileDirectClub’s claims in the lawsuit. The Court dismissed all of the claims against the Board as an entity, as well as any claims against the Board’s individual members seeking monetary damages.
AAO Responds to SmileDirectClub in Georgia Lawsuit
The AAO filed a motion seeking leave to file a response brief in further support of the Georgia Board’s Motion to Dismiss, supporting the position of the Board and its members in the lawsuit, and in opposition to the claims and arguments made by SDC.
AAO Responds to SmileDirectClub’s Efforts in Washington
A proposed rule change in Washington state would have permitted dental hygienists to perform many orthodontic procedures without close supervision. SmileDirectClub sent a representative to testify in support and the AAO’s attorney Trey Lawrence spoke in opposition. In the end, the Rules Committee voted to remove these unsafe sections.
AAO Secures Veto of Problematic Teledentistry Bill
In an effort to protect patient health and safety, the AAO and the New Mexico Association of Orthodontists (NMAO) worked to stop Senate Bill 241 from becoming law.
AAO President, Dr. Brent Larson, Addresses DTC Treatment
Dr. Brent Larson, AAO president, took part recently in a nationwide Satellite Media Tour (series of coordinated media interviews), speaking with nearly 25 television and radio interviewers on the topic of direct-to-consumer orthodontic treatment.
AAO Files Amicus Brief in SmileDirectClub's Georgia Lawsuit
The AAO filed a motion seeking the court’s permission to file an amicus brief in support of the Georgia Dental Board in the lawsuit brought against the Board by SDC. The court granted the AAO’s motion and accepted the brief for consideration in the lawsuit. The lawsuit remains pending.
AAO Weighs In – How Worried Should Align Technology Investors Be About the SmileDirectClub Threat?
“The company faces significant pushback from the American Dental Association and the American Association of Orthodontists, which filed complaints against SDC in 36 states for alleged violations of regulations and statutes applying to orthodontic treatment.”
AAO Addresses SmileDirectClub Efforts in Arizona
The SmileDirectClub appeared before the Arizona State Board of Dental Examiners (Dental Board) to discuss its business model and Arizona SmileShops. The AAO’s Sean Murphy attended to provide the AAO’s perspective on orthodontic treatment and address the arguments made by SmileDirectClub. The AAO was the only party that responded to SmileDirectClub’s statements during the Dental Board’s public comment period. The Arizona Dental Board thanked the AAO for its perspective and indicated they would be considering the information presented and likely schedule a subsequent meeting on this topic.
New Jersey Dental Association Files Lawsuit Against SmileDirectClub
The New Jersey Dental Association (“NJDA”) and one of its members, Dr. Scott D. Galkin, filed a lawsuit against SmileDirectClub (“SDC”) and three of the doctors who allegedly work with SDC, Dr. Danny Leeds, Dr. Robert DeRosso, and Dr. Issac Perle (the “Associated Doctors”).
AAO Files Amicus Brief in SmileDirectClub's Alabama Lawsuit
The AAO filed a motion seeking the court’s permission to file an amicus brief in support of the Alabama Board of Dental Examiners in the lawsuit brought against the Board by SDC. The court granted the AAO’s motion and accepted the brief for consideration in the lawsuit. The lawsuit remains pending.
AAO Weighs In: Teeth-Straightening Boom
“Orthodontics is the movement of biological material, and it’s best done under the supervision of a licensed orthodontist,” said Sean Murphy, AAO’s general counsel. “If not done correctly, (it) can lead to potentially irreversible and expensive damage…”
Alabama Dental Board Defends Itself against SmileDirectClub Lawsuit
On October 12, 2018, SmileDirectClub (“SDC”) and Dr. D. Blaine Leeds filed a lawsuit against the Board of Dental Examiners of Alabama (the “Board”) in federal court for the Northern District of Alabama. On November 21, the Board and its individual members filed a Motion to Dismiss SDC and Dr. Leeds’ claims against them, arguing that SDC and Dr. Leeds have failed to adequately plead claims against the Board and its members.
Georgia Dental Board Defends Itself against SmileDirectClub Lawsuit
On May 21, 2018, SmileDirectClub (“SDC”) filed a lawsuit against the Georgia Board of Dentistry (the “Board”) in federal court for the Northern District of Georgia. On November 21, the Board and its individual members filed a Motion to Dismiss SDC’s claims against them, arguing that SDC has failed to adequately plead claims against the Board and its members.
AAO Advocates on Behalf of Canadian Orthodontists to the Royal College of Dental Surgeons of Ontario
The AAO worked with a Toronto law firm, Norton Rose Fulbright Canada, to attend a meeting and communicate to the Royal College of Dental Surgeons of Ontario concerns regarding stores in Ontario that appear to be providing patients with orthodontic treatment absent any in-person evaluation or in-person supervision by a licensed dentist.
AAO Addresses SmileDirectClub Efforts in Georgia
The Georgia Dental Board held a public hearing on the rule requiring direct supervision for digital scanning for fabrication of orthodontic appliances, over which SDC sued the Board. The AAO made a presentation at that hearing in support of the Georgia Dental Board’s rule. SDC also made a presentation at that hearing.
AAO Responds To SmileDirectClub’s Efforts in Arkansas
In September 2018, SmileDirectClub held a meeting with members of the Arkansas State Board of Dental Examiners to discuss an Arkansas regulation that states an “in person” dental examination creates a proper dentist/patient relationship, and a “dentist/patient relationship must be established before the delivery of services via ‘teledentistry.’” AAO Attorney Sean Murphy attended the Arkansas State Board of Dental Examiners meeting with the AAO’s Arkansas lobbyists and voiced opposition to SmileDirectClub’s efforts.
AAO Weighs In: Teeth-Straightening Startups
“There’s more to treating a smile than just moving visible portions of the teeth,” said AAO associate general counsel Sean Murphy. “If you want to increase access to care, you have to make sure it’s in the best interest of patient health and safety.”
Letter to the FDA
The AAO sent a letter to the Food and Drug Administration regarding SDC, asking the FDA to investigate whether SmileDirectClub’s sale and distribution of dental aligner devices is consistent with applicable law and that the appropriate action be taken with respect to SmileDirectClub’s historic and continued sales and distribution of dental aligners. The AAO is awaiting the FDA’s response.
The AAO filed with the United States Federal Trade Commission (FTC) a twenty-plus page “Petition to Initiate Enforcement Action against SDC, LLC in Connection with Unfair and Deceptive Practices.” The AAO is awaiting the FTC’s response.
Dr. Snyder and the AAO Comment on SmileDirectClub to Virginia Board of Dentistry
Recognizing his right to petition his state dental board, in October 2017 Virginia AAO member Dr. Edward Snyder submitted a letter on his own to the Virginia Board of Dentistry, reflecting his thoughts and opinions about SmileDirectClub.
Message to AAO Members Regarding Recent SmileDirectClub Claims
State Dental Board Complaints—SmileDirectClub
The AAO filed complaints with 36 state dental boards and authorities against SmileDirectClub alleging specific regulatory and statutory violations. A majority of those complaints are still pending and the AAO continues to monitor them.