European Consensus: “Do-it-yourself-Orthodontics” is hazardous for patients

The Orthodontic Society of Ireland is one of 31 professional dental and orthodontic societies, associations, and institutions from 25 countries who have come together to endorse and fully support a Joint Declaration regarding the growing and concerning trend for “remote” orthodontic treatment. This Declaration by EFOSA (European Federation of Orthodontic Specialists Associations) has been issued in response to the increasing activities of companies promoting and selling orthodontic treatment using aligners, often by post. The Dental Council of Ireland issued guidance on orthodontic devices in 2017 that orthodontic treatment should be preceded by a full clinical examination by a registered dentist or orthodontist, Orthodontic treatment without proper initial diagnosis and regular clinical monitoring can cause risks to patients’ health.

The Joint Declaration on the remote treatment of  is available in twelve languages. It reads:

On the remote treatment of malocclusions

Various companies offer self- and remote treatment of malocclusions without direct contact between patient and a regular dentist by means of tele-media by transmitting image or video files. Treatment planning is based on impressions taken by the patient themselves, followed by consecutive manufacturing and deployment of treatment devices – particularly aligners – to the patient via mail. Treatment progress monitoring happens entirely without patient contact.

In this respect we declare:

  1. Any treatment of malocclusions represents a medical intervention in the stomatognathic system and should therefore be exclusively performed by a fully qualified dentist.
  2. Any treatment of a malocclusion must be preceded by a thorough clinical examination of the patient. Moreover, imaging findings must be evaluated for adequate treatment planning in order to identify contraindications or special risks.
  3. Any treatment of malocclusion requires regular clinical monitoring. It is essential to assess the treatment progress, but also to detect possible complications such as undesirable tooth movement or other intraoral pathologies at an early stage.
  4. Patient self-treatment and exclusive patient remote treatment must therefore be rejected as potentially hazardous to the patient’s health. Exclusive self- and remote treatment cannot be justified from a professional dental perspective. Exclusive self- and remote treatment represents a serious violation of the dental standard.

EFOSA Press Release Joint Declaration