Is advertising for clear aligner treatment truthful?
Clear aligners are now a significant component of contemporary orthodontic care. Recently, there has been an increasing amount of research into Clear Aligner Treatment. This reveals that they are indicated for treating mild to moderate orthodontic problems. In addition, there may be no other advantages other than better aesthetics than fixed appliances. Yet, the aligner companies make different claims for their treatments.
This situation has become more complicated with the advent of Direct-to-Consumer Orthodontics. A cursory review of the advertising reveals that these companies make many claims for this treatment.
But what claims are currently being made, and are they truthful? This was considered in this new study.
A team from Otago, New Zealand did this research. The Australasian Orthodontic Journal published the paper. It was great to see that this paper was open-access.
Cynthia Shi et al. Australian Orthodontic Journal 28:2: 2022.
What did they ask?
They did this study to:
“Investigate the existing and available CA brands and companies and assess their marketing claims”.
What did they do?
They did this study in several main stages. These were.
- An extensive search of internet search engines to identify as many clear aligner companies as possible.
- Identify interest in clear aligner treatment over time.
- Reviewed the website of each company in October 2020.
- Recorded the advertisting claims and looked for references to research on the websites.
What did they find?
They identified 75 clear aligner brands for inclusion in the study. Half of these were in the USA (37%) and China (14.7%). Most companies have globalised their products.
Most companies (78%) required patients to visit a qualified clinician for treatment. However, 21% of the companies operated a direct-to-consumer model.
They identified the main themes of the claims that were made. These included “improved aesthetics”, “increased comfort”, “improved length of treatment”, “superior materials”, and“treatment cost”.
Notably, only 4.5% of the advertising claims were supported by references on the websites. Furthermore, this was predominantly internal studies and experiments done within the company rather than peer-reviewed studies. Finally, the companies claimed that there were “multiple scientific studies”, but the study team could not find any.
In other words, there was no evidence to support these claims.
Their overall conclusions were:
“While companies made claims about their appliances, most did not provide supporting evidence. This could lead to public misconception. Furthermore, clinicians should be able to appraise the contents of claims and company advertisements”.
What did I think?
This was a concise, simple study that provided us with useful information. This is the first time there has been a systematic review of companies’ claims. As a result, this paper is important.
However, the authors drew attention to some areas for improvement. Firstly, they confined their search to English, Chinese and Korean sources. As a result, they could have missed some companies. Importantly, they did not attempt to contact the companies to obtain records of “data on file” references. I did not feel this was a problem, as the companies could easily have provided links to the data but chose not.
My interpretation of the study suggests that the most critical finding of this study was that the companies “made up” the claims they made. This is likely to be unethical, mainly because these are healthcare claims. However, one could argue that the salesforce does not have to work according to clinicians’ ethics. Nevertheless, these claims must be supported or refuted by the highly paid-KOLs who advise the companies. They do not seem to do this. We know who you are…..
So, we are still where we were many years ago and have not moved on much from “In the land of no evidence is the salesperson King?” Quite simply, we cannot trust most advertising on clear aligners.
Emeritus Professor of Orthodontics, University of Manchester, UK.