UK Dental Regulator acts on Direct to Consumer Orthodontics.
I have posted a lot about Direct to Consumer Orthodontics. In one of my posts, I discussed the role of the dental regulator in this form of treatment. I was also critical of the amount of time that the UK Dental Regulator was taking to address this problem. I am pleased to see that they have produced some useful documents on their approach.
You can find these documents here.
Dentists and orthodontists are concerned about the risk to the patient of DTCO. These companies seem to be flourishing in many countries. The specialist societies are working on providing information for patients on this treatment. However, the regulatory bodies are now making progress on highlighting issues. The UK Dental Regulator (the General Dental Council) has recently produced three related documents. I am going to highlight the main points of each one.
This first document outlines their overall viewpoint; they direct this to dentists and other dental care professionals. They make the following points.
- Any innovation should not compromise patient safety measures.
- Anyone who is not registered and practices dentistry could be prosecuted.
- Face-to-face interaction or a physical clinical assessment is necessary to ensure patient safety.
- The responsibility for treatment rests with the treating dentist.
- Direct interaction between the patient and dentist is essential. Patients must be able to make contact with the treating dentist. They must know the full name of the treating professional.
In this second document, they outline in more detail the GDC standards that are relevant to dentists who are involved in DTCO. These are:
- There is no authoritative clinical guidance that supports a remote substitute for a physical clinical examination. Any dentist proposing to deviate from established practice and advice in this way must record and be able to justify their decision.
- ‘You must communicate effectively with patients – listen to them, give them time to consider information and take their individual views and communication needs into account.’
- Make sure that there is an effective complaints procedure readily available for patients to use and follow that procedure at all times.’
They also produced advice for patients who are seeking DTCO. I thought that the main points of this were:
- Without seeing you in person, the dentist might not have all the information they need about your oral health.
- To give valid, informed consent, you need to have been given all the information about what the treatment involves.
- Knowing the name of the person treating you is very important as the dentist who prescribes your aligners or braces is responsible for all your treatment.
What do I think?
Firstly, I think that the GDC has taken a disappointingly long time to issue these guidelines. I discussed the role of the regulator in DTCO in a blog post in August 2016. If you want to reread this, you will see that I raised all the issues that the GDC has mentioned in its guidance in the last section. I cannot understand how or why this has taken nearly four years to address.
Nevertheless, I do think that the guidance is good. The GDC have written it clearly, and they have provided good information for the prospective patients. It is also important to see that they have mentioned that they will prosecute unregistered providers. They have also used their Standards to warn UK based dentists/Dental Care Professionals that their licence is at risk if they work with one of these companies.
However, there is one massive hole in this process. This problem is the role of the “treating” dentist based outside the UK. The General Dental Council has no jurisdiction outside the UK. As a result, there is a role for the specialist/dental societies in pointing this out to prospective patients.
We are now in a position to see the action that the GDC takes when we report a company for illegal practice etc. So let’s get reporting!
Finally, I am not sure whether the other dental regulators throughout the World have addressed this problem. Does anyone want to add this information in the comments?
Emeritus Professor of Orthodontics, University of Manchester, UK.