Understanding risks and liabilities of DIY dentistry

It won’t be news to many of you that there are an increasing number of companies selling do-it-yourself (DIY) dental products direct to consumers. These include whitening kits, mouthguards, anti-snoring devices and more recently orthodontic appliances. In a recent article, “Teeth whitening: Surging popularity brings issues to resolve”, we updated you on what the ADA is doing to try and get some better regulations about teeth whitening products so you won’t be surprised to hear that the ADA cautions consumers about the problems about taking up these DIY offers. We have also approached both the ACCC and the Dental Board seeking action.

The latest issue on this front is the significant push by certain companies to get dentists and orthodontists to actively engage in supporting the sale of DIY products by recruiting them to act as reviewers/case managers through a Teledentistry service model. Companies are using claims of clinical oversight in their marketing plan to reassure ‘clients’ that their treatment is under the care of a registered dentist or orthodontist.

So, what is the pitch? One US company, that the ADA is aware of, has advertised for dental assistants to work in their sites to take impressions or undertake 3D scans on ‘clients’ as part of offering orthodontic treatment. The ads give no indication that there will be any form of supervision from a dentist or orthodontist or that patients will have been deemed suitable for treatment. They are also expecting the assistants to provide complimentary whitening as part of the ‘client’ recruitment process.

Next is where dentists and orthodontists come in. The company is also advertising for dentists and orthodontists to sign up as providers and provide remote Teledentistry services to these ‘clients’ by assessing the scans and in an ongoing capacity, ‘check[ing] in’ remotely with the consumer every 90 days to monitor progress and making recommendations on changing their aligners to the next in the kit.

As a registered practitioner, you know that you are responsible for the treatment provided to any patient in your care. This includes any services provided through Teledentistry or remote contact. It goes without saying therefore, that if you have never examined the patient, never viewed a panoramic radiograph or full mouth series of radiographs of the patient, taken or supervised the taking of the impressions or scan yourself, or advised the patient of other options available to them and something goes wrong, there is a risk a panel of your peers, who would be appointed to determine the merits of the situation in the case of a complaint, would most likely find that you had not acted in a manner which would be expected of a registered dentist or orthodontist. You would also most likely be held liable for any damage that occurs as a result of the process.

Needless to say, neither the ADA nor the Australian Society of Orthodontists recommends that members participate in these schemes without fully understanding the risks, levels of reimbursement and that you have checked with your professional indemnifier that you are covered for participating in such a scheme.

Building a practice or a group of loyal patients takes more effort than a quick chat over skype so don’t say you haven’t been warned.

/ADA Public Release. View in full here.