It’s highly possible that at some point in the next couple decades it will be legal for non-dentists to provide tooth straightening with clear aligners directly to the consumer. Outcome data from past cases we orthodontists have treated is constantly running through AI and eventually tooth movement algorithms will become accurate enough to bypass dentists and orthodontists. When this happens it’s probable that the legal landscape will change just as it’s changing now in regard to driverless cars. As we have mentioned before, we believe simple orthodontics will follow the same path as tooth whitening did (that transition from requiring a dentist to not is very well documented for the curious reader – see FTC v NC Board of Dentistry). This probable scenario brings to mind two questions:

Question 1: If this happens, will orthodontists unite with general dentists in an attempt to block dentistless orthodontics from happening in order to defend our collective turf?

Question 2: If direct to consumer, doctor directed orthodontic treatment is not a passing fad and it cannot be destroyed quickly by consumer dissatisfaction, state boards and the AAO as some predict, what will happen?

Here are our theoretical answers to these hypotheticals FWIW:

If and when simple straightening no longer requires a licensed dentist, we believe orthodontists and dentists will put aside our long-standing turf war and work together to defend “the profession”. If this is likely or even possible, what does that tell us about who we are, what we do and why? What does this eventuality reveal about our motivations as orthodontists? This thought experiment is an awesome opportunity for self discovery and self knowledge if we can bear it.

As to the second question, we keep hearing that a new crop of popular orthodontic gurus is promising the social media masses that DTC orthodontics will be destroyed by consumer outrage and lawsuits over poor results, state boards/attorneys general and organized dentistry. We find this position interesting and very similar to what those with a vested interest in taxi cabs said for years about Uber. We have seen first hand how emotional this topic is for orthodontists and know that it is appealing to our peers to fantasize about the demise of DTC, doctor directed, simple orthodontics but we wonder upon what factual basis these predictions are founded.

Nonetheless, if the predictions of doom and gloom for DTC orthodontics bear out, we will be more than happy to admit publicly that we were completely wrong about this entire delivery system. We wonder if the newly appointed orthodontic Facebook prophets will do the same if DTC orthodontics defies their assertions and is still around in 3, 6, 9 or even 12 months? Guess we will all find out soon enough. The great news about having so many of these discussions online is that they are all written down and searchable for posterity.

Predictions, ours along with everyone else’s, are just relatively educated guesses about what will happen in the future. We don’t claim to be prophets nor do we expect 100% accuracy of others but we do feel it’s important to review predictions periodically in the light of reality. It’s an interesting and exciting time to be alive. There is tremendous change in our industry and, as always, with great change comes great opportunity. When the meteorologist predicts rain, many huddle in their houses and fret but some plant crops in order to harness the coming windfall. Which are you? The choice is yours!

Marc Ackerman

Ben Burris