Background: The use of direct-to-consumer (DTC) orthodontic aligners is growing. The purpose of this study was to evaluate the quality of information contained within the websites of DTC orthodontic aligner providers. Methods: Websites that satisfied inclusion criteria were assessed for the presence of specific treatment-related features. Four validated quality of information instruments and readability tools were used to evaluate the content of the websites. Descriptive statistical analyses and intra-examiner reliability tests were performed. Results: Twenty-one websites were evaluated. Few websites referred to the need for pre-treatment dental health (38.1%) and indefinite post-treatment retention (23.8%). Most websites (95.2%) were categorized as either 'poor' or 'very poor' according to their DISCERN scores. DISCERN items regarding information bias and treatment risks scored particularly poorly. Cohen's kappa intra-examiner reliability testing for DISCERN scores was 0.81-0.89. Three websites honoured two out of the four Journal of the American Medical Association benchmarks and 18 honoured one benchmark only. The readability scores indicated 'difficult to read' content. Conclusions: The quality of information contained within the websites of DTC orthodontic aligner providers is poor. Patient consent for DTC aligner treatment based solely on the information contained within the websites is likely to be invalid.
Background
Data regarding the quality of information (QOI) related to orthodontic clear aligners (OCAs) on the internet are lacking. The aim of the present investigation was to assess the quality and readability of websites providing information regarding OCAs to prospective patients.
Methods
Three search terms were entered separately into three search engines. Four validated QOI instruments were used to determine the QOI and readability of the content contained within the websites that satisfied predetermined criteria. Descriptive statistical analyses and intrarater testing for DISCERN scores were calculated.
Results
Forty‐nine websites satisfied inclusion/exclusion criteria. General dentists (44.9%) and specialist orthodontists (26.5%) authored the majority of websites. One website contained the Health on the Net (HON) code seal. Cohen’s kappa for DISCERN scores was good (0.87). The overall mean (SD) DISCERN score was 38.55 (8.00)/80, range 26–60. The websites authored by ‘Direct‐to‐consumer’ OCA providers recorded the lowest DISCERN mean score (33/80). One website contained all four Journal of the American Medical Association (JAMA) benchmarks. The mean (SD) Flesch Reading Ease score was 53.92 (9.08), range 36–82.5.
Conclusions
The QOI of the website content related to OCAs is poor and is ‘fairly difficult’ to read. Website authors should consider using QOI instruments and readability tools to enable the delivery of evidence‐based and easily readable information regarding OCAs to prospective patients.
Upper central and lateral incisors of three human skulls were used to assess radiographically the possibility of detecting cavities of different sizes and locations, drilled to simulate external root resorptions. The sequence of radiographs was evaluated by three endodontists, who were unaware of the experiment being done, using a 2 x magnifier. The first observation was done without comparing the radiographic images of the different cavities with the preoperative radiograph. For the second round of observation, each sequence was compared with the preoperative X-ray. The results showed that small cavities were more difficult to detect than the medium and large ones. Moreover, cavities located on the proximal surfaces were more easily detected than those located on the buccal surfaces. Finally, when the observers could compare with the preoperative radiographs (second round of observation), the rate of detection was considerably higher.
Female adolescent patients tended to experience worse psycho-social impacts related to their malocclusions compared with males with similar index-determined OT need. Index-determined OT need scores did not correlate with the OHRQoL scales. Adolescent patients expected OT to improve their dental appearance and QoL aspects.
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