An assessment of the treatment information contained within the websites of direct‐to‐consumer orthodontic aligner providers

Abstract

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.

Availability of ‘Do-It-Yourself’ orthodontics in the United Kingdom

“…In the absence of informed choice, valid consent cannot be achieved. This article supports the findings by Meade and Dreyer (2021), which also found the quality of information on DIYorthodontic websites to be poor, thus meaning consent for aligner treatment based on these websites would be invalid (Meade and Dreyer, 2021) According to the GDC Standards ( 2013) and guidance on advertising, all information made public must be truthful and credible (GDC, 2013a(GDC, , 2013b. Claims made by companies on their websites included that the aligners are '0% more comfortable than regular aligners' (company 7) and they were '50% faster than traditional clear braces treatment' (company 1).…”

“…All websites scored poorly or very poorly according to the DISCERN score and the predetermined scales where 16-26 was very poor, 27-38 was poor, 39-50 was fair, 51-62 was good and > 63 was excellent (Charnock, 1999;Meade and Dreyer, 2021).…”

Information on the Internet about clear aligner treatment—an assessment of content, quality, and readability

“…[ 4 ] qualitatively assessed websites about orthodontic treatment modalities, including findings related to CAT. Recently, Meade and Dreyer [ 31 , 32 ] conducted two very informative studies on this topic. One provided a general assessment of websites from different authorships in Australia, and the other focused on DTC aligner systems only.…”

“…In a recent study, 73% of patients were informed about CAT by advertisements on social media and networks [ 17 ]. Despite the increased data on the Internet, limited information exists about the accuracy, reliability, readability, and overall quality of the information provided by websites on CAT [ 4 , 31 , 32 ]. The studies have varied in how they examined web-based data about CAT, such as being a part of different orthodontic treatment modalities [ 4 ] or DTC marketing [ 31 ].…”

“…Despite the increased data on the Internet, limited information exists about the accuracy, reliability, readability, and overall quality of the information provided by websites on CAT [ 4 , 31 , 32 ]. The studies have varied in how they examined web-based data about CAT, such as being a part of different orthodontic treatment modalities [ 4 ] or DTC marketing [ 31 ]. The only study examining the quality of online information about CAT, by Meade and Dryer, [ 32 ] reported that websites contained mostly poor-quality data.…”