California has made significant progress in improving access to dental care services to many Californians who have limited resources or who live in communities with few providers. For example, five years ago the state passed legislation that further encouraged the advancement of teledentistry paving the way for more children living in underserved communities to receive quality dental care.
As a part of this progress and innovation, there has been a rise of clear-aligner therapy delivered through teledentistry services. These services have made it possible for consumers with mild to moderate cases of malocclusion – commonly known as crooked or gapped teeth – to conveniently access a product for up to 60% less than traditional orthodontics.
Teledentistry gives consumers who otherwise don’t have access to a traditional dentist or orthodontist as a result of their job, school, disabilities or other factors, the opportunity to access remote dental care. Crooked teeth can have a serious impact on a child or an adult creating insecurities, and potentially negatively impacting school, work and daily life. Since the advent of teledentistry services to offer better access to clear aligner therapy, close to 100,000 Californians – both teens and adults – have been able to achieve an improved smile.
However, these services are now coming under assault from an unlikely source–the California Dental Association.
The CDA has recently supported last minute amendments aimed at protecting their own businesses from the threat of competition. The amendments were inserted into a sunset re-authorization bill for the state’s dental board that had to pass this year or California would be without a regulatory board. Using this tactic forced legislators and the governor into a position to support the re-authorization legislation with policy changes aimed to benefit one industry without meaningful stakeholder and public input. In fact, when Assembly Bill 1519 was signed this weekend, the Governor included a signing message that called out these tactics as unacceptable.
Unfortunately, these policy recommendations create new barriers for consumers who want and need more low cost and accessible dental and orthodontic options. The amendments require dentists to review x-rays that are not necessary prior to prescribing clear aligners for mild to moderate cases of malocclusion. There is no clinical basis for this type of policy according to both the American Dental Association (ADA) and the federal Food and Drug Administration (FDA) guidelines, which also warn that unnecessary x-rays pose a risk to patients.
Rather than focus on patient care, this new law eliminates the dentist’s discretion for patient care and is a clear attempt to require patients to first have an in-office visit with a dentist before they can access care through teledentistry – maintaining customers for brick and mortar dental practices. While teledentistry providers and the medtech platforms they partner with to provide clear aligner therapy can and will continue to operate successfully, this bill marks a clear signal that progress and increased access to care are under attack by powerful special interests.
As a California-licensed dentist who has seen the benefits of teledentistry, I know firsthand that modern technology should be used to benefit our most vulnerable and disadvantaged communities. Teledentistry offers more convenient and affordable options for children and adults to receive dental care that will make a difference in their lives. Putting barriers between the millions of other Californians who could benefit from clear aligner therapy using teledentistry harms those who need improved access the most.
California has led the way so many times – especially when it comes to the use of technological tools to improve people’s lives. That tradition should continue. As we look forward to 2020, we encourage our state leaders to work with stakeholders and the public to pass transparent policies aimed at improving health care options and care.