The bill, AB 1998, which will now advance in the California legislature, aims to establish additional consumer protections for direct-to-consumer orthodontic patients. 

The California Dental Association (CDA) issued a statement saying it fully supports a new bill introduced earlier this year, and recently amended, that builds upon Assembly Bill 1519 which became law in January 2020, providing protections to direct-to-consumer orthodontic patients. 

The CDA worked with Assemblymember Evan Low (D-Silicon Valley), author of the 2019 bill and the current AB 1998, to refine the current bill’s language. CDA maintained that safe dental care can be provided under the right conditions without an in-person examination by the treating dentist and, as such, initially took a “support if amended” position on AB 1998. In a press release from the CDA, the association maintains that it wants to establish additional consumer protections while “protecting the progress CDA and California have made with the virtual dental home telehealth model of care.”

AB 1998 was heard last week in the Assembly Appropriations Committee where the bill was significantly amended. The new bill language removes the in-person examination requirement and adds the following consumer protections: 

  • Refines diagnostic record requirements for orthodontic treatment to meet the minimum standard of care and prevent further noncompliance by direct-to-consumer orthodontic companies that continue to not review patient radiographs prior to treatment;
  • Codifies dental record retention requirements to prevent direct-to-consumer orthodontic companies from threatening patients that they will delete records if a treatment plan is not purchased immediately;
  • Further defines at what point during treatment a patient must be given contact information about their treating dentist;
  • Expands the prohibition for any person, including an employee, to enter into a contract that limits their ability to submit complaints to a regulator; and
  • Establishes explicit rights to request dental records copies of any documents signed by a patient.

As the CDA puts it, “The added consumer protections ensure that direct-to-consumer orthodontic businesses provide the same level of patient safety but without reversing the improvements California has already made in teledentistry policy.”

According to the CDA, opposition to the bill has mostly focused on the amendments that clarify the legislative intent of last year’s dental board sunset bill, which established a standard of care by requiring X-rays be reviewed prior to moving patients’ teeth for orthodontic treatment. The amendments to AB 1998 reportedly stemmed from ongoing patient accounts that many direct-to-consumer orthodontic companies had not asked to review previous radiographs, as required by the law that took effect in January. 

With the new amendments, CDA has taken a full “support” position on the bill.