Tabbaa S, Nguyen T, Toubouti Y, Saltaji H. Direct-to-consumer orthodontics: Exploring laypeople's perception of orthodontic treatment complexity. J Am Dent Assoc 2022; DOI: 10.1016/j.adaj.2022.10.017.

How do people decide?

Direct-to-consumer orthodontics (DTC) is increasing in popularity, partly due to convenience (no visits to the clinic) or due to lower cost than traditional treatments. Concerns have been expressed about the health risks of unsupervised treatment but companies providing DTC claim that cases are assessed and planned by dentists, even though in most cases, the patient is never seen clinically. Information provided on DTC companies' websites has been found to be of poor quality but consumers may be doing their own research. Little is known about why or when consumers choose DTC over traditional treatment.

Photographs of cases of different levels of complexity were shown to 1,362 individuals aged 18+ in an online survey. Participants were asked to assume the pictures depicted their own teeth and whether they would choose DTC for treatment in each case. Cases of mild complexity (minimal or no crowding) were more likely to be chosen for DTC but participants were unable to identify complexity factors such as skeletal or tooth size discrepancies. Males and younger adults were more likely to choose DTC.