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 categorised 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 2 out of the 4 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.