California Takes Another Shot at Separating Telehealth and Dentistry

Less than a year after enacting legislation that restricts the use of telehealth for dental services, California lawmakers are once again looking to curb its use.

California Assemblyman Evan Low this week introduced AB 1998, the Dental Practice Act, which would require dentists in the state to conduct an in-person visit with a patient before using telehealth. The bill takes specific aim at online companies like SmileDirectClub that prescribe aligners and offer certain other services.

"California is proud to be the incubator of innovation — but we cannot sacrifice patient health and safety in exchange for making billionaires out of tech bros," Low said in a statement provided to Politico. "The industry should view AB 1998 as a sign that the Legislature is serious about requiring meaningful safeguards if these questionable and controversial business practices are allowed to continue."

Last October, Governor Gavin Newsom signed into law AB 1519, which reauthorized the Dental Board of California and included restrictions on how dentists and orthodontic companies can use connected health technologies.

Under the law, teledentistry companies and online orthodontic services must now obtain written or verbal permission to use telehealth and review a patient’s dental x-rays prior to treatment. In addition, online services must identify the dentist offering treatment and give patients a clear path to file complaints with the Dental Board of California.

While Newsom lamented the telehealth language in the bill, saying it should have been discussed more thoroughly rather than added into the bill at the last minute, the California Dental Association supported the new law.

“The first of its kind in the nation, the new law will protect patients from DTC orthodontic companies that are putting profits before patients by taking potentially unsafe shortcuts to the accepted standards of care,” the organization said.

“Providing dental care to patients, especially moving teeth, without sufficient diagnostic information can potentially lead to serious patient harm, including loose or cracked teeth, gum recession and tooth loss,” the CDA added. “With emerging business models offering various dental services outside of a dental office’s four walls, including companies that provide direct-to-consumer orthodontic services, it is imperative that dental treatment continues to meet the standards of care.”

SmileDirectClub apposed the law, calling it a “thinly-veiled attempt to protect traditional dentistry at the expense of Californians.”

Low’s bill won’t win their support either. If passed, it would prevent consumers from getting aligners or other dental products online without first seeing a dentist.