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Will California ACT 1519 Stop DTC Aligners?

ACT 1519 was signed into law by Gov. Gavin Newsom on October 15. The following is an open letter from StraightSmile Solutions.

SACRAMENTO, Calif. — ACT 1519 was signed into law by Gov. Gavin Newsom on October 15. The following is an open letter from StraightSmile Solutions.

  1. This bill doesn’t take effect until Q1 2020
  2. This bill has a sunset of Q1 2024
  3. This bill doesn’t stop DTC aligner companies in California, but it does put more responsibility and risk on the treatment planning doctor. This is not retroactive so the doctors are “safe” with historical cases
  4. This bill will not only affect the bottom line of DTC companies doing business in California but it will also directly affect many privately-owned dental offices and DSOs. It is now standard-of-care to have X-rays taken and interpreted for orthodontic treatment. The author has had 15 years practicing in California and seen hundreds of private practice patients who neither had a panoramic X-ray takenbefore orthodontic treatment nor interpreted by the treating dentist. DSOs will need to button-up their practices and QC a little bit. There are far worse outcomes from those DSOs mentioned above than ever seen through tele-orthodontics.
  5. This bill has several flaws: It fails to designate what kind of X-ray is considered acceptable and also how aged the x-ray can be. Does this mean that bitewings from 3 years ago are acceptable and standard-of-care? How will this be relevant? It will be very easy for every DTC Aligner company to just have the patients sign a release to retrieve their X-rays from their general dentist.
  6. It will be very easy to put a panoramic machine in a scan shop and to have the dentist of record review the panoramic X-ray.
  7. This bill does allow DTC aligner patients to file complaints with the Dental Board of California. As someone who has been on both sides of the CADB Peer Review process, this is the biggest stumbling block. Doctors who are doing remote treatment plans are now going to be held accountable for inferior treatment plans. Case selection is key.
  8. This bill does not prohibit scan shops from operating without direct supervision of a dentist.
  9. Licensed Dental Assistants with their radiography license can take x-rays under general supervision of a dentist; that means the dentist doesn’t need to be in the room. This means that scan shops can continue to operate as-is but the X-ray equipment will need to be licensed to a managing dentist.

Review the bill at: https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201920200AB1519

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