The Texas Dental Board enacted regulations on teledentistry providers requiring an in-person examination when the treatment calls for it.

The Texas State Board of Dental Examiners took final action to enact strong new teledentistry regulations for the State of Texas.

The regulations provide the board with a basis for enforcement against teledentistry providers (including mail-order orthodontic companies) that do not meet the minimum standards of care for orthodontic treatment. 

The new rules require that anyone providing treatment through teledentistry perform and review a limited physical examination when a reasonable and prudent dentist would do so under the same or similar circumstances. 

At a minimum, the rules stipulate that a limited physical examination should be performed and reviewed annually—that is, an in-person examination must be performed at least annually for teledentistry patients, or more frequently/sooner if the standard of care requires it.

As part of the regulatory rulemaking process, the Texas Governor’s office confirmed that this new language gives the Texas board authority to enforce, where appropriate, a standard of care requiring an in-person examination prior to beginning remote orthodontic treatment. 

In a letter to the dental board, the regulatory compliance division of the Governor’s office stated:

“Importantly, the proposed rule still refers to what a reasonable and prudent dentist would do and does not foreclose that, under certain circumstances, the standard of care may require a dentist to perform an in-person examination of or have other in-person contact with a patient before providing teledentistry dental services.”

The American Association of Orthodontists and the Texas Association of Orthodontists have worked together to advocate for teledentistry regulations in order to protect orthodontic patient health and safety.  The AAO and TAO worked with the board for nearly 2 years in the effort.

AAO legal and advocacy staff attended and spoke at numerous Texas dental board hearings, rule committee hearings, and met with personnel from the Texas Governor’s office. 

TAO members repeatedly attended dental board hearings, provided oral and written testimony, and contacted legislators.

Additionally, federal relationships built through the AAO Political Action Committee (AAOPAC) opened doors for the AAO to share concerns relating to mail-order orthodontic treatment and changes to the standard of care in Texas with key members of Congress. 

AAO urged Congressman Brian Babin (R-TX) and Congressman Lloyd Doggett (D-TX) to speak with decision makers in Texas and help advocate for patient health and safety.

At the conclusion of the rulemaking process, the Texas Dental Board went on record during the hearing thanking the AAO and the Texas Association of Orthodontists for their heavy involvement in the process.

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