Relating to the sale, design, and manufacture of orthodontic devices.

New Dental Safeguards Limit Online-Only Orthodontics

Beginning September 1, 2025, Texas requires dentist-led care before personalized orthodontic devices are sold or designed or manufactured for patients. Sellers and service providers must be Texas-licensed dentists, act under a prescribing dentist, or obtain written or electronic dentist confirmation. Patients must receive an in-person mouth and head-and-neck exam, recent diagnostic imaging review, and medical and dental history review. Imaging must identify conditions that could make treatment unsafe, such as tooth decay, gum disease, root problems, or implants. The examining dentist must prescribe the device, or the treating and monitoring dentist must prescribe it with documented clearance or referral. Patients must receive counseling about treatment choices and risks, sign an acknowledgment, and have it kept in their file. Dentists cannot require patients to choose a device type before providing the required exam or imaging review. Sellers and service providers must keep required care documents they receive for at least seven years after the sale or service. Examining dentists must share exam and imaging records when another dentist requests them and disclosure is legally authorized. These rules cover personalized Class II or III medical devices that move teeth or the jaw, but exclude retainers used only to hold teeth fixed. Earlier sales and services remain governed by prior law.