Communications from the company directly to the patient, sending the devices home, App that allow you to make an appointment with the nearest dentist who does not make the diagnosis but acts as a simple ‘arm’. The phenomenon of a particular ‘do-it-yourself’ for transparent dental aligners is spreading more and more all over the world, including Italy, with manufacturers “addressing patients directly, bypassing the professional, who becomes everyone the effects are a ‘virtual figurehead’ because he does not make a diagnosis, he only carries out what is established by an anonymous clin-check, convinced that he has more job opportunities, unaware of the coroner’s responsibility that weighs on his shoulders “. And not without risk to patients. Raoul D’Alessio, professor of orthodontics and coordinator of the unitary union specialty orthodontics (Suso), reports it to Adnkronos Salute.
In the care of the 4.0 smile, do-it-yourself and ‘disintermediation’, which ‘bypass’ the figure of health guarantee, or the dentist, seem to have gotten out of hand, D’Alessio complains. “The company – says coordinator Suso – advertises orthodontic treatment with transparent aligners and acquires new patients through marketing campaigns. Patients then book a free appointment online and go to the partner dentist for an intraoral scan at available times. The intraoral scanner is supplied by the company and the scan is then sent to the company laboratories which provide for the elaboration of the treatment plan “.
The aligners, then, “are sent directly to the patient who shows up in the office indicated by the company, where the attachments are made, followed by remote control visits via an app. For each service, an economic compensation is provided for the operator, to whom the company says he is exonerated from any medical responsibility relating to the treatment plan and its outcome, which is absolutely false “.
A system not without pitfalls and problems. In fact, D’Alessio recalls that, according to the Legislative Decree of February 24, 1997, n.46: “advertising to the public of devices is prohibited which, according to provisions adopted by a decree of the Minister of Health, can only be sold on medical prescription or possibly be used with the assistance of a doctor or other health professional. “It follows that” some manufacturers of transparent aligners, medical devices tailored to all intents and purposes, when they advertise on various channels, including social media, are carrying out an illegal act “.
Another problem, “not just, is the diagnosis, which in these cases is made by who is not well known. Yet the Code of Ethics specifies that ‘the prescription for’ diagnosis, treatment and rehabilitation is a direct, specific, exclusive and non delegable competence of the doctor, commits his autonomy and responsibility and must follow a detailed diagnosis or a well-founded diagnostic suspicion. ‘Then the dentist who did not make a diagnosis performs an act contrary to the Code, on which he swore at the time of enrollment to the Order, and therefore is subject to disciplinary proceedings “. And also “the medical-legal responsibility which, unlike what is claimed by the companies, is borne by the operator, that is to say the person physically carrying out the orthodontic treatment in their own office or in the office provided by the company”. Another delicate aspect is the sending of customized medical devices directly to patients, with a series of possible findings on a professional level.
“Orthodontics – concludes D’Alessio – is a very difficult branch of dentistry in terms of diagnosis, therapy and coroner responsibility, often exercised on pediatric patients or adults with critical periodontal conditions, towards whom we also have a clinical responsibility, in view of a future improvement. The transparent aligners are only one of the therapeutic means that however presuppose a substantial knowledge of the subject, acquired over the long years of study and training, and like everyone they have limits that we must know and that the general dentist often takes lightly , at your own risk. Before formulating a therapy plan, which we call ‘clin – check’, it is essential to start with the diagnosis, and this must be explained to patients, who risk relying on companies that aim exclusively for profit “.
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