Product advertisements in orthodontic journals: Are they evidence-based?

Assessment of the quality and accuracy of information contained within the websites of marketed orthodontic products: a cross-sectional investigation

OBJECTIVES

To assess the quality and accuracy of information contained within the websites of providers of marketed orthodontic products.

MATERIALS AND METHODS

Twenty-one websites of orthodontic appliance and adjunct (product) providers were identified. The website content was assessed via two validated quality-of-information instruments (DISCERN and the Journal of the American Medical Association [JAMA] benchmarks) and an accuracy-of-information instrument. Website content was qualitatively analyzed for themes and subthemes.

RESULTS

More than half (n = 11; 52.3%) of the assessed websites contained clinician testimonials. The mean (SD) DISCERN score was 33.14 (5.44). No website recorded the minimum of three JAMA benchmarks required to indicate reliability. The most common content themes related to quality-of-life impact and treatment duration. Just 8% of the statements within the websites were objectively true. The Pearson correlation coefficient indicated that the DISCERN scores were correlated with the accuracy-of-information scores (r = .83; P < .001).

CONCLUSIONS

The quality and accuracy of information contained within the websites of the providers of marketed orthodontic products was poor. The combined use of DISCERN and the accuracy-of-information instrument may help overcome the shortcomings of each. Clinicians should check the accuracy of information on orthodontic product provider websites before adding links to those websites on their own sites.

Clinical evaluation of marketed and non-marketed orthodontic products: are researchers now ahead of the times? A meta-epidemiological study

BACKGROUND

The advertisement and adoption of untested orthodontic products is common. This study aimed to provide an update regarding the prevalence of clinical trials in orthodontics evaluating commercially marketed products. Associations between marketed/non-marketed products and study characteristics such as direction of effect, declaration of conflict of interest and industry sponsorship were evaluated. In addition, within the marketed products associations between direction of effect and study characteristics were explored.

MATERIAL AND METHODS

Electronic searching of a single database (Medline via PubMed) was undertaken to identify Randomized controlled trials (RCTs) published over a 5-year period (1st January 2017 to 31st December 2021). Descriptive statistics and associations between trial characteristics were explored.

RESULTS

196 RCTs were analysed. RCTs were frequently published in Angle Orthodontist (18.4%), American Journal of Orthodontics and Dentofacial Orthopedics (14.8%) and European Journal of Orthodontics (13.3%). 65.3% (128/196) of trials assessed marketed products after their introduction. The majority of trials assessed interventions to improve treatment efficiency (33.7%). Growth modification appliances were typically analysed in non-marketed compared to marketed products. An association between the type of product (marketed vs non-marketed) and both the declaration of conflict of interest and industry sponsorship was detected. For individual RCTs assessing marketed products either a positive effect (45.3%) or equivalence between interventions or between intervention and untreated control (47.7%) was evident. In 27% of these trials either no conflict of interest or industry funding was not clearly declared. Within the marketed products, no association between the direction of the effect and conflict of interest or funding was detected.

CONCLUSIONS

The analysis of marketed orthodontic products after their introduction is still common practice. To reduce research waste, collaboration prior to the licensing and marketing of orthodontic products between researchers, industry and manufacturers is recommended.

Orthodontics social media, perceptions of science- and non-science-based posts among orthodontists, dentists, students and laypeople

Worldwide, social media is gaining popularity year after year. In Brazil, by 2027, there will be more than 188 million users of social media sites, against 165 million in 2022, therefore, the usage of general population and health care professionals, including orthodontists, is increasing. Differently from scientific journals that undergo a rigorous peer review process prior to publication, the same level of demand is not found on social media. Hence, this study aimed to assess whether orthodontists can recognize scientifically based and non-science-based posts and if their perceptions are different from general opinion (laypeople), dentistry students, and dentists (non-orthodontists). The posts were created using the search tool on Instagram with the hashtags #clearaligners #acceledent #selfligatingbraces and #propelorthodontics, four scientific based posts and four without or with low scientific evidence were selected and evaluated through a virtual questionnaire in the QUALTRICS platform by 385 people, (175 laypeople, 102 dentists, 58 dentistry students, and 50 orthodontists) using a visual analogue scale (VAS). In addition, four questions were asked. ANOVA (Adjusted Bonferroni correction) and Pearson's chi-squared, and Student T tests were applied to identify statistical differences. Significant difference was found only for posts with no scientific evidence between orthodontist's group when comparing with laypeople (p < 0.001) for the #selfligatingbraces, and the #propelorthodontics for the group orthodontists when compared with laypeople (p = 0.031) and dentists (p = 0.033). Instagram was the favorite social media where most of the participants spend more than 3 h. Of the participants, 97% used social media to keep informed and read the news. Almost half of the respondents search for orthodontics services on social media. Orthodontists were able to perceive differences in only two posts from the general perception (laypeople) regarding non- or low-scientific-evidence posts.

The quality and content of websites in the UK advertising aligner therapy: are standards being met?

Aims To evaluate the quality of information and compliance with General Dental Council (GDC) ethical advertising guidelines for English-language orthodontic websites providing orthodontic treatment with aligners in the United Kingdom (UK).Materials and methods The term 'orthodontic aligners or braces' was entered into the Google online search engine. The first 100 English language orthodontic websites (practice or company) were pooled. Both the quality (DISCERN instrument) and compliance with GDC ethical advertising guidelines were assessed. Frequency distributions and the overall summative DISCERN score for each website were calculated.Results The overall mean DISCERN score was 42.9 (SD = 9.4). The quality of information was only rated as good-excellent for 16% of websites and only 11% of websites showed full compliance with GDC guidelines on ethical advertising. A link to the GDC/authority website (75%), the date when the website was last updated (72%), and the practice complaints policy (66%) were not commonly provided. The country of qualification, a statement of whether practices provide NHS or private treatment or a combination of both, and the date when the website was last updated, were significant predictors for the overall quality based on DISCERN score.Conclusions The quality of information provided on websites providing aligner therapy and their compliance with GDC guidelines on ethical advertising was suboptimal. An improvement in both areas is required.

The nature and accuracy of Instagram posts concerning marketed orthodontic products: A cross-sectional analysis

OBJECTIVES

To scrutinize claims contained within Instagram posts related to six popular marketed orthodontic products.

MATERIALS AND METHODS

Three hundred publicly available Instagram posts were identified using the following Instagram hashtags: #carrieremotion, #damonbraces, #invisalign, #acceledent, #propelorthodontics, and #myobrace. Pilot coding was undertaken on a subset of claims (n = 50) and a coding guide was developed. The associated claims were categorized under 24 recognized themes and their accuracy assessed on a five-point scale.

RESULTS

Of 1730 posts screened, 300 were included for analysis. The majority of posts were based on photographs (n = 244, 81.3%) with the remainder (n = 56, 18.7%) including videos. Half of the posts involved a picture of the product in isolation (n = 150, 50%), with clinical cases presented in a minority (n = 99, 33%). Overall, 472 claims were included with treatment duration being the most frequent theme (n = 125, 26.5%). In terms of accuracy, most of the claims were judged to be "false" (n = 283, 60%) with less than 2% considered "objectively true."

CONCLUSIONS

Most of the claims relating to six popular marketed orthodontic products concerned treatment duration. The vast majority of these claims were not supported by evidence and were judged to be false. Efforts should be made to promote the provision of accurate orthodontic information and to verify marketing claims on social media platforms.