Evidence map›Paper›PMID 41755480›Full record

ArticleJournal of orthodontics2026

Advertising of orthodontic appliances on websites in the UK: Do they comply with advertising standards? A cross-sectional study.

Arunika Nehra, Adam Jones, Trevor Hodge

Abstract read
In one paragraph

Article in Journal of orthodontics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Arunika NehraGeneral Dental Practitioner, NHS, London, UK.
Adam JonesDepartment of Oral Surgery, University of Leeds, Leeds, UK.ORCID 0000-0001-5687-7571
Trevor HodgeDepartment of Orthodontics, Leeds Teaching Hospitals NHS Trust, Leeds, UK.ORCID 0000-0002-3581-4018

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimTo evaluate the compliance of websites promoting proprietary orthodontic appliances available in the UK against advertising standards outlined by the Advertising Standards Authority Committee of Advertising Practice (ASA CAP) Code.

designCross-sectional study.

settingWebsites promoting proprietary orthodontic appliances available in the UK, including fixed, removable and aligner systems sold as a complete system under a brand name.

methodsA comprehensive, systematic approach was adopted, beginning with a 2020 scoping search on Google and social media platforms (Instagram and Facebook) to identify keywords. Keyword searches were conducted on Google in 2020, 2023 and 2025 to identify relevant websites. To ensure contemporary relevance, only websites identified in the final 2025 search were included for analysis. Raters underwent training and calibration before independently evaluating websites for compliance with advertising standards using bespoke judgement criteria derived from the ASA CAP Code, across four domains: comprehensiveness of treatment information; presentation of treatment information; objectivity of treatment information; and substantiation of claims. Discrepancies were resolved through group discussion to determine agreed scores. Data were analysed using descriptive and inferential statistics (Fleiss' kappa and Kruskal-Wallis tests).

resultsThe 2025 search identified 970 websites, of which 39 met the inclusion criteria. Inter-rater reliability showed almost perfect agreement (kappa >0.9). Compliance varied significantly across domains: 45% of all claims provided comprehensive information, 54% had clear presentation, 38% maintained objectivity and only 4% of claims were substantiated with evidence. Nearly all websites (95%) omitted common risks and 92% failed to mention alternative treatments. Direct-to-consumer and tele-dentistry websites showed poorer compliance than dentist-delivered systems.

conclusionsOrthodontic appliance websites showed poor compliance with ASA CAP Code standards. The majority used descriptive language and words in place of numbers to quantify magnitude, alongside subjective content and unsubstantiated claims, with omissions of treatment risks. These findings raise significant concerns about online orthodontic advertising and its potential impact on informed patient decision-making.

Indexed as

AdvertisingGuideline AdherenceInternetOrthodontic AppliancesCross-Sectional StudiesHumansUnited Kingdomadvertisingalignersdirect-to-consumerorthodonticsquality of informationtele-dentistry

Identifiers

PMID41755480
PMCPMC12999987

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.