Perception of Direct-to-Consumer Orthodontics in Saudi Arabia

Direct-to-consumer orthodontics (DTCO) has gained popularity in some countries as a convenient and affordable alternative to traditional care, especially with the rise of clear aligners. Despite increasing use, concerns remain regarding the lack of professional supervision. While DTCO trends have been examined in other countries, there is limited data on public perception in Saudi Arabia. This study aimed to assess interest in and preferences for DTCO versus conventional orthodontic treatment in Saudi Arabia.

A descriptive cross-sectional study was conducted among 507 adults aged 20 to 60 years across Saudi Arabia. A structured, self-administered questionnaire was used, consisting of demographic questions and 30 items that assessed the primary outcome variables: levels of awareness, perceptions, and preferences regarding direct-to-consumer orthodontics (DTCO) compared with traditional in-office orthodontic care. Convenience sampling was employed, and participants were recruited through social media platforms and direct outreach across various regions of Saudi Arabia. Data were analyzed using SPSS version 20, and chi-squared tests were applied for categorical variables.

Of the participants, 44% were familiar with clear aligners, but only 16% had heard of DTCO. Despite this, 70% expressed willingness to consider DTCO for themselves or their children. Convenience was identified as the main advantage, while key concerns included lack of supervision and uncertainty regarding treatment quality. Furthermore, 82% believed radiographs were essential for diagnosis, and 84% were aware of the risks of unsupervised treatment.

Although interest in DTCO continues to rise, limited awareness of its risks suggests that marketing influences patient decisions more strongly than clinical understanding. These findings highlight the need for improved patient education. While DTCO offers flexibility, the absence of professional oversight remains a major concern.

The findings indicate that although public awareness of direct-to-consumer orthodontics (DTCO) remains limited, there is considerable interest in utilizing such services, primarily driven by their perceived convenience and affordability. However, major concerns persist regarding treatment supervision, safety, and diagnostic accuracy. These findings emphasize the need for public education on the importance of professionally supervised orthodontic care and the potential complications associated with unsupervised treatment.