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Quality and reliability of clear aligner information on Brazilian orthodontists' websites: a DISCERN-based evaluation
Mohamad Jamal Bark1, Gil Guilherme Gasparello1,2, Rosilene Andrea Machado1
1Pontifícia Universidade Católica do Paraná, School of Medicine and Life Sciences (Curitiba/PR, Brazil).
Objective:
This study aimed to evaluate, using the DISCERN questionnaire, the quality, reliability, and decision-support capacity of aligner-related information published on orthodontists' websites.
Methods:
A cross-sectional study was conducted in July 2024. Google (www.google.com.br) was searched using Portuguese-language keywords ("tratamento ortodôntico", "alinhadores", and "ortodontia") in incognito mode from a Brazilian IP address. The first 130 non-sponsored websites were screened; 113 met the inclusion criteria. Two calibrated orthodontists independently evaluated each website using the validated Brazilian Portuguese version of the DISCERN instrument. Inter-rater reliability was assessed using the Intraclass Correlation Coefficient (ICC). Descriptive statistics and Spearman rank-order correlations were calculated using SPSS v.25.
Results:
The mean overall DISCERN score was 26.3 (SD = 5.8; range 15-52) out of a maximum of 75. The ICC was 0.87 (95% CI = 0.82-0.91), indicating good-to-excellent inter-rater reliability. Among the 113 websites, 54.3% were rated as very poor, 30.7% as poor, 11.5% as fair, 3.5% as good, and none as excellent. The lowest-scoring items were Q4 (sources of information, 99.1% very poor or poor), Q5 (publication date, 87.6%), Q8 (areas of uncertainty, 95.6%), Q11 (treatment risks, 98.2%), and Q12 (consequences of no treatment, 100%).
Conclusions:
The quality of clear aligner information on Brazilian orthodontists' websites is critically poor. Orthodontists should provide evidence-based, transparent, and balanced content - including treatment risks, alternatives, and references - to support informed patient decision-making.