Sir, traditionally, dentists might have advertised their practices in the local paper, Yellow Pages or using flyers, but with an ever-growing online platform and around one million new internet users every single day worldwide1 as well as the emergence of social media in the form of Facebook and Instagram, online-marketing has become the new cornerstone of dental advertising. Irrespective of the channel utilised to promote dental services, the UK has strict regulations in place when it comes to advertising. According to the Dental Defence Union, dental professionals are obligated to 'advertise in accordance with standards set out by the Advertising Standards Authority (ASA) and the Committee of Advertising Practice (CAP)'.2 Additionally, any promotional content published needs to comply with the General Dental Council's guidance on ethical advertisement.3

In modern dentistry, many patients no longer only seek treatment of disease but rather improvements of aesthetics,4 and many are seeing cosmetic dentists to obtain their dream smile. A 2019 survey showed that 43% of UK respondents were looking to improve their smile using cosmetic procedures such as whitening, veneers or Invisalign.5 The promotion of such dental services, also known as dental advertising, is the key to success for many dental practices and practitioners to obtain their share of the profit from an industry worth around £3.6 billion per year in the UK.6 Advertising on social platforms has become increasingly popular and offers the advantage of being able to reach a wider audience as well as targeting specific groups of people. In 2018, Parmar et al found that more than 55% of dentists have a social media presence related to their dental practice,7 used to promote their work and create a following. Considering that the pandemic has led to screen-time increases of several hours per day across all age groups,8 social media presence is becoming more and more important to promote brands and services including dental and facial aesthetic treatments such as Botox and dermal fillers. Many posts are now sponsored meaning that healthcare professionals will promote and endorse certain products in return for a financial reward. This practice clearly raises numerous ethical issues which have been explored in detail.

The commercialisation of oral healthcare seen in recent years has started to blur the lines when it comes to ethical advertising, particularly in the field of cosmetic dentistry. It is of utmost importance to uphold advertising standards as dentists become more and more business-focused. Advertising has the potential to shift social norms with respect to dental appearance and concerns have been raised whether ethical and professional standards can be upheld. As a profession we are now standing at the crossroads; our actions or inactions at this point with regards to the promotion of the so-called 'perfect smile' will pave the path for the future of dentistry and what it stands for within society. We need to take a stronger stance and advise patients that aesthetic treatments may not necessarily be in their best interest and that a natural smile can be just as desirable as straight white teeth.