HB4070

HB4070 requires patient examinations, diagnostic review, a prescription and counseling before covered orthodontic devices are sold or related design/manufacturing services are provided to Texas patients. The covered devices are individually manufactured FDA class II or III devices used to move teeth or jaws or correct their alignment. Retainers used to keep teeth in a fixed position are excluded. The bill became law without the governor’s signature June 20, 2025, and applies to sales and services on or after September 1, 2025; earlier transactions remain under prior law. Final act · History

Before the sale or service, the patient must receive an in-person examination inside the mouth and of the head and neck; a dentist’s review of recent, appropriate diagnostic imaging; and review of medical and dental histories. Imaging must be sufficient to detect conditions that make treatment unsafe, including untreated decay, gum disease, tooth-root problems, implants or other fixed appliances, and cracked teeth or roots. The act permits several appropriate imaging methods; it does not require every listed scan for every patient or specify a universal number of months for “recent.” Section 431.024(c)

The prescription must come from the dentist who examined the patient and reviewed the imaging, or the treating/monitoring dentist who received a referral or obtained and retained clearance from that examining dentist. A prescribing dentist must explain treatment options and risks, and the patient must sign a written acknowledgment kept in the patient’s file. A seller or design/manufacturing service provider must be a Texas-licensed dentist who provided the required services or receive written/electronic confirmation from such a dentist. The law does not prohibit all remote follow-up care; it requires these prerequisites. Section 431.024(b)–(d)

Sellers and service providers must keep documents received under the prerequisite provisions for at least seven years after the sale or service. Dentists cannot condition the examination or imaging review on agreement to use a particular device type. The examining dentist must provide collected exam/imaging records to a requesting dentist when disclosure is authorized, under the existing dental-record rules. Those rules generally require disclosure within a reasonable time, no later than 30 days or a court-ordered date, while retaining confidentiality, the specified harm-based refusal process, redaction and reasonable-fee provisions. Section 431.024(e)–(g) · Occupations Code 258.109