title: The design and content of orthodontic practise websites in the UK is suboptimal and does not correlate with search ranking.
abstract: OBJECTIVE
  This study investigated standards of ethical advertising; design and content; and information quality associated with UK dental practice websites offering orthodontic treatment.
  
  
  METHODS
  The World Wide Web was searched from a UK-based computer using the Google search engine combined with the term 'orthodontic braces'. The first 100 UK-based dental practice websites were pooled and saved following duplicate removal. Websites were evaluated for compliance with current General Dental Council ethical advertising guidelines; accessibility, usability, and reliability using the LIDA instrument (a validated outcome tool for healthcare website design and content evaluation); and quality of information using the DISCERN toolkit (a validated method of quality assessment for online written patient information).
  
  
  RESULTS
  Nine per cent of websites demonstrated full compliance with current guidelines on ethical advertising. Mean total LIDA score was 110/144 (76%) [range: 51-135; 35-94%]. Eleven websites reached a gold standard of 90% or more for total LIDA score. Mean total DISCERN score was 48/75 (64%) [range: 19-73; 25-97%]. Five websites achieved a total DISCERN score above 90%. Spearman's rank correlation coefficients demonstrated no significant correlations between LIDA (0.1669; P = 0.4252, confidence interval [CI]: -0.2560 to 0.5362) or DISCERN (0.3572; P = 0.0796, CI: -0.0565 to 0.663) score and ranking amongst the 25 highest ranked websites.
  
  
  CONCLUSIONS
  Most UK websites offering orthodontic services are not fully compliant with national guidelines relating to ethical advertising. Validated measures of website design (LIDA) and information quality (DISCERN) showed wide variation amongst sites. No correlation existed between ranking amongst the highest 25 sites and either of these measures.
  
  
  CONCLUSIONS
  This investigation was limited to a subsample of UK-only websites; and whilst not representative of European-wide sites, it does suggest that in the UK at least website quality can be improved.
authors.affiliation: *Orthodontics and.
authors.forename: Annika
authors.initials: A
authors.lastname: Patel
authors.affiliation: **Orthodontics and Craniofacial Development, King's College London Dental Institute, London, UK martyn.cobourne@kcl.ac.uk.
authors.forename: Martyn T
authors.initials: MT
authors.lastname: Cobourne
mesh_terms: D022126:Access to Information; D000329:Advertising / Q000941:ethics / Q000592:standards; D057189:Checklist; D004990:Ethics, Dental; D019983:Guideline Adherence; D006801:Humans; D020407:Internet / Q000592:standards*; D009970:Orthodontics / Q000941:ethics / Q000592:standards; D017410:Practice Guidelines as Topic; D015203:Reproducibility of Results; D057386:Search Engine; D006113:United Kingdom