Before-and-after photos in dental advertising: what you can and can't show

The short answer

What the ASA requires

The ASA is the UK's independent advertising regulator. It enforces the CAP Code, the rulebook for non-broadcast ads, which covers your website and your own social accounts as well as paid ads.

On 9 May 2024 the ASA published a warning to dental advertisers. It said before-and-after images are treated in a similar way to testimonials, and that advertisers must hold "documentary evidence that the images are genuine", have permission to use them, and not "give a misleading impression about the effects likely to be achievable".¹ Its dental advice asks for "signed and dated proof" behind images that are "genuine and representative".⁴

The CAP Code rules behind this, in their current numbering:³

For the rest of the CAP Code as it applies to dentistry, see the CAP Code for dental practices. Patient reviews and written testimonials more generally are covered on the reviews and testimonials page.

Consent

Consent comes from the GDC's confidentiality standard, not only from advertising rules. Standard 4.2.9 says the duty of confidentiality "also covers recordings or images of patients such as photographs", and that you "must not make any recordings or images without the patient's permission".²

Standard 4.2.7 then sets out what to do if you want to use patient photographs "for any reason". You must explain how the images will be used, check the patient understands, "obtain and record the patients' consent", use the minimum necessary, and explain "that they can withdraw their permission at any time".²

Clinical photographs kept with a patient's record are also likely to be health data, a type of "special category" data under UK data protection law that needs stronger justification to use.⁷ Consent specific to marketing is the cleanest route.

A marketing consent form for images should cover:

• which images (identify them, do not rely on "photos taken during treatment")
• where they will appear: website, social media, paid ads, print
• whether the face or other identifying features will show
• how long you will use them
• how to withdraw consent, and what you will do when they do

Your indemnity provider may publish a template. The MDU and DDU both publish guidance on marketing and images; their pages were behind a security check when I reviewed this page, so I have not summarised them here. Ask your own indemnifier for its current wording.

Editing and filters

Do not edit anything that affects the result. Cropping to remove a background is fine; whitening the "after", smoothing gums, changing the lighting or adding a filter isn't.

The ASA's position on filters comes from beauty advertising and applies with full force to smiles. It found that filters "were likely to have exaggerated the efficacy of the products", and said "the responsibility ultimately lies with the advertiser".⁵ A caption saying "filter used" doesn't fix it. The ASA's dental advice specifically warns against exaggerating whitening results through "digital manipulation of imagery".⁴

Practical rules I apply:

• Same camera, lens, distance, angle and lighting for both shots.
• Same shade reference in both images where colour is the point.
• Keep the unedited originals with their file dates.
• No photos taken through a phone app's beauty mode, which can apply smoothing by default.

Typical results

The ASA's test is whether the images are "reasonably representative of the effects likely to be achieved by most consumers".¹ Your single best case of the year fails that test if most patients would not get close.

Ways to stay on the right side:

• Use cases that reflect your normal outcome for that treatment.
• Show the starting point honestly; a mild case next to a dramatic claim misleads.
• Say what was done: "six composite bonding restorations, one visit" gives the viewer context.
• Do not pair an image with words that promise the same for everyone. The GDC also bars claims likely "to create an unjustified expectation about the results you can achieve".⁸

How before-and-afters fit into treatment campaigns (which cases to choose, where they sit on a page) is a creative question covered in composite bonding marketing. This page stays on the rules.

Social media

Your own Instagram, Facebook and TikTok accounts are advertising when you use them to promote treatment, so the CAP Code applies to a before-and-after carousel on your profile just as it does to a paid ad.

Three extra points apply on social platforms:

1. The GDC's assessment wording. Promotions on social and marketing sites must make clear that treatment "may not be appropriate for every patient" and depends on "a satisfactory assessment".⁸ Put it in the caption.
2. Paid posts on Meta. Meta allows before-and-after images for cosmetic procedures only in ads targeted at people aged 18 or over.⁹ A boosted post counts as an ad.
3. Prescription-only medicines. The ASA says before-and-after photos of Botox results are prohibited, because they promote a prescription-only medicine to the public.⁶ That applies on every channel.

A pre-publication checklist

The claims a gallery supports fall under the CAP Code for dental practices, the natural next read. To have your gallery read against this list, email Fayez@imfayez.com; the first read is free.

Frequently asked questions

Can dentists post before and after photos on Instagram?

Yes, with the patient's recorded consent, proof the images are genuine, no editing that changes the result, and results that are typical. Promotional posts also need wording that treatment is subject to assessment.⁸¹

Is verbal consent enough?

The GDC requires you to "obtain and record" consent.² A signed form is the practical way to record it and to hold the "signed and dated proof" the ASA refers to.⁴

What if a patient withdraws consent?

The GDC says patients can withdraw permission "at any time".² Remove the images from your channels promptly and record what you removed and when. Printed material already distributed is a question for your indemnifier.

Can I use before-and-after photos supplied by an aligner or implant company?

Only if you can meet the same tests: evidence they are genuine, permission, and results typical of what your patients would get. Images of another clinician's work presented as your own would also mislead about your skills.

Next step

To have your gallery read against the checklist, email Fayez@imfayez.com.