A new South Carolina law buried a requirement that's reshaping how teledentistry businesses can operate.
Most health service owners offering teledentistry in South Carolina don't realize they're now operating under a mandate that could fundamentally change their business model. South Carolina Bill S0453 contains a provision requiring an in-person, physical examination of every patient before any teledentistry treatment can be delivered—a rule that takes effect upon the Governor's approval.
Section 40-15-520 of S0453 establishes a straightforward but consequential requirement: before a dentist or dental provider can treat a patient remotely—whether through video consultation, digital imaging review, or any other teledentistry service—that patient must first be examined in person.
This applies to all teledentistry services, including orthodontic treatment plans, initial diagnoses, follow-up care, and treatment adjustments delivered remotely. The law does not carve out exceptions for established patients, follow-up visits, or specific types of treatment.
The requirement impacts several categories of health service providers:
Direct-to-consumer teledentistry platforms that operate without physical locations or in-network dental offices must now establish a way to conduct initial in-person exams—either by opening a brick-and-mortar facility, partnering with local dental practices for referrals, or using mobile examination services.
Dental practices offering remote consultations already have in-person infrastructure, so compliance is typically straightforward: conduct the exam, then deliver remote services.
Orthodontic services, including direct-to-consumer aligners, fall under this requirement if they operate as teledentistry providers in South Carolina.
Purely remote business models—where a patient never visits a physical location—are effectively prohibited under this law.
If you operate a teledentistry service in South Carolina, you now have three practical options:
First, establish or maintain a physical examination location where patients can be seen before remote treatment begins. This requires space, staffing, and scheduling infrastructure.
Second, formalize referral arrangements with licensed dental practices in your service area. Patients would visit a partner practice for the required in-person exam, then return to your teledentistry platform for treatment.
Third, discontinue teledentistry services in South Carolina and operate only as an in-person practice.
The law eliminates the option of operating a purely remote service without any in-person examination component.
The provision takes effect upon approval by the Governor. Providers should verify the current status of S0453 and plan compliance accordingly, as the in-person exam requirement will apply to all new teledentistry relationships formed after the law's effective date.
If you operate a health service offering teledentistry in South Carolina, reviewing your current business structure against Section 40-15-520 is advisable. A detailed, business-specific summary of this provision is available to help you assess compliance requirements for your practice.