Before-and-after photos and testimonials: what the board allows and what AI can reuse
A smile gallery is the most persuasive page on many dental sites, and also the one most likely to break three sets of rules at once.
A dental practice may publish before and after photos and patient testimonials, but state boards set conditions on both, the FTC bans fake and suppressed reviews, and a recognizable patient photo can itself be protected health information. For AI visibility, what matters is also narrower than most practices assume: a system that reads text gets almost nothing from an unlabeled image, and a great deal from an accurate caption.
Before and after photos
California is the most specific. Section 651 of the Business and Professions Code requires a patient's before and after views to state "in a prominent location in easily readable type size what procedures were performed," and requires the views to "be comparable in presentation so that the results are not distorted by favorable poses, lighting, or other features of presentation," and to "contain a statement that the same 'before' and 'after' results may not occur for all patients." Brighter light on the after shot or a new angle fails that test, and the same section separately treats any image "altered in any manner" from the actual patient as misleading, so a filter on the smile is out.
Privacy comes before any of that. The ADA's marketing and advertising guidance notes that "a photo or video of a patient, even just sitting in the waiting area, may constitute PHI." A smile close up that shows a face needs the patient's written authorization, and that authorization should cover the website and every place the photo will be reposted.
Testimonials
New York's professional conduct rule, 8 NYCRR 29.1, permits testimonials and portrayals only under conditions, the first being that "the patient or client expressly authorizes the portrayal in writing." California's section 651 treats a claim as misleading when it fails to disclose material facts, which is how a testimonial that describes an unusual result as a typical one becomes a problem.
At the federal level the FTC's rule on consumer reviews and testimonials covers fake or false reviews, buying reviews, insider reviews by staff and relatives, company controlled review sites, and review suppression. A testimonial page built only from the happiest patients, with the rest quietly withheld from a review platform, is the pattern this rule was written for.
What a text-reading system can take from a gallery
An assistant that answers in words mostly works from words. A gallery of forty images named IMG_4471.jpg tells it very little. The same gallery with a caption per case, in text, tells it a lot: "Six porcelain veneers on the upper front teeth, placed by Dr. Lee, general dentist. Photos taken under the same lighting. Results vary between patients." That caption also happens to satisfy the California disclosure and the general dentist notation some states require, which is the point: the version that is compliant is also the version that can be quoted accurately.
We make no claim about how any assistant interprets image content itself; none of them document it for this purpose.
Reviews on your own site
Many practices copy their best reviews onto the homepage and add rating markup. Google's review snippet documentation supports review stars for local businesses only on sites "that capture reviews about other local businesses," so a practice marking up praise for itself is not eligible. Republishing a patient's review also raises the consent and privacy questions above, since the practice is now the publisher. Link to the independent platforms instead, and let the reviews live where the patient wrote them.
What to do
- Audit the gallery: written authorization on file for every identifiable patient, comparable photos, and the variability statement where your state requires it.
- Add a text caption to every case: the procedure, who performed it with the right designation, and the conditions.
- Remove review rating markup about the practice itself, and any testimonial without a signed authorization.
- Ask for reviews from every patient in the same way, never only from the happy ones.
Review replies carry their own risk, covered in replying to reviews without a HIPAA violation. The full list is on the AI visibility guide for dental practices.
Not dental, legal or medical advice. This describes how AI systems can read a dental practice in public; your state dental board and your own counsel set the rules for your practice.
Questions
What must a California dental before and after photo include?
Under California Business and Professions Code section 651, an advertisement using before and after images must be comparable in presentation so results are not distorted by favorable poses, lighting or other features, and must state that the same before and after results may not occur for all patients. Altered images, and photos of models without a prominent statement that they are models, are also treated as misleading.
Can a dental practice put its patient reviews on its own website with star ratings?
It can publish them, subject to consent and privacy rules, but Google's review snippet documentation supports local business review stars only for sites that capture reviews about other local businesses. A practice marking up reviews of itself is not eligible for review stars on those pages.
More questions from dentists
This page is part of AI visibility for dentists, the AIOInsights guide to how AI systems find, read and describe this kind of practice.
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