Before and after photos are the backbone of cosmetic dental marketing everywhere else in the world. In Canada they are one of the least clearly documented areas of dental advertising, and the honest starting point for this article is an admission rather than a rule.
What governs the question instead is Ontario’s dental advertising provisions, which were written about claims rather than images.
Can Canadian dentists post before and after photos?
The Ontario advertising advisory does not address photographs at all. We looked specifically. The RCDSO Practice Advisory on Professional Advertising sets out a detailed list of what a dentist must not include in advertising material, and images are not on it, in either direction. No permission, no prohibition.
That means anyone telling you Ontario flatly bans before and after photographs is asserting something the advisory does not say, and anyone telling you they are simply fine is doing the same in the other direction. What actually applies are the general provisions, which were written about claims and reach images through their effect rather than their form.
Dentistry is regulated provincially, and one province does address photographs directly. Manitoba is the only jurisdiction in Canada we have found with an on-point clinical photograph rule, and it is covered below. Everywhere else the question is answered by the general provisions.
Why is a clinical image comparison restricted at all?
Because of what a comparison implicitly claims. Ontario Regulation 853/93, section 2, paragraph 60 makes it professional misconduct to publish advertising that is “likely to create expectations of favourable results”. A pair of images showing a poor starting point and an excellent outcome is, functionally, a statement about what a patient can expect.
The same paragraph prohibits advertising that “makes comparisons with another practice or member or would be reasonably regarded as suggestive of uniqueness or superiority”, and information that is “false, misleading, fraudulent, deceptive, ambiguous or confusing or likely to mislead or deceive the public because, in context, it makes only partial disclosure of relevant facts”.
That last clause is the one that catches most galleries. A gallery of exceptional outcomes, with no indication of how typical they are, how long treatment took, what it cost or who is a suitable candidate, is making only partial disclosure of relevant facts.
The image itself asserts almost nothing. What surrounds it does the claiming. The same clinical photograph can sit inside a compliant educational page or a non-compliant promotional one depending entirely on the caption, the heading and the promise attached. That is why there is no simple yes or no answer here.
What makes a before and after presentation more defensible?
These are risk-reduction measures drawn from the provisions above, not a safe harbour. There is no published Ontario checklist for this.
- Frame it as education, not proof. A page explaining what a treatment does, illustrated with a real case, is a different thing from a results gallery headed “see what we can do for you”.
- Disclose the relevant facts. What the treatment was, roughly how long it took, how many appointments, and what the patient’s starting situation was. This directly addresses the partial-disclosure clause.
- Say plainly that results vary. Individual outcomes depend on the starting point and on suitability. This is the single cheapest mitigation against the expectations clause.
- Avoid superlative or emotional captioning. “Life changing”, “stunning transformation”, “incredible result” convert a clinical image into a claim about feelings and outcomes.
- Do not pair the images with a promotional offer. Combining an outcome demonstration with an incentive compounds two separate problems.
- Keep it representative. A gallery composed only of exceptional cases is arguably misleading by selection even where each individual image is accurate.
Which province actually has a photograph rule?
Manitoba, and only Manitoba. The Manitoba Dental Association Code of Ethics states that “any use of clinical photographs must identify the clinician and/or publication who provided the service”, and that dentists “must also ensure that such information does not give rise to unreasonable expectations for the purpose of inducing the public to utilize the services of any sponsoring dentist.”
Two obligations there, and the first is unusual anywhere in the world: attribution. If the case was not treated by the dentist whose advertising it appears in, the photograph must say who did treat it. Stock clinical imagery, or a case treated by a former associate, presented without attribution, is caught by that clause on its face.
The second obligation, not creating unreasonable expectations, is the same standard the other provinces reach through their general provisions.
One caution on this source. The only date printed on that Code of Ethics is from 2002, and Manitoba’s health professions are migrating to a new regulatory framework. We have not been able to confirm whether a newer advertising bylaw has replaced it. Treat the attribution rule as a live risk to design around rather than as settled current law, and confirm with the Association if you practise there.
How strict are the other provinces?
No province among Ontario, British Columbia, Alberta, Quebec, Saskatchewan, Nova Scotia and New Brunswick has an explicit clinical photograph provision. That is a verified absence rather than a gap in searching. What differs is how much the general provisions catch.
- Nova Scotia is effectively strictest. Its standard requires that advertising “not refer to the quality of service to be provided” at all, which reaches an outcome gallery more directly than a rule about images would.
- Quebec is close behind. Advertising may contain only information “susceptible to help the public make an informed choice”, and all comparative advertising is prohibited outright with no exception.
- Saskatchewan prohibits “suggestions of better results or unjustified expectations”.
- British Columbia and Alberta have no applicable college rule at all. General misleading-advertising law and the Competition Act still apply, so no college rule is not the same as no rule.
The practical consequence for anyone advertising across provincial lines is that Manitoba’s attribution requirement and Nova Scotia’s quality-claim prohibition together set the ceiling. A gallery built to satisfy both will satisfy everywhere. The full province-by-province comparison is here.
What consent is needed to use dental patient photos?
This is a separate obligation from advertising, and it is the one with the clearer answer.
Clinical photographs of an identifiable patient are personal health information. Using them for marketing is not the provision of health care, and guidance for regulated health professionals is explicit that “express consent from the client must be obtained for all marketing and market research activities”.
Practical implications most practices have not covered:
- Consent for treatment records is not consent for advertising. They are different purposes and need separate, express agreement.
- Consent should identify where the images will appear. Website, social media, paid advertising and print are different exposures.
- Consent can be withdrawn, which means you need a way to find and remove a specific patient’s images afterwards.
- Cropping to the mouth does not reliably de-identify. Combined with other page context it often still identifies.
Clinical images are patient records before they are marketing assets, which drags in a whole separate set of obligations about how patient information is handled.
Do the rules apply to social media?
Yes. The RCDSO defines a professional advertisement as material related to your practice published, displayed, distributed or used “regardless of the form or the manner of distribution”, and lists websites among the examples. Nothing in that language exempts a social platform, and nothing exempts content posted by a team member rather than the dentist, because the definition covers material published “by someone on your behalf”.
A results post on Instagram is advertising. So is a story, so is a reel, and so is a photo an associate posts from their own account about work done at your practice.
This constraint bites hardest in cosmetic dentistry marketing, where visual proof is the natural language of the work and the alternatives are less obvious.
What should a cosmetic practice do instead?
Cosmetic and orthodontic practices feel this constraint most, because visual proof is the natural language of the work. Three approaches that do not depend on outcome galleries:
- Show the process rather than the result. What a smile design consultation involves, how a wax-up or digital preview works, what the appointments are. This is informative, verifiable, and it answers what a hesitant patient is actually anxious about.
- Explain candidacy honestly. Who a treatment suits, who it does not, and what the alternatives are. Very few competitors will do this, and it builds more trust than a gallery.
- Compete on being found and being responsive. No advertising rule restricts ranking well for the treatments you provide, or answering the phone quickly.
Where this article could not verify a rule, it has said so. Before building any campaign around clinical imagery, put your specific proposal to your college. The RCDSO advisory states the College “will offer advice about any proposed advertisement” and provides a contact address for the purpose, which is a better answer than any agency’s opinion including ours. The full picture of what the regulation does say is set out in the advertising regulation that governs your licence, and the closely related restriction on patient statements is in the testimonials guide.
There is a version of this constraint that is genuinely freeing. A gallery invites a patient to compare themselves to a stranger’s mouth and decide whether they qualify. An honest explanation of candidacy invites them to ask. The second conversation starts from a better place, and it is available to any practice willing to write it, which is where we would start.
This article describes advertising and privacy rules as they applied on the review date shown. Regulations change and vary by province. This is general information, not legal advice. Confirm anything you intend to rely on with your own regulatory college.
Speak to a dental marketing specialist