Dental practices send a lot of SMS: booking confirmations, reminders, recall messages, reactivation campaigns and the occasional promotion. Most of it is perfectly legal. But the Spam Act 2003 applies to commercial electronic messages, and the line between a factual reminder and a marketing message is easier to cross than many practices realise.
The Australian Communications and Media Authority (ACMA) enforces the Spam Act and has taken action against businesses that wrongly treated messages as "factual" or "transactional". This guide explains the rules in plain English for dental practices.
This article is general information, not legal advice. Check ACMA's guidance and get advice for your specific messages.
Key takeaways
- The Spam Act applies to commercial electronic messages, including SMS and email.
- A message is commercial if one of its purposes is to promote goods or services, even if that isn't the main purpose.
- Purely factual messages, such as a plain appointment reminder, are generally outside the commercial message rules.
- Adding a promotion to a reminder can make it commercial.
- Commercial messages need consent, must identify the sender and must include a working unsubscribe, honoured within 5 business days.
What counts as a commercial message?
Under the Spam Act, a commercial electronic message is one where a purpose, or one of the purposes, is to offer or promote goods or services. ACMA looks at the content, how it's presented and any links, not just the label the business gives it.
So a message that's mainly a reminder but also says "Book a teeth whitening session this month and save 20%" has a promotional purpose. That can make the whole message commercial.
How common dental messages compare
Usually factual
- Booking confirmations: date, time, clinician, address
- Appointment reminders with a confirm or reschedule option
- Running-late or cancellation notices from the practice
- Account or payment information about services already provided
These are about care the patient has already arranged. Keep them free of promotional content.
Grey areas
- Recall messages. A message saying a patient is due for their check-up relates to their ongoing care, but it also invites them to buy a service. Many practices treat recall as part of the patient relationship. The safer course is to make sure you have consent and include an easy opt-out.
- Reactivation messages to patients you haven't seen in years. These are closer to marketing. Treat them as commercial.
Commercial
- Promotions, offers and discounts
- New service announcements, such as "We now offer clear aligners"
- Newsletters with promotional content
- Referral programs
These need consent, identification and an unsubscribe.
The three rules for commercial messages
1. Consent
You need the recipient's consent, either:
- Express consent: the patient actively agreed to receive marketing, for example by ticking an unticked box on your new-patient form, or
- Inferred consent: in limited circumstances, from an existing relationship where the patient would reasonably expect the messages. Relying on inferred consent is riskier, so express consent is better.
Keep records of when and how each patient consented.
2. Identify the sender
Each commercial message must clearly identify your practice as the sender and include accurate contact details.
3. Unsubscribe
Every commercial message needs a functional unsubscribe option, such as "Reply STOP to opt out". Requests must be honoured within 5 business days, and patients mustn't be asked to log in, create an account or pay to unsubscribe.
Practical rules for your practice
- Separate reminders from marketing. Keep reminders and confirmations purely factual. Send promotions as separate messages, only to patients who've consented.
- Get express consent for marketing on your new-patient form, with a clear opt-in that's not pre-ticked.
- Record consent and opt-outs in your practice software.
- Include "Reply STOP to opt out" on all recall, reactivation and promotional messages.
- Respect opt-outs across systems, so an unsubscribe in your SMS tool also stops messages from your AI agent and email platform.
- Watch the wording. Ahpra's advertising rules also apply to promotional health messages. See Ahpra advertising rules and AI chatbots.
What about AI-generated messages?
The same rules apply, whether a person writes the message or an AI system generates it. If you use AI to send recall, reactivation or follow-up messages, make sure:
- Templates are reviewed and kept factual where intended
- Commercial messages include sender identification and an unsubscribe
- The system checks consent and opt-out status before sending
Example messages
Factual reminder:
"Hi Sam, a reminder of your appointment with Dr Chen at Harbourside Dental on Tue 14 May at 9:20am. Reply Y to confirm or call 02 XXXX XXXX to change."
Recall with opt-out:
"Hi Sam, it's Harbourside Dental. You're due for your check-up with Dr Chen. Book online: [link]. Reply STOP to opt out."
What to avoid in a reminder:
"Hi Sam, see you Tuesday at 9:20! PS: 20% off whitening this month!"
Frequently asked questions
Do appointment reminders need an unsubscribe?
Purely factual reminders are generally not commercial messages, so the unsubscribe requirement for commercial messages doesn't apply. But adding promotional content changes that. Many practices still let patients choose how they're reminded.
Can we text patients about a new service?
Yes, if they've consented to marketing messages, the message identifies the practice and it includes an unsubscribe.
What are the penalties?
ACMA can issue formal warnings, accept enforceable undertakings and issue infringement notices, and courts can impose significant penalties. Recent enforcement has involved large businesses, but the rules apply to every sender.
Next steps
Review your SMS templates this week and remove any promotional add-ons from reminders. Read our guides on reminder timing and patient reactivation for compliant wording.