As an Invisalign provider, it’s been alarming for us to see that there are now direct-to-consumer models of clear aligner treatments being sold online. I guess that’s what you can expect when the original patents inevitably run out! Some of the newer clear aligner systems may be similar to the original, but I would warn patients strongly against using any products that come to you through the mail without an exam and ongoing monitoring from a dentist. There are several things that can wrong in this scenario!
1 – Direct-to-Consumer Aligners are Based on Home Impression Kits
Taking a dental impression may seem so easy that even a child can do it, but I promise you there is a benefit to having an experienced provider complete the process. Home impression kits completed by patients may have flaws that a non-dental professional would never notice. This can disrupt the possibility of creating aligners that work properly.
2 – No Face-to-Face Consultation Means Oral Health Issues May Be Missed
At every six-month visit, your doctor completes an oral health exam to look for signs of gum disease and tooth decay that may not be visible to the naked eye. When you skip a consultation with a dentist before you start aligner treatments, you put yourself at risk of a minor problem turning into a major one! When you wear aligners, problems can escalate because your teeth do not receive the benefits of regular contact with saliva. Without saliva, bacteria may proliferate, cavities may develop, and gum disease may develop.
3 – Impressions are Not the Full Picture
Impressions are not the only thing that must be considered when assessing how and where the teeth should move. The underlying bone that supports the teeth needs to be strong enough to withstand orthodontic treatment; individual differences in bone density may affect your candidacy for treatment.
4 – Mid-Course Corrections are Not Possible
Possibly the most significant concern about direct-to-consumer aligners is the fact that you have no one to monitor your progress. Unless you are a dentist, you cannot tell on your own whether your alignment changes at three months are going to lead to the results you seek. Some aligner “clubs” claim to offer mid-course corrections. However, without a dentist to explain things to you, how can you be sure they will be effective?
5 – Oral Hygiene Issues May Escalate
This may not apply to all the responsible adults out there who have excellent oral hygiene and brush and floss their teeth thoroughly before wearing their aligners. However, we can’t always count on children and teens to do a great job, especially when they have to fit brushing into a busy day at school. Regular visits to the dentist during treatment help us check for signs that oral hygiene routines may need targeted sharpening.
6 – Buyer Beware
Without naming any names, if you look online at consumer reports and Yelp reviews, you will find a ton of horror stories from patients whose aligners-by-mail situation turned into a fiasco. Some stories are customer service nightmares, and some report bad changes to their tooth alignment during treatment—or aligners that don’t fit well. Overall, even if the aligners work, there are too many things that can go wrong when you don’t have a face-to-face relationship with a provider you trust.
Only a Dentist Can Monitor Ortho Treatments
While it may be tempting to opt for a less-expensive dentist-free course of aligner treatments, there are too many factors that are left to fate. At best, you might end up with slightly straighter teeth, but at worst you could end up with worse misalignment or advanced oral health problems. If the cost of Invisalign is prohibitive, you may want to consider traditional braces or looking into financing programs like CareCredit! About the Author: Dr. Mickiewicz owns a private practice in Sacramento and lectures across the nation on TMD treatments. He is a diplomate of the American Academy of Pain Management and holds membership in many professional associations for dentistry, sleep medicine, and TMD. In addition, Dr. Mick, as his patients call him, founded Pacific Orofacial Pain Consultants, a team of experts in various disciplines, who tackle the issue of TMD pain and treatment, to help sufferers find relief from chronic pain. To talk with Dr. Mick, call his Sacramento dental office at 916-469-9178.