Things to consider before choosing direct-to-consumer ortho kits
As dentists, seeing more and more of those do-it-yourself dental straightening kits is worrying. When you don't have a dental professional keeping a close eye on your orthodontic case and the progress of your teeth movement, you may end up impacting the functional aspects of your smile/bite.
But let's backtrack a bit.
When we say talk about these "Home Ortho Kits" - we mean those ones where you take your own impression and send it to a company (Alternatively, they also have a network of dental professionals who can do the impression for you). They fabricate clear aligner trays and send them to you to wear regularly to shift your teeth. A "Remote Dentist" checks in on your progress every now and then. And before you know it, you have straighter teeth.
They're advertised as much more cost effective because it cuts out the 'middle man dentist'.
Sounds easy-peasy and actually a lot like Invisalign right? Well, yes and no. The clear plastic aligner trays are definitely similar and there's no doubt in our minds that aligner trays really can and do shift teeth. That's not the sketchy-sounding part of this business.
The risk lies in the interaction with the dentist - or lack thereof. We're not buying this whole "remote dentist thing". We dug into this topic a little more and it seems as though patients are asked to take selfies of their smiles to send to these dentists. We've had patients describe their conditions and ask for diagnoses and/or prescriptions over the phone and/or send us images of their 'problem tooth' via email. And our answer is always the same - they are recommended to come in for an examination by the dentist to see what's really up.
Why? We hate to be overly blunt, but sometimes the description isn't the most accurate - it could be something spun off the internet and totally different from what the patient actually presents with. Sometimes, miscommunications can happen - over the phone and in person - so it's safer to let the dentist do a direct assessment and go from there. And sometimes you just want the dentist to do treatment asap - especially if it is a dental emergency. So no phone diagnoses, just book an appointment.
Well, how about with teeth straightening - surely the problems that could arise aren't as bad? They could be - and without adequate monitoring, it could have greater consequences for you than initially believed.
Here are some of the things you should be aware of before ordering orthodontic appliances online:
Did you know that when we do orthodontic cases, our primary focus isn't 'getting you straight teeth'? That may be a shock to hear, but our number one priority is to make sure that after you get your braces off, you have full functionality of your bite. Straight teeth are just a happy side-effect, when you look at it from our point of view. So if you don't have someone monitoring you from beginning to end of braces treatment, you could be setting yourself up for a distorted and ineffective bite. And if that is the case, get this: you'd have to get more orthodontics to fix - preferably from a professional and likely at an additional cost. Our recommendation is to do it once with an expert in the field, invest a little more money to get it right (rather than choosing a mail-ordered orthodontics kit!) and never go through the braces process again. **It is important to do your research before committing to a treatment plan because even some orthodontists/dentists end up causing an open bite and/or other problems in their patients. Sometimes when we refer people out, patients respond with, "but my teeth aren't that crooked, I thought that braces would be easy!" Well, it's likely the doctor is seeing something that we're not seeing at face-value!
Not only can you end up with a wonky open bite, but you can also have a smile where only some of your teeth touch together. While this is in the same family of 'bite issues' - think to the future and what your biting forces will do to these isolated teeth. It can wear these teeth away quicker than if the force was distributed evenly between all your teeth.
Sometimes, the anatomy of your teeth can impede the movement of dental arches. If you see a real-life dentist, they can help you reshape that tooth (or teeth) if needed. With online aligners, you don't have that one-on-one interaction and the smile you're left with might not be the one you want.
You may be at higher risk for cavities, gum disease, etc when you're wearing trays. Left untreated, these can escalate to more serious problems like needing a root canal if a cavity isn't filled or losing teeth due to severe gum recession from periodontal disease. Therefore, if you take this route, it's still a very good idea to maintain routine checkups with your dentist.
If a tray doesn't fit, we can usually address the issue fairly quickly. Good luck with that with the direct-to-consumer trays (yes, we've even read some of the reviews online with customer support of these companies!)
Sometimes, to get your teeth to move as desired, we use buttons or attachments and other 'add-ons' to your trays. You just don't get that with online-ordered trays.
You could also end up affecting the temperomandibular joint without proper monitoring.
So, would you ask a random person off the street to fix your plumbing, then take a picture of what they did to send to an actual plumber to assess? Probably not because they likely don't have the know-how of the inner workings of your pipes to do an effective job. Not only that, but the random stranger might make the situation worse by doing a band-aid fix. The direct-to-customer companies we found online are run by business-people with no background in dentistry. Isn't that just a little concerning? Would they really know - or even care - about the consequences if your bite is worse off than it was before? Probably not. There's a reason why dental professionals have to go through extensive education, hands-on training, board exams and take continuing education courses in order to practice!
While we're not saying that these companies won't work, we are saying to be discerning about who - or what - you choose to conduct your orthodontic treatment because there are so many implications you may not be considering. Sometimes it's worth the expertise to avoid future hassle and headaches (this can be literal!) that can come with a botched case!