A nice smile is the first thing many see in photos and selfies posted on any social media. Filters enhance skin tone, eyes are brightened/enlarged, however a natural smile is difficult to enhance on an app! Recently, many at home/Do It Yourself smile companies have popped up, creating many questions that we hope to answer in this post!
You hear advertisements on TV describing how easy and inexpensive mail-order orthodontic treatment is. (Saving you all those “pesky” visits to a dental professional’s office… ) And you may also hear your dentists give you a strong warning against the risks of those DIY orthodontics, but perhaps it isn’t clear what the risks are?
So today, I’m going to break down a few of the unanswered questions based on my current understanding. First of all, let’s define what we’re talking about. What is DIY orthodontic treatment? When I began practicing 30 years ago I often suggested DIY orthodontics, in it’s most simplistic form. Early treatment sometimes consisted of holding a pop-sickle stick in their mouth while watching TV at night to correct a cross-bite of the front teeth. Many patients respond well to this, and I sometimes still suggest this to 6-7 year olds’ to help guide the eruption of their teeth.
So DIY orthodontics isn’t a new idea, but it has at least gotten a little more advanced! In this case, I’m referring specifically to mail-order clear aligners from several companies. These are marketed as invisible aligner treatment (similar to Invisalign) without the need to visit a doctor’s office. You fill out a form online and pay a nominal fee to request some materials from the company. They send you a kit that you use to take an impression of your teeth at home. You send the impressions back, and they propose a treatment plan. You then have the option to view a video animation of how they expect your teeth to move and pay for the aligners if you want to. They are reportedly reviewed by a licensed (In your state) dental professional, but you will monitor your own treatment at home, without the opinion of a dental professional. If you look at reviews on YouTube, Facebook and Instagram, the reviews vary widely, but your access to Q&A during the treatment process appears limited.
- Convenience – These companies advertise that you can skip trips to the orthodontist’s office… Is this true? Perhaps. If you take an excellent impression of your teeth at home, and your treatment goes well, you may avoid trips to an office! Here are a couple things to keep in mind. Taking impressions is something that does not have a 100% success rate even for orthodontic techs and doctors who have done it many times before. Distortion in impression or during transit will lead to poor fitting aligners. If you end up needing help or a digital scan (rather than an impression), you may end up visiting an office (or a shop or kiosk) to have this part of the work performed. Also, keep in mind that during clear aligner treatment in most orthodontic offices, you only need to visit about every 8 to 10 weeks and likely for no longer than half an hour at each appointment, to monitor tooth movement and assess the health of the bone and supporting structures around the teeth. Remember, you are actually moving teeth thru bone, which has limitations!
- Cost – The company also advertises that you’ll save lots of money compared to traditional orthodontic treatment. Is this true? Perhaps. You are essentially eliminating the monitoring process. But is this a good choice? Eliminating the middle-man when you buy products online is great because you get the same product either way. With orthodontic treatment, when you eliminate the middle-man, you also eliminate a person who can give you customized personalized advice, guidance, and help getting the results you want. You may save money, but it’s hard to guess whether you’ll get the same value out of your treatment. There are likely cases where equal success is achieved, but more often than not, aligner treatment does not go precisely as planned, and the in-person help of a professional can help get you back on track. Also, cooperation varies greatly from one patient to the next, and we have found ways to improve the performance of aligners based on your lifestyle and commitment level.
And what are the disadvantages we’ve been talking about?
- Limited options – DIY Companies advertise that they will use aligners to correct your “smile.” This does not necessarily include making improvements in the way your teeth bite together. Orthodontists are trained to address all aspects of treatment. In some cases, aligning your teeth could put them in a position where they will be subject to problems later.
- Worsening of dental health – Before beginning orthodontic treatment, an orthodontist should perform an exam and/or consult with your general dentist to be sure that your teeth and bones are healthy enough for tooth movement. If they are not, moving your teeth could lead to tooth loss, recession (gum problems), or mobility of teeth. In addition, orthodontists monitor your treatment throughout the process to be sure that your teeth are moving to a healthy position. If they aren’t biting properly, adjustments need to be made, and sometimes treatment plans need to be revised in order to prevent bite problems. A worsened or un-corrected bite often if not always results in a high likelihood of relapse or changes back towards the original problem.
- Cost – Yes, I mentioned cost as both an advantage AND a disadvantage. It’s great if your treatment goes smoothly – you will probably save money! However, if you complete treatment and aren’t satisfied with the results, as has been the case for many patients, you may find yourself in an orthodontist’s office anyways, looking for another treatment option and facing the possibility of paying for treatment all over again. Some patients have worsened dental health that requires additional expenses outside of the orthodontic problem.
So, should you try it? We are obviously fans of treatment that is supervised by a board-certified/AAO trained orthodontist, but most importantly, we just want you to be aware of the risks and benefits before you make the decision to try this type of treatment! And if you decide against it or if you’ve already tried it and you’re not satisfied with the results, we are still here for you!
Keep smiling, Park City!