Getting teeth straightened with invisible aligners by mail-order is becoming a popular alternative to traditional braces. But does it work and is it safe? What are the risks?
With “traditional” invisible aligner treatment (such as Invisalign or ClearCorrect), your local dentist or orthodontist evaluates you in-person with x-rays and impressions, makes a comprehensive treatment plan, and oversees your treatment. You go into their office every 4 to 6 weeks for a progress check until your treatment is done and you are satisfied with the results. The process usually takes anywhere from 6 months to 2 years and costs from $3,000 to $6,000.
Mail-order aligner companies operate in a totally different manner. With many of these systems, you don’t need to see a dentist or orthodontist before beginning treatment — you just answer a few questions online. Then you either go to a local location to get a 3-D scan of your mouth, or do an impression kit at home. Everything else is done online and by mail. An orthodontist or dentist, who is employed by the invisible aligner company, remotely reviews the 3-D scan of your teeth and makes a treatment plan for you. In about six weeks, you get your aligners in the mail, follow the instructions, and begin your treatment, which lasts anywhere from 3 months to a year. The cost is between $1,000 to $3,000.
A few weeks into treatment, you may be required to take some photos of your face and teeth from different angles and send them to the mail-order aligner company. However, photos alone generally aren’t as comprehensive as an in-person evaluation with x-rays, so valuable clues about your treatment progress could be overlooked or misunderstood.
You Get What You Pay For
While mail-order aligner treatment sounds easy, simple, and relatively inexpensive, it has many worrisome drawbacks. Most mail-order invisible aligner companies promise to straighten the six top and six bottom front teeth in a few months, and that’s all.
Here’s what they don’t do:
- Address the alignment of your molar teeth
- Analyze your jaw function
- Analyze your aesthetic outcome (how your face will look)
- Analyze your bite (how all of your top and bottom teeth line up)
- Ask about TMJD or frequent headaches
- Evaluate periodontal disease
- Do x-rays to evaluate diseased teeth and roots
- Consider other serious dental or health concerns
Because they don’t consider any of the above, they might accept you as a patient and make aligners for you without taking your total oral health into consideration. You might think this is an advantage (less hassle), but the truth is, NOT taking these things into consideration puts your teeth and oral health at risk.
“I Just Need A Couple of Teeth Straightened!”
Do you really need full-on orthodontics if you just have a few crooked teeth? Can’t you just pop in a few aligners for a few months to straighten them? Here’s the thing: you might think that you have a very simple, straightforward case (“just a couple of crooked teeth,”) but chances are, you’re wrong.
Let’s be honest: you are not a dental professional and you don’t have any training in oral bio-mechanics or orthodontics. There is usually more going on inside your mouth than just a couple of crooked teeth. And because of that, mail-order aligner treatment could cause more problems than it corrects — problems that could later require full braces or oral surgery. It could give you an unintended underbite or overbite. Technically your front six teeth could be straight, but your entire facial profile and jaw function could suffer. Also, if gaps between your front teeth are closed, gaps between your molar (back) teeth will open up (that space needs to go somewhere!) Think that a gap between your molars is no big deal? Try eating a few meals that way and see how it feels to have bits of food painfully lodged between your teeth and into your gums!
Orthodontic treatment involves more than just having cosmetically straight teeth. It is a complex process of jaw alignment, jaw function, facial aesthetics, and tooth aesthetics. Your teeth could be straight and look terrific, but if your bite is off, you could develop TMJD, cracked teeth, headaches, and chewing dysfunction. Plus, if you develop an underbite or overbite, your profile will not look very good and people will wonder what you have done to your face.
It usually isn’t as simple as “just having a couple of teeth straightened.” There’s more to it; a lot more!
Do Some Research First
It’s easy to get carried away by slick ads, cheap prices, and marketing hype that appeals to your emotions — most of these types of companies spend a considerable amount of money on advertising and social media marketing. Before jumping in, do your research by searching Google, YouTube, Reddit, and social media outlets for stories, complaints, and information from other patients who have completed mail-order invisible aligner treatment. Search the websites of the Better Business Bureau, Yelp, and other consumer affairs companies to understand more about the credibility of the company. Look at the company’s website to understand how long they have been in business, who owns them, and where they are located (often mentioned in an “About Us” link, or found in a press release via a Google search).
In July, 2019 The American Association of Orthodontists (AAO) issued a consumer warning about mail-order aligners. The warning was an effort to help educate the public about the dangers and disadvantages of not having a local dentist or orthodontist direct their aligner treatment. While it might seem that the AAO is just trying to protect the interests and income of orthodontists, what they say merits a lot of serious consideration.
In newer developments, NBC News reported several horror stories associated with SmileDirect Club, which the company refutes. See this article for more details.
Ask Your Own Dentist
Of course, there have been many success stories with mail-order invisible aligners, and many happy patients — maybe you even know some yourself. But you need to go into the process fully aware of the risks. Before you take the plunge, ask your dentist for their opinion about your teeth and your bite the next time you get your teeth cleaned. Most dentists have completed study in basic jaw mechanics and tooth movement, and can give you an honest informed opinion about whether mail order invisible aligners will work for you. If they say yes, then go for it. But if they have misgivings, take their opinion seriously and get another opinion from an orthodontist. Most orthodontists offer free consultations, and can tell you whether you have more going on than “just a few crooked teeth.”
Questions To Ask Before You Buy Mail-Order Invisible Aligners
Here is a list of questions to ask a mail-order invisible aligner company before starting treatment:
- Will a dentist or orthodontist evaluate my teeth and oral health in-person before treatment begins?
- Will you need records from my dentist before treatment begins?
- Will you take x-rays of my teeth, or get the latest x-rays from my dentist?
- How will this treatment affect my bite? Will my bite be addressed or ignored?
- Can this treatment be done if I have crowns, implants, or veneers?
- What happens if your treatment misaligns my bite?
- How long will the treatment take?
- How many sets of aligners will I get?
- How should I clean my teeth and aligners while in treatment?
- Specifically which teeth will be moved, and in what direction(s)?
- Does your system use attachments or buttons on the teeth?
- Does your system use elastics or hardware with the aligners?
- Who makes the treatment plan for the aligners? Is that person a dentist or an orthodontist? What is their name and where are they located?
- What should I do if I develop dental problems during treatment?
- What is your refund policy?
- Who do I contact if I have questions after my treatment begins?