Alright this is a lengthy article because there is A LOT of information to go over, but if you are interested in at home kits for clear braces it’s worth the read 😉 So let’s begin….
Until recently, if you wanted to straighten your teeth with regular braces or clear aligners, you needed to visit an Orthodontist. (Orthodontist is a dentist who specializes in moving teeth and aligning the jaw/bite)
This could cost you anywhere between $1000-$4000 or more depending on how much movement is needed and which route you chose to go, wires vs clear braces.
However, for the past few years companies like SmileDirectClub, Candid, Smilelove, Byte, and many other companies have offered an at-home aligner service for about half the cost and time compared to traditional braces. In fact, you can get some of these kits at your local CVS and Walgreens.
This means people can get their teeth straightened without ever seeing an orthodontist in person.
With certain aligner companies, they may have a smileshop or store front you can visit to get a personal scan and pictures taken of your teeth. You can also video chat with a dentist or orthodontist about your treatment. However, if you are like most people and don’t have one of those stores around you then you can buy an at home kit. If you are buying a kit to do at home you are taking pictures of your teeth, taking molds of your own teeth, filling out paperwork and then sending it off in the mail to wait for your own individual aligner set. After this it’s all about following instructions and doing what the kit guide tells you to do in the correct order of treatment. You then send updated photos of your teeth every 3 months to check on the progress.
Sounds pretty easy right?
Well it is….BUT it doesn’t mean it’s the best choice of treatment for every person!!!!
I am not going to sit here telling you that I don’t like the idea and concept of this new approach to ortho/braces treatment because my main goal when it comes to my job and this blog is to help as many people as possible. It’s also to give the best dental care/advice/opinion EVERYONE deserves.
Bottom line is I like affordable dentistry, but I also like great dentistry. Sometimes these don’t go hand in hand. Think of the old saying “you get what you pay for.” I feel like this moto is usually right, but that being said I don’t like overpaying either. Not everyone can afford $3000+ for braces, and this is why so many adults never got braces when they were young…. affordability.
Some parents can’t afford to shell out that much money. Plus, if you are lucky enough to have dental insurance you may still have to pay a lot out of pocket because usually dental insurance only pays about 50% and that’s if you have a really great plan. (However United Healthcare and Aetna announced in 2019 that they are covering SmileDirect as an in-network service for their members.)
So, this is why I love to see the price of braces/aligners being more affordable thus allowing more people to get the treatment they deserve!
I myself have so many patients that won’t smile or laugh much because of their teeth. They tell me that they hate there smile and are insecure about it. This is the part of job that pulls on my heart strings and if braces can fix that and give people confidence then why wouldn’t I support such a product.
I need to explain why I have some apprehension and why most of the dental community dislikes this new concept……
The problem is if you align teeth too quickly and improperly it can cause permanent/irreparable damage to the teeth, roots, bone, jaw and joint!!
There is a reason why Orthodontists go to school for an additional 2-3 years after dental school, which means Orthodontists go for a total of 10 years of college to get their degree. For dental providers there is so much risk when moving teeth and there is very little follow-up or supervision when you are doing at home braces/smile shops.
If you are an individual that has already started treatment with one of these aligner company’s, you are probably thinking “but I was seen by an orthodontist or talked/emailed one.” Yes, you are correct, you do get an initial view from an orthodontist in person or they looked at your pictures from your phone, but it is not a thorough or continuous evaluation like you get in a traditional orthodontic office.
If there wasn’t such a science to moving teeth every dentist would be doing it!
The main reasons I am so concerned with these companies is they like to claim it is CHEAPER and FASTER if you pick them vs a traditional orthodontic office.
ASK YOURSELF WHY THAT IS!!!!!??????????
When you see a traditional Orthodontist, you are getting the one on one treatment/conversation/physical exams/checkups by an Orthodontist in your mouth clinically looking at YOUR SPECIFIC CASE. A good Orthodontist will look not just at aesthetic but also function. This means they are looking at everything that involves changes in jaw and facial bones and the soft tissue as teeth are moved into their new positions.
What about your jaw? Yep Orthodontists NEED to look at that too! They need to look at your bite and positioning of your jaw. If this is not properly aligned then you may need additional treatment with spacers, bands, a palatal expander, head gear, surgery, teeth extracted or something else. The jaw alignment is crucial for long-term bite, alignment, wear of your teeth and overall health of your mouth. Plus, it can even affect the jaw joint down the road, which can cause headaches, joint wear, TMD, and pain if it’s not aligned like it should be. (I will discuss in a future posts)
When you are under treatment of a traditional Orthodontist your care starts with a thorough exam of the teeth and mouth. Photos and molds are taken as are x-rays(which the other guys don’t do!). In fact, California has become the first state in the U.S. to pass a law that aims to better protect patients who undergo clear aligner companies/orthodontic treatments by requiring x-rays and more before moving ahead with care.
Because orthodontic treatment is such a complex process, even the simplest movements/treatments should be monitored regularly to make sure treatment is on course. If anything is amiss, a regularly scheduled visit gives the Orthodontist the opportunity to appropriately intervene in a timely manner. This is a key difference of traditional Orthodontist vs at home aligners!
Appointments are scheduled roughly every several weeks to assess tooth movement and oral health, and to adjust your treatment as needed. Which is important step when going thru ortho treatment.
Unfortunately, with these new “at home braces” and one stop shops, they are providing orthodontal treatment but with extremely low levels of care and routine follow ups. The “at-home dentistry” concept in theory might seem like a good idea for braces but the risk can outweigh the reward. Especially when it comes to more complex cases.
***Orthodontic treatment is not a quick fix!!***
I have had some patients who are very happy with the outcome of their at home braces kit. I myself recommended invisible braces for my nephew since he was a good candidate with mild movement needed. However, I personally selected an orthodontist in their area that I did research on who had a great reputation. (If anyone is in the Hershey/Harrisburg area I will highly recommend him if you want to know his name.) In fact, I had my niece and my nephew go to his practice, but my niece had more of a complex case. Unfortunately, she had to get traditional wire braces vs my nephew who could get invisible braces. (I will discuss in a future post about wires vs clear braces)
However, I have also seen patients have negative outcomes of moving teeth to quickly with at home kits like tooth resorption (tooth resorption is when the roots of the tooth shorten and it can cause permanent mobility of the tooth aka wiggly teeth, in extreme cases this means you can even lose the tooth/teeth). Tooth resorption is a very real risk, and that’s not the only problems we dental professionals have come across since these new at home aligner kits have come on the market. The bite is the BIGGEST issue we see. Patient’s teeth are straight in the front, but their teeth don’t touch in the back evenly anymore, typically known as an “posterior open bite”.
This is why the ADA strongly discourages at home braces kit due to the risk. The American Association of Orthodontists, warned consumers against moving teeth without an initial exam clinically and continuing supervision by an orthodontist in person. “Our concern is that patients who don’t see an orthodontist for regular checkups and/or for a complete diagnosis are more likely to be harmed,” said Dr. Rolf Behrents, a spokesman for the association. They also state these companies are unsafe and not properly regulated.
I know that for every bad case there will be plenty more good ones. From one perspective I like the change to more affordable braces. I know saving money is always a great feeling BUT dental treatment is not yet at the point that the medical community is at with tele-video appointments. Looking in someone’s mouth can be difficult enough but is way too hard to do with just pictures/video from your phone.
However, with current 3D imaging and the advances of dental technology, I think one day we will get to the point that we can do some sort of tele-dentistry exams at home but we are not quite there yet.
Listen, I love competition and new technology means change which is awesome! I also like making things more accessible to all people at a good price. With all this said, these at home braces can work for people who have little movement or spaces between teeth. The “at home” kit is more intended for patients who have slight to mild misalignment.
If you can’t afford braces with an orthodontist, I know it can be very hard to hear that a more affordable option may not be one that works for your individual case. You may end up just fine with the at home kit— people have (I have read the reviews and seen some patients), but if you go remote, please be careful! Research as much as you can and follow the instructions carefully!!
Don’t speed treatment up or skip retainers to get to the end result quicker, you will only do more harm then good!!! As always if you have questions or concerns you should always ask YOUR dental provider!