SmileDirectClub Problems

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We sometimes get inquiries about SmileDirectClub from patients and others who do not feel they can afford Invisalign but want to straighten their teeth. In doing some research, we came across a warning given by mynewsmile.com. You can find the original post for that here. They talk about pages of complaints from patients who’ve tried the service and have been dissatisfied.

SmileDirectClub Advert

In an attempt to be careful with our conclusions we decided to verify the claims. Doing our own research, we went back to the dates he originally mentioned on two different websites. One that posts general reviews about SmileDirectClub and the other being the Better Business Bureau. There were more than we could reasonably place in a blog post.

One thing we noticed is the complaints fell into three different categories: First, not receiving their aligners and unable to get a refund. Second, the aligners didn’t work. Third, their teeth ended up in a dangerously worse situation.

Aligners Don’t Arrive as Promised

Review of SmileDirectClub where aligners didn't arrive

There were many similar reviews such as this one, including some patients who received some aligners but not others which completely threw off their treatment. Another waited months for their retainer after treatment, by which time her teeth had shifted out of place again.

Treatment Doesn’t Work

SmileDirectClub Review about the treatment not working

It is hard to imagine going through orthodontic treatment, investing all that time and money, and then having no improvement on your teeth. Imagine then trying to get this rectified and being given the run around over and over again.

Teeth End Up Damaged

SmileDirectClub review about teeth coming loose

One of the biggest issues of not having your orthodontic work done with a dentist is things can get overlooked. For instance, before Dr. Cheek would move forward with any orthodontic treatment, she would do a thorough exam. This simple, but imperative step protects the patients. As an example, let’s say a patient had the early signs of gum disease. That would get addressed before moving forward with any type of braces. Otherwise, you risk something like this patient above experienced. Your teeth can come loose.

If that happens, you will no longer be looking to straighten your smile but to replace missing teeth.

Based on these reviews, I would say approach this option with caution. If finances are what are drawing you to a mail order service, talk to your dentist. They may have payment plans for you. Another option is to try Care Credit. They are a medical loan service that offers low-interest plans enabling you to get your treatment and pay it out over a period of time you can choose.

This blog is brought to you by East Cobb Dentist Dr. Cristi Cheek. You can read more about SmileDirectClub here.

Will Medical Insurance Cover My Dental Implants

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I’ve lost quite a few teeth over the years, several not replaced, and have three dental bridges, all of which are over 30 years old. Because of this, I’ve had a hard time eating. I’d like to replace everything and get a dental implant denture. Will my medical insurance cover this because it is affecting my health?

Stephanie

Dear Stephanie,

Implant Overdentures

Dentists get this question a lot. While it is true that not having teeth affects your overall health, medical insurance almost always has a dental exclusion in their policies. This is unfortunate because while many people have health insurance, not nearly as many have dental insurance. All that being said, you need teeth. If you’re removing or lost all of your teeth, the best replacement would be dental implants. It sounds like you already know that though. What you may not know is how important they are.

Once your teeth are gone, your body senses there are no longer there. Always striving to be efficient with its resources, it will then resorb the minerals, which your jawbone no longer needs to support your teeth, in order to use them elsewhere. Unfortunately, this begins to shrink your jawbone. In as soon as ten years, you’ll start to notice it is hard to keep your dentures in. A short time after that and it will become impossible. This is known in dentistry as facial collapse. Once this happens, you won’t even have denture teeth to eat with. Talk about impacting your health!

The solution to this is having implant-supported dentures, as you’ve expressed. The dental implants signal to your brain you still have teeth. Because of that, it leaves the minerals intact, thereby protecting your jaw.

Paying for Implant Supported Dentures

While your medical insurance won’t cover the cost. There are some ways to make this easier. First, most dentists don’t make you pay for the whole procedure upfront. Instead, you’ll cover the surgical part first. Then, when you’ve had time to heal and the bone has integrated with the implants, your dentist will then do the denture and you can pay the second part.

I realize, for many people even, that can be challenging. Some dentists let you pay it out as you go. Those who don’t almost always offer Care Credit, which is a medical credit card. They’ll pay for your procedure upfront and then you pay them out. They have low-interest payment plans and you get to choose which plan you go with.

This blog is brought to you by Marietta Dentist Dr. Cristi Cheek.

Implants versus Implant Dentures

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I am curious. I’m losing all of my teeth and really wanted to get dental implants to replace them. When I priced how much it would cost to replace each tooth that way, it was astronomical. However, I’ve heard there is something called implant dentures. Will these do close to the same thing or is it just like regular dentures?

Rita

Dear Rita,

Implant Overdentures

I hope your dentist didn’t imply that you needed a dental implant for each tooth. That would be too expensive for anyone, except for the wealthiest of individuals. It’s also totally unnecessary. When you’re talking about replacing all of your teeth, you’ll actually want implant overdentures (pictured above).

These use four to six dental implants in each arch and will completely secure your denture to your jawbone. They also give you all the protection of dental implants.

Advantages of Implant Supported Dentures

  • Your dentures will be completely secure
  • Your chewing capacity will allow you to eat whatever you want
  • The implants protect you from facial collapse

The Biggest Danger of Dentures

facial collapse

When your teeth are removed, your body will immediately begin to resorb the minerals in your jawbone. After ten or so years, you will no longer have enough jawbone left to even support dentures. This is known as facial collapse. Getting those dental implants placed signals to your brain that your body still has teeth and needs those minerals to support the roots of your teeth. This protects your jawbone and protects you from facial collapse.

This blog is brought to you by East Cobb Dentist Dr. Cristi Cheek.

Are Steriods the Right Option After a Root Canal?

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I had a root canal treatment which seemed fine at first, but then I started to have tooth pain several weeks later. I went to see the endodontist, who then prescribed me a course of antibiotics. That helped and she said I’d be fine now. However, a few weeks later the pain returned. She’s since placed me on a course of steroids, but I’ve gotten worse instead of better. I’m not sure what to do.

Adrian

Dear Adrian,

a woman holding her jaw from TMJ pain

While we do sometimes prescribe steroids with a root canal treatment, it seems like your endodontist doesn’t understand the science behind it. Steroids are an anti-inflammatory. There are times this is an appropriate treatment. Generally, with a root canal treatment, there can be some irritation at the end of the tooth root. This can happen for several reasons. The file could poke through the end of the root or some materials, such as the infected pulp, the disinfection solution, or the filling material itself can make their way out. This causes a vicious cycle of pain and inflammation, but there is not necessarily an infection.

The inflammation causes swelling of the tissues around the end of the tooth, This, in turn, pushes the tooth up causing traumatic occlusion (how the teeth meet together). That then aggravates the inflammation, causing more swelling, starting the cycle over again. Prescribing steroids, in this case, can help stabilize the body’s response.

Because sometimes there could be infected tissue being pushed through, a brief course of antibiotics is generally prescribed along with the steroids.

However, this isn’t your problem. The best dentists will find the cause before prescribing a treatment. In your case, it was the wrong treatment. We were dealing with an obvious infection here. In that case, prescribing steroids is the WRONG treatment. Steroids are an anti-inflammatory. However, that inflammatory response is necessary in the case of infection. It brings necessary white blood cells and antibodies necessary to fight the infection. By prescribing steroids your dentist actually hindered your ability to heal.

Root Canal Treatment Failure

Your situation sounds more a case of root canal treatment failure. This doesn’t mean your endodontist did the root canal incorrectly. While I’ve been harsh on her diagnostic and follow up treatment skills, you can do everything right in a root canal and it will still fail.

The canal system inside a tooth is complex. It is easy to miss a small canal. Plus, some shoot off at a 90-degree angle and there is no way for the tool to reach everything. When a tooth flares up weeks after the treatment, it means there is an infection present and the root canal didn’t succeed. This is why your antibiotic treatment she gave you after the first flare-up made your tooth feel better. It brought the infection under control.

However, without getting in there and ridding the tooth of the infection completely it will rear its ugly head again. This is what you’re experiencing now. In this case, steroids are a hindrance rather than a help. You have some options here. The first is to have another root canal treatment done to try to completely get the infection. You should be aware the risk of failure increases with each root canal re-treatment. That doesn’t mean it is a waste of time to try, just be aware of the statistics. Two other options are root canal surgery or having the tooth extracted.

If you do end up extracting the tooth, don’t wait too long to replace it. There are more than esthetics to factor in. Your other teeth will begin to shift into the empty space. You can ask your dentist about tooth replacement options, including dental implants. Then decide which is best for your situation.

This blog is brought to you by East Cobb Dentist Dr. Cristi Cheek.

Her Dentist Said Everything Is Fine, But it’s NOT!

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I’m hoping you can give me some guidance. I’ve never had a cavity before so I don’t know what a cavity feels like but am wondering if I’ve developed my first one. I had a check-up just a month ago and my dentist said everything looked fine, so it would have to be pretty new. It is a bit hard to describe but feels a bit like someone is pulling my back teeth and then letting go. It only lasts a short time, but it is distracting and I don’t want to ignore if anything is wrong. My husband says I grind my teeth when I’m sleeping. Could that be it? Or is this what a cavity feels like?

Miranda

Dear Miranda,

a woman holding her jaw from TMJ pain

I know you said everything was fine at your last check-up, but if you are a tooth grinder, everything is not fine. I’m worried you are not getting adequate care. Some discount clinics only focus on cavities and don’t pay attention to important issues such as gum disease, bruxism (teeth grinding and clenching) or other occlusion issues such as TMJ Disorder. Overlooking these things can cause serious long-term problems.

I haven’t examined you and wish I had an x-ray to look at, but what you are describing does not sound like decay to me. The two possibilities that come to mind immediately are gum disease or damage from the grinding. Either one of these would need to be dealt with and the sooner the better.

If You Are Grinding Your TEeth

Grinding your teeth is an urgent matter, especially if you’ve been doing it for a while. You can end up cracking your teeth or grinding them down to nubs. This will cause you to need a full mouth reconstruction which requires placing a porcelain crown on every tooth.

There is a simple fix for this which can save your teeth. Your dentist can make a custom-fitted night guard. This will protect your teeth from the grinding as well as pressure if you clench. It’s much better to get a night guard than to leave your teeth unprotected and end up having to spend tens of thousands of dollars crowning every tooth.

If You Have Gum Disease

Gum disease is also serious. If left untreated, your teeth will eventually fall out. Then you’ll need expensive tooth replacement options, such as dental implants.

As I said earlier, I’m not sure you’re getting adequate care from your current dentist. I’d like you to see another one, sooner rather than later.

This blog is brought to you by East Cobb Dentist Dr. Cristi Cheek.