We get questions from patients about new orthodontics-from-home options for straightening their teeth, such as SmileDirectClub. This company claims they can eliminate the direct supervision of a dentist and save you money over in-office options such as Invisalign.
If you’re considering this option, please do so carefully. Many of the online reviews of SmileDirectClub are directly managed by the company, and it takes a little searching to find independent reviews. One review site, Highya.com, had overwhelmingly negative reviews before mid-January 2020, and then it appears that SmileDirectClub began to get involved in managing the reviews, and they all of a sudden became overwhelmingly positive. Check YouTube for videos of patients’ experiences with the process.
In January, 2020, The New York Times ran a story talking about what SmileDirectClub has done to squelch complaints, adding that there have been many complaints. In its short lifespan, as of the date of their article, they had been the subject of more than 1,670 Better Business Bureau complaints. By contrast, Invisalign, which has been in business since the 1990s, has had five BBB complaints.
Potential Problems with SmileDirectClub Treatment
By trying to bypass the dentist, here are some problems that do-it-yourself orthodontics can run into.
- First, we believe that skipping the examination is risky. Orthodontists are trained to begin orthodontic treatment with an x-ray of the entire jaw of the patient, usually a panographic view. It’s important to know how much bone support the teeth have. The rest of the clinical examination is also important. Is there gum disease? Are there abscessed teeth? loose teeth? or sensitive teeth? When this examination is skipped, there are reports of teeth being made more loose or teeth weakened by being pushed through their bony support.
- Second, when there are crooked teeth, usually it is because of crowding. So the first step in orthodontic treatment needs to be making more space. Extracting some teeth will make more space. If the space needs aren’t great, a little shaving of the sides of some of the teeth can maybe make enough space. But with these do-it-yourself treatments, there is no way to make more space, so they have to resort to pushing the teeth out into a wider arch—not the best way to handle this. Patients in online reviews have complained that only their front teeth were straightened and their back teeth were left with crowding, cross-bites, or other problems.
- Third, Dr. Cheek knows from experience that there are issues that come up during treatment. She relies on periodic office visits while you are undergoing treatment to address these issues. Sometimes, for example, a little button of composite needs to be bonded to a tooth to enable the aligners to rotate the tooth a little, and once that is done that button can be removed. This option isn’t available with do-it-yourself treatment. Or a course correction may be needed partway through treatment.
If you check online reviews, you will see that this is a frequent source of patient complaints because when issues come up they don’t get a satisfactory response from the company.
- Fourth, the do-it-yourself companies offer a “take-it-yourself” impression option. But this impression that is taken to begin treatment is critical. It is very easy for a physical impression, if it isn’t taken very carefully, to be distorted. Dr. Cheek believes that a do-it-yourself impression is inadequate.
- Finally, SmileDirectClub suggests an option of wearing the aligners only at night, for 10 hours at a time. What happens when this is done is that the teeth get moved while you are wearing the aligners and then they relapse when you’re not. We don’t believe this continual back-and-forth movement is healthy.
By comparison, the Invisalign process involves a lot of input from the dentist. Dr. Cheek and Dr. Chandler will begin with a comprehensive examination, including a full-mouth x-ray and a digital impression. From that, they will first decide if you are a good candidate for Invisalign, and if you are, will make a plan for your treatment. If there is crowding of your teeth, they will have a plan for making more space.
You’ll return to the office to get your aligners, which they will insert for you and coach you about their use. If there are teeth that need to be rotated, you will often need a small composite button temporarily bonded to the tooth to accomplish that rotation. You’ll return to the office every few weeks to monitor your progress and address any issues that come up.
Have You Had Trouble with SmileDirectClub?
If you have begun treatment with SmileDirectClub and have had any problem with your treatment, we can help, and Invisalign has a special offer for you. Bring your SmileDirectClub receipt, and Invisalign will give us a discount on your laboratory bill, which we will pass on to you. This offer is valid until the end of the year.
To make an appointment, just call our office. Or you can fill out our online appointment request form and we will call you. If you’re not ready to commit to an examination or just have questions about whether or not you are a good candidate for Invisalign, just ask for a complimentary consultation.