Amber M Allen, DDS
Creating Beautiful Smiles in Omaha, NE

Mail Order Braces Scare Me

January 14, 2020
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Posted By: Amber M. Allen, DDS

I don't know if it's just because I'm a dentist and the machine of Google has pinpointed my interests, but anytime I get on social media I'm inundated with advertisements for 5 to 6 different "Clear Braces" Aligner companies. These companies say they can straighten your teeth at a portion of the $ and time of typical orthodontia treatment. I'm all for free market and new technology improving all aspect of our life, including healthcare and dentistry.

However as a licensed dentist who has been providing Omaha, NE Invisalign Clear Aligners to my patients for the past ten years I can tell you I'd be very wary of these offers. STRAIGHT TEETH is only a small portion of orthodontic treatment. Maintaining or correcting a proper "bite" or occlusion (how your teeth hit together) is the most difficult part of providing ideal treatment outcomes. It takes me hours of diagnostic evaluation and treatment changes to give both straight aesthetic results while at the same time matching it with your bite.   

I tell my patients there are many reasons that I would not do mail order aligners on myself, a friend, or a family member:Ineffective movement:  Without the small tooth-colored attachments that are bonded to the teeth by a dentist or orthodontist when using a clear aligner system such as Invisalign or ClearCorrect, it is difficult or impossible for the aligner to grasp or push/pull on the tooth enough to accomplish many movements, such as multiple degrees of rotation, extrusion/intrusion, or root torque for proclining or reclining an angled tooth.  Often mail order aligners can achieve some sort of improvement in condition such as crowding, but an ideal outcome is not common in the patients I have seen. 

Risk of bone loss, gum recession, tooth mobility, and/or tooth sensitivity or tooth nerve death:  It is so easy, when pushing on a tooth in some patients, to have any of these problems occur – even for a doctor who has done hundreds or thousands of similar cases!  Some patients are at higher risk than others, but monitoring all of these factors, and sometimes even taking an xray periodically throughout treatment, is crucial to “do no harm” when working toward a beautiful and healthy smile.

Changes in bite:  this can be related to the above, but one of the most common ill-effects of mail order aligners is an undesirable change in the occlusion, or “bite.”  Most patients don’t realize how important it is that the teeth all “hit” simultaneously when the lower jaw hinges closed, and that this is also in coordination and harmony with the activity of the jaw muscles, and also with the TMJ or temporomandibular “jaw” joint.  Failure to achieve this ideal match can result in soreness, nerve death, mobility, or shifting of teeth; pain, clicking/popping/dislocation of the TMJ; and headaches, neck/back aches, ear pain or ringing.

To me, these are scary, often irreversible results warrant much caution in the face of mail order aligners that are appearing seemingly everywhere.  Your teeth, gums, jaw and muscles may be okay after using them, but they also may not.  I think the additional cost and appointments are worth getting a good result that lasts your lifetime by a qualified trusted dentist or orthodontist. 

Apparently the Aligner industry is unregulated as there seems to be a very low barrier for entry.  So it’s no surprise that the use of mail order aligners has become so widespread, and that we see ads for them everywhere.  There are 6-8 different companies supplying them now, although the largest – Smile Direct Club – is dealing with multiple lawsuits against it, and its stock has plummeted. 

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