For a while there, I couldn’t seem to get away from those ads on Instagram and Facebook: SmileDirectClub! Straighten your teeth for half the price, from home! Great results in six months! Fortunately, my ad targeting algorithm seems to have caught the hint that I’m not interested. Yet, I’m still seeing several patients who have chosen to go the online route for their orthodontic care. Every one of them has been hesitant to tell me they’re using the service, because they have a suspicion, I won’t be pleased about it. And they’re right! Here are a few reasons to stay far away from online orthodontics.

Six Months Is Too Fast

My first concern with these online ortho services is that they claim to get results in six months. Six months is way too fast to be moving teeth, in most cases.

The way orthodontia works, in broad strokes, is that creating pressure on the teeth stimulates cells in the bony socket around the root of the tooth to eat away the bone in front of the root and rebuild the bone behind the root. By moving with slow, even pressure, you give the cells enough time to remodel the bone in a healthy way. However, by pushing too hard on the teeth and forcing them through the bone too quickly, you can damage the nerves and blood vessels to the teeth. Although it may not happen for several years afterward, this can create pain, nerve death, and root resorption. Basically, you can end up needing a root canal in teeth with damaged nerves. In extreme cases, it becomes necessary to extract the tooth and replace it with an implant. Slow and steady is the way to go with ortho, always!

Straight Teeth Does Not Mean a Healthy Bite

The other major concern I have with these services is that they do not take the patient’s bite into account with as much precision as a traditional orthodontist. While the teeth may become cosmetically straighter, the bite may be thrown completely off. This, in turn, leads to uneven pressure which can cause grinding, clenching, headaches, wear on the teeth, cracked teeth, and so on. It’s a cascade of issues that can start from an uneven bite.

A few of my own patients have had this problem with SmileDirect. They started out with a pretty good bite, but wanted a little cosmetic correction up front. No reason to spent $6,000 at a traditional orthodontist, right? Unfortunately, in most of those cases which I have seen first-hand, the patient’s bite was thrown out of alignment and they came back with complaints of tooth sensitivity and jaw pain. We had to send them to the orthodontist to have this corrected. Which means they still had to spend the traditional fee, on top of the money they wasted with the online option.

Poor Diagnostics

Even if these online services did evaluate the bite more carefully, and even if they slowed their timeline, I would still have one major complaint: their diagnostics are just not as thorough as a traditional orthodontist.

While these websites claim to do the same due diligence as a regular orthodontist, in actuality they frequently have patients sign a document saying they’ve had a full evaluation with their general dentist. Most patients do not even read the form completely.

If a patient has undiagnosed or untreated cavities, sealing that bacteria in with aligners can supercharge the decay process and destroy the teeth. Likewise, if a patient has periodontal disease (which they may not even be aware of), or other hidden pathology, applying orthodontics inappropriately can lead to severe harm including tooth loss. In short, it is essential to have good oral health before starting orthodontic treatment, and the internet is just not a good place to make sure everything is healthy.

Online services can be a real boon in many ways. Who doesn’t love the convenience of ordering groceries online and having them delivered right to your door? Even those new services where you can chat with your doctor through Skype are pretty cool. Dental care, on the other hand, is still something best done in person. Here at Lake Baldwin Dental, we work with an amazing team of specialists and will be happy to refer you to an appropriate orthodontist if you want to straighten out those pearly whites. So keep smiling, Orlando! Just… not with mail-order ortho.

For more on this, check out these articles:

NBC News article: “Things Didn’t Feel Right.”

Article from the ADA: New Jersey Dental Association Lodges Complaint