Heading Off the Orthodontics DIYers

by Charles Sutera, DMD, FAGD

There will always be people who will try to go the do-it-yourself (DIY) route, even when it comes to their teeth.

And there’s no shortage of companies willing to take advantage of that fact.

But, when it comes to the health of our patients, it’s our job to educate, explain, and do all we can to steer them away from products that could be unpredictable.

One such trend is DIY teeth aligners.

Given the expense of orthodontics, it’s perfectly understandable that some people would look for less costly alternatives.

So, how do we keep patients from making a decision that could create more problems than it solves?

Below are some points to keep in mind when counseling would-be DIYers (with the full knowledge that we, ultimately, can’t save people from themselves):

Cost—Because, in the end, it’s possible that anyone who chooses to order aligners online may end up needing professional help to finish the job, at the very least, and possibly address oral health issues caused by the aligners. It’s unlikely that patients can recoup the cost of subsequent treatment required to address orthodontic and dental issues that arise or are exacerbated by the DIY aligners.

Damage—Improperly or poorly fitted aligners can cause more damage than good, moving teeth too fast, cutting into gums, even causing misalignment that interferes with proper function. There are several reasons DIY aligners can create oral health problems:

  • No pre-exam—Aligners you can order online advertise bite review by orthodontists, but the supervision is variable. Sometimes the review is conducted only by looking at the bite impression sent by the patient, for the purpose of determining if the patient is a “good candidate” for clear aligners. Without a comprehensive exam before beginning treatment with clear aligners, patients with serious oral health problems like gum disease or cavities could compound those issues.
  • No supervision—Unlike clear aligners prescribed by an orthodontist, the DIY aligners are strictly that – do it yourself. There are limited checkups that could catch developing gum disease, cavities, or potential damage from teeth moving too fast. So it’s on the patient to make sure they are current with proper monitoring by their general dentist for other oral health issues.
  • TMJ Disorder—The big takeaway about orthodontics is that it’s not just about the teeth. Yes, aligning teeth is good, but doing so also alters other head and neck structures. It’s possible for the teeth to be oriented into a beautiful position, yet that same beautiful position may also create TMJ dysfunction without careful consideration.

Ineffective—While wire braces are easy to see and understand, it’s what you can’t see about clear aligners that can cause people to assume the DIY aligners are just as good as professionally prescribed aligners. People don’t understand that an orthodontist carefully maps out the types of movement required for proper alignment and designs a treatment plan for the clear aligner fabricator. And then the orthodontist applies a carefully planned selection from more than 40 different types of tiny “anchors” to the teeth, used in conjunction with the aligners, depending on what type of movement is desired.

Some patients are stubborn and may need more information to persuade them to seek proper dental care. Here are some additional points you can share with patients to help steer them in the right direction:

Orthodontist. Why? Aside from the fact that straightening teeth is one of their specialties, the orthodontist conducts a comprehensive exam before treatment. During the exam, they may find serious oral health concerns that require treatment before teeth can be realigned.

Too fast. Really? An uninformed patient may think faster is better when they’re longing for a nicer smile. They should be educated about the danger of moving teeth too quickly and the potential for actually damaging teeth that are moved too quickly.

Not for them. Patients may also think that clear aligners are not only just as good as “old fashioned” wire braces, they may think they are actually better. But clear aligners aren’t the right choice for people with severe rotation, intrusion, extrusion, overbite, underbite, crossbite, open bite, crowding, or other issues that may cause the aligners not to fit or work properly.

You can’t steer every patient in the right direction, but, armed with the right information, you can help a few to get better, healthier results.

About the Author

Dr. Sutera , FAGD, is a nationally-recognized oral health expert and Doctor of Medicine in Dentistry.  He is  board certified in dental sedation, a  TMJ expert and has earned recognition as a certified Fellow of the Academy of General Dentistry, a distinction earned by only six percent of DMDs nationally.  He has completed post graduate education programs in the fields of dental anesthesiology, dental implantology, TMJ and oral surgery. He believes a multidisciplinary expertise and knowledge allows for the highest level of oral care, reconstruction, and maintenance. Dr. Sutera is board certified in moderate parenteral sedation by the Massachusetts Dental Board. Dr. Sutera also completed a TMJ residency at the University of ..  Dr. Sutera completed his implant training at the Whitecap Surgical Center in Salt Lake City, extensive periodontal training at the GIDE Institute, and has trained in 3rd molar surgery. He continues to maintain certification in proficiency by the Academy of Laser Dentistry.

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