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Clear Aligners By Post and the Perils of Online Dentistry

The idea of getting clear aligners by post based on a few photographs you have taken yourself and a DIY dental impression is a very scary idea.

Yet this is what is on offer in America and, if we do not make a robust case against it, we will see one day pedalled here in the UK.

Cheap clear aligners – but what is the cost to your dental health?

The arguments these people put forward are mostly financial. Their websites tell people they will save a small fortune via this DIY approach. But what price will they pay in the long run?

I have several major issues with online cut price braces treatments.

  1. For a start the patient is overtly encouraged to self diagnose the problem and prescribe the necessary treatment. Those selling these clear aligners are under no professional obligation other than to take your credit card details and issue their clear aligners.
  2. They may also issue a series of waivers, disclaimers and advice on post-op sequelae which includes everything from teeth falling out to your head falling off. You, the patient, will often ignore these under the auspices of a perceived bargain. You will be “saving thousands,” they say.
  3. The patient is encouraged to ignore any advice from a dental professional, whether they are General Dental Practitioners, orthodontists or other specialists within the dental field. (One can assume no 2 is correct by offering the assertion that no dental professional in the UK would put their name to/expertise behind this practise).
  4. It is unlikely that a full orthodontic assessment will be carried out, far less a routine dental examination prior to treatment. These might enlighten patients as to the expected outcome, potential for catastrophic side effects and long term tooth loss as a result of undertaking this type of plan. Periodontal disease/gingivitis is a major issue with respect to ‘suitability’ with respect to number 3.
  5. No radiographs will have been taken prior to treatment. One of the major sources of referrals for Short Term Orthodontics are adults who have undergone conventional orthodontic treatment as a youth and failed to wear retainers afterwards. “Retention is for life.” Radiographs will pick up most cases of root resorption or undiagnosed problems which lie beneath the surface, as a consequence of or incidental to prior treatments and/or historical trauma.
  6. This is the biggest issue. Over expansion in the dental arches can often have disastrous long term effects. Without extractions and/or in Interproximal Reduction (polishing small amounts of enamel in between teeth) in all crowding cases, expansion of the dental arch beyond the safe outer limit of dental bone is often likely.
  7. Most orthodontic corrections involve crowding. The over expansion phenomenon will almost certainly lead to ‘stripping’ of gum and bone tissues later on in life. This will be exacerbated by the mild trauma of toothbrushing on those outer tooth and gum surfaces throughout adult life. Front teeth become loose and usually require extraction later when this occurs. If there is no room for teeth we must make room or expand the dental arches. These fellows are only making room within the confines of their account.

In essence, the best advice before embarking on any dental treatment is always to listen to your dentist.

However in my view, these procedures will only be offered online and not within a practice registered with the General Dental Council here in the UK. The GDC having been set up to regulate dental teams and protect the patient.

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