At-Home Aligners: Too Good to be True?

So, you’re unhappy with your smile and ads keep popping up on your Facebook to straighten your teeth at home with clear aligners on the cheap. No office visits, a steep discount and a promise of results in under a year…it’s not hard to see the appeal. However, just as the old saying goes, if something sounds too good to be true, it probably is. Direct-to-consumer aligner companies claim to be “disrupting” the orthodontic biz.


However, their model simply does not work.  It is essentially DIY orthodontic treatment and aligners are created based on a scan at a regional center or, even worse and less reliable, impressions you do yourself or photos you snap and send in. Then, you straighten your teeth without having a thorough in-person evaluation or supervision by a doctor. That means there’s no safety net to protect you from damaging your teeth, gums or jaw.

Dr. Sturgill went through years of specialty training in a post-doctoral residency program to become a board-certified specialist in orthodontics and gain the necessary knowledge to safely and effectively improve patients’ bites.  He has two doctorate degrees and a master’s, in addition to being an associate professor; all to become an orthodontist. Why? Because, a lot goes into perfecting a smile, beyond just what you can see on the surface.

Orthodontic treatment is a medical treatment and biological forces are involved. When you’re moving the teeth and jaw, bone remodeling occurs and the changes, including those that happen to your facial structure, can be permanent. Orthodontics is not simply moving teeth, the facial balance, profile, lip support, midlines, functional bite, TMJ position, gum heights, patient age, airway, tongue position and periodontal status are just a few of the hundreds of variables that have to be considered when creating the perfect smile.  

When things don’t go as they should, which there are already cases mounting of mail-order treatment gone wrong, the damage to the gums, teeth and bone can be extremely costly and frustrating to remedy. You’ll end up spending way more time and money than you would have had you visited an orthodontist in the first place.

The American Association of Orthodontists issued a consumer alert concerning direct-to-consumer orthodontic companies and rightfully so. While it may seem alarmist and you might be thinking, of course we’re not into mail-order aligner treatments as orthodontists, keep in mind, Dr. Sturgill became a doctor to help people.

A huge corporation that fabricates aligners didn’t take an oath to “do no harm” and could quite possibly be more interested in their bottom line than the health of their customers. If you suspected you broke a bone, would you skip the x-rays and doctor’s visit and buy a DIY cast online and try to set it in your living room? Most people wouldn’t and mail-order aligner treatment really isn’t much different. So, before you fork over thousands of dollars, there are a few things to consider.

The Severity of Your Case

We’re the first to admit that a mail-order system could potentially work for a patient who had braces or Invisalign in the recent past and forgot to wear their retainer for a few months. However, anything more than a mild case, will have a compromised result and lead to a worse bite.

The aligners only really move the teeth that are visible when you smile and they’re not designed to fix an actual bite issue. Even in the instance of someone seeking a quick touchup, we’d still advise at least getting evaluated by a pro first and having x-rays taken because things can change and before you start shifting the teeth, you need to make sure your teeth and gums are in good shape.

Aligners Alone Don’t Always do the Trick

As we just mentioned, if an orthodontic problem is more than merely cosmetic, aligners alone often won’t do the trick. A little known fact about Invisalign treatment is that many cases require the use of attachments, which are tooth-colored buttons that are bonded to the teeth to provide an anchor to create the necessary force to get results. The mail-order aligners don’t include these extras, so change will be minimal. You absolutely cannot achieve a dramatic outcome with this type of treatment.

We have, unfortunately, seen many patients in our Johnson City, TN orthodontic office who have spent thousands on DIY aligners and can put in the first tray and the last tray at the same time (WOW!).  That’s because, without the correct treatment plan and attachments, no movement occurred! Now, they’ve lost their insurance benefit to the DIY aligners, as well as thousands of dollars and nothing was accomplished – truly a gimmick.

How Healthy are Your Teeth and Gums?

Teeth move how they’re supposed to when your mouth is healthy. If the gums and bone aren’t adequate or healthy enough to support the teeth appropriately, shifting them can actually lead to tooth loss. If you’re set on direct-to-consumer aligners and you can’t be persuaded otherwise, make sure you see a dentist and get a clean bill of health before moving forward. This brings us to our next point.

X-Rays and an Exam are Essential

Most mail-order systems don’t involve dental x-rays and it’s all based on a scan of your mouth or DIY impressions. There’s no way to see under your gums to determine your bone condition without an x-ray, so you can’t tell if your teeth and gums are healthy enough for treatment. Additionally, the combination of x-rays and a clinical exam by a professional ensures they understand the relationship between your teeth and jaw and your skeletal structure. You don’t want to shift the teeth without knowing whether or not everything will work together to create a result that will be harmonious with your facial features.

What Happens if Things Go Wrong?

Having someone supervising your treatment is important. If something goes wrong, they can step in early to keep things on track and prevent any serious issues from cropping up. With mail-order aligners, you may have a customer service email or telephone number you can call.

Then, you’ll be speaking with a company representative who isn’t a certified specialist and wasn’t the person who created your treatment plan. In the end, you’ll most likely have to go to a local orthodontist to seek help. At that point, you’ll be have to pay for treatment at an actual office anyway on top of what you already spent on your aligners.

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It’s Not That Much Cheaper

In almost every instance, DIY clear aligner systems end up costing the consumer more money. Because, as noted in our last point, patients have to pay to have what was damaged corrected. Most consumers of mail-order aligners will either be forking over money for a second round of orthodontic treatment or putting a serious dent in their wallet to get extensive dental work.

At our office, the cost of orthodontic treatment is based upon case complexity, therefore, an easier case that would qualify for DIY treatment will be the same price, or less, at our office as it would be if you ordered the aligners online. So, why not choose the option that will get you better, safer results?

Don’t forget about retainers either, as they cost more, and there’s no recourse for tooth movement after treatment with DIY systems. We provide you with retainers at Sturgill & Storie and guarantee your smile. If your teeth shift post-treatment, we’ll get your smile back to where it was. The same definitely can’t be said with mail-order aligners.

The Bottom Line

It can be seriously tempting to order aligners online and straighten your teeth in the comfort of your own home in an effort to save time and money. However, it can be dangerous to take that route and the only way to determine if you just need a minor touchup is to see an orthodontist for an evaluation and x-rays.

At Sturgill & Storie Orthodontics, we offer free consultations for potential patients in northeast Tennessee and southwest Virginia who are considering Invisalign or braces. If you’re not in the area, you can probably find an orthodontist in your city or town that does the same.

Additionally, our practice accepts most insurance and we have low down payment and no-interest financing plans to make treatment affordable for everyone. This way, you don’t need to break the bank and you can still get expert care without risking your smile and oral health. Your smile is too important to leave in the hands of someone who’s never evaluated it in person.

You have nothing to lose by scheduling a free consultation, so book yours and let’s talk about how treatment can work for your needs.