General Dentistry.
Apri 2020
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WHAT TO CONSIDER IF YOU’RE THINKING ABOUT
MAIL-ORDER ALIGNERS
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n the past few years, there has been an increase in the number of companies offering direct-to-consumer or mail-order aligners. These companies sell their products to customers who are interested in straightening their teeth. They ship custom aligners directly to homes. While in theory this sounds like a benefit due to the convenience of being able to start orthodontic treatment without leaving your house, there are some precautions to consider before trying. Some companies ask customers to take their dental molds to create custom aligner trays. Creating dental molds without training or prior experience may result in inaccurate molds, which in turn could cause potential issues with aligner trays. Other companies have physical locations, such as stores in malls, where staff are available to scan a customer’s teeth with a three-dimensional intra-oral scanner. Using a scanner not only allows for the capturing of the shape and position of a person’s teeth, but also allows for the obtaining of a person’s bite – the way their teeth fit together when their jaw is closed. Once consumers start treatment, they may not provide photos or feedback to their assigned dentist for up to 90 days. It’s important to realize these scanners do not capture any information regarding the general health of the teeth, gum tissues, the bone surrounding the teeth or the joints in the mouth area — all essential factors to consider before moving teeth. Also, a 90-day window for checkins can allow a variety of issues to manifest and worsen before being addressed. While direct-to-consumer aligners can move teeth, doing so without proper diagnosis and treatment planning can lead to permanent damage that can be avoided if treatment is administered via an expert in moving teeth — an orthodontist. Earlier this year, California established a law to protect consumers, requiring all teledentistry patients to acquire an X-ray or diagnostic bone scan before starting dental treatment. Other states may follow. Orthodontists familiarize themselves with the relationship of a patient’s teeth and surrounding bone and structures before creating a personalized treatment plan. Often this starts with a free initial consultation in the orthodontist’s office, followed by a diagnostic appointment where various X-rays and other information are collected. From there, orthodontists will create a personalized treatment plan and discuss options with the patient, including whether additional dental services should be considered before orthodontic treatment, what type of orthodontic appliance might work best for the patient’s needs and what results to expect at the end of treatment. Upon starting treatment with an orthodontist, patients will generally visit with their doctor every four to six weeks to ensure treatment is progressing as needed and to receive any necessary adjustments to their dental appliance. Doctors will also monitor the patient’s general oral health and communicate with a general dentist should the patient develop issues such as gum inflammation or a cavity. While this may lack the convenience factor of direct-to-home options, it helps avoid potential permanent damage such as gum recession, tooth and bone loss and worsening of the patient’s bite that could occur if treatment is not monitored in person by a professional. If a mail-order aligner patient feels their teeth are a little straighter following treatment, but this gain has come at the cost of creating a worse bite or bringing about a situation where their jaw doesn’t close as well, they haven’t gained anything.
Moving teeth without taking proper pretreatment records, including X-rays
MAY LEAD TO: • •
• • •
EXCESSIVE LOSS OF BONE AROUND TEETH. GUM RECESSION, A SHRINKING OF THE GUMS, WHICH CAN BE UNAESTHETIC AND CAN CAUSE SENSITIVITY TO COLD WORSENING OF THE BITE OR HOW THE MOUTH FITS TOGETHER WHEN CLOSED TOOTH LOSS ISSUES WITH STRAINED MUSCLES IN THE JAW AND NECK AREA
Unsupervised tooth movement can cause damages that are more complex than tooth misalignment. Before choosing a direct-to-consumer aligner option, ask yourself a question: What other medical treatment would you undergo without in-person pretreatment evaluation or ongoing in-person supervision from a medical professional? In short, when seeking orthodontic treatment, you need an expert that can deliver desired realistic esthetic results without causing any damages to oral tissues and structures. Remember, orthodontic treatment is not a product or device. Orthodontic treatment is a professional medical service. About the Author
Dr. Mohamed Bazina is an assistant professor at the University of Kentucky College of Dentistry and a Diplomate with the American Board of Orthodontics. His interests include orthodontics, 3D imaging and craniofacial orthodontics. More information about UK Dentistry is available at www.ukhealthcare.uky.edu/dentistry.
ABOUT UNIVERSITY OF KENTUCKY COLLEGE OF DENTISTRY Clinic Info: 859-323-DENT (3368) • ukhealthcare.uky.edu/dentistry UK Dentistry offers expert, personalized care for the general and specialty dental and oral health needs of adults and children. We're committed to improving Kentucky, and beyond, one smile at a time.
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