NOTE: The author, Dr. Jared Gianquinto, is an orthodontist in the private practice of orthodontics and dentofacial orthopedics in Bakersfield, CA. He was trained at Temple University and Naval Medical Center San Diego, completing orthodontic specialty training at Temple University and is past president of the Kern County Dental Society. Dr. Gianquinto’s unique combination of extensive past general/cosmetic and current specialty orthodontic practice qualify him an expert in two-phase treatment, extraction and non-extraction treatment, clear aligners (Invisalign), 3D printing, accelerated orthodontics and multiple bracket systems. The opinions expressed here are protected by copyright laws and can only be used with written permission from the author.
At-Home Orthodontics – Buyer Beware!
In this new age of YouTube, Amazon and 3D printing, I’ve had a lot of questions about at-home clear aligner treatment to straighten teeth. With slogans such as “Straighten your teeth for 60% less than braces”, “Get straight teeth in months” and “You shouldn’t have to pay a fortune for a smile you’ll love,” their marketing is definitely generating some buzz. These at-home orthodontics services advertise a process where they send you some materials, you take molds of your teeth at home, and a few weeks later you receive a set of clear aligners that will deliver the smile of your dreams. In a matter of months, of course. The questions I hear are, “Does this really work?” and “Is straightening teeth really that easy?”
First, I have to disclose that I am a trained specialist, and have been treating patients with clear aligner therapy for over 10 years. I’ve also treated many patients with complications brought on by aligner therapy and braces performed by general dentists. In certain cases, I had the unfortunate responsibility of informing patients that their complications were severe enough that further orthodontic treatment would result in loss of teeth, with the risks outweighing the benefits of treatment.
The greatest concern I have about at-home aligner therapy is the lack of diagnostic information and a treatment plan. With any kind of healthcare, no treatment should ever be provided without an actual diagnosis. In short, if you don’t know what the problem is, how can you fix it? Every single patient we see in our office undergoes a thorough examination including x-rays, diagnostic photos and evaluation of the gums, teeth and supporting bone. Before we propose any kind of treatment, we need to understand what the patient’s concerns are, what’s going on underneath the gums, and what kind of complications there might be, if any. Why is this important? Without this information, you’re basically flying blind, and there’s a very real possibility that teeth can be moved right out of the bone and supporting gum tissue. If this happens, the damage will most likely be irreparable. At-home molds of the teeth just don’t provide enough information to develop an accurate diagnosis and safe treatment plan.
Aligner therapy does work really well, especially with a solid understanding of underlying biology, how teeth move, and how to design the appliances to get the treatment done. In short, the aligners are only as effective as the skills of the doctor designing them, using properly gathered and analyzed diagnostic information. Aligners by themselves are just pieces of plastic, and computer simulations of tooth movement are really just cartoons. Tooth movements that are shown on screen are may show a set of crowded teeth unraveling and straightening, but years of experience have taught me that every single person’s teeth respond differently to treatment. The human body is an extremely complex mechanism that doesn’t always react to forces the way mathematical formulas say they will. When the teeth don’t move according to plan, it’s critical to have an experienced orthodontist there to make sure things stay on track. When you’re using at-home aligners, you’re on your own. You may have the option of seeing a professional if something isn’t going the way it is supposed to, but by that time, there may be damage done that is impossible to fix.
It’s easy to see crooked teeth that could be straighter, but straightening them without causing any damage, and making the bite fit together at the end is a lot more complicated than it looks. Getting straighter teeth doesn’t have to break the bank either. If all you want is straight teeth in a short amount of time and aren’t concerned about how your bite will fit together, we can help. It’s called “limited treatment”. Here at Gianquinto OrthoArts, full braces and comprehensive aligner therapy aren’t always the right smile solution for every patient. If limited treatment can address your concerns, and we can make those corrections safely, we’re happy to present that as an option. And you can be sure that your treatment will be done right the first time.