The implication is that dentists are simply retailers of the aligners, and you are simply buying the product directly from the aligner company. I understand the possible natural assumption that any criticism or defense from a dentist is self-serving or "protecting our turf." I hope you'll indulge me for a few minutes and read on.
You shouldn't buy scalpels or Botox "direct," either.
In order to receive the braces directly from the online retailer, you need only to send them self-administered dental impressions (molds) and some selfie photos of your smile and teeth. That's it. No live examination by a dentist needed. If you're "approved," you get your braces in the mail.
If a dentist, in any state in the U.S., provided any kind of orthodontic treatment, including aligners, with only impressions and cell phone photos as "diagnostic records," it would be a slam-dunk case of malpractice. Slam. Dunk.
That should be enough information to end this article. But, I'll continue to elaborate.
What could go wrong?Orthodontic treatment (moving teeth) without a comprehensive dental examination, including x-rays and periodontal (gums - soft tissues and bony support) examination would rightfully be considered below the standard of care, because
it would potentially place patients at significant risk. For example, straightening teeth that have gum health issues can lead to worse gum problems and even tooth loss (see news report video below). Teeth with cavities, bone loss, abscesses, impacted teeth, retained baby teeth, and other conditions should not be moved orthodontically until those issues are resolved. With DIY braces, those issues will not be known nor addressed. This is dangerous and could result in significant damage. Really. It can. The logical question that follows is, "Who is accountable?" You may find this news story about a mail order braces case gone wrong interesting:
Why a dentist?Beyond establishing the patient's dental health status, the dentist must also diagnose the orthodontic condition and then formulate a proper treatment plan. The treatment plan includes which teeth will be moved, where, when, and how. There is considerably more to it than taking impressions and applying the aligner trays. For example, in many cases, the teeth are crowded due to "more teeth than space." We need to create space. This is often done by reshaping some of the teeth, progressively, throughout the treatment. This doesn't happen with DIY braces.
Orthodontic aligner therapy in a dental office also usually includes critical "attachments" placed on the teeth. These are temporary "buttons" bonded to the teeth so the aligners can make very precise movements of each tooth. These attachments are often added at the very beginning of treatment. But, they may also be changed or added during and throughout the course of treatment. This doesn't happen with DIY braces.
In some cases, the treatment plan has to be modified to make "mid-course corrections." Orthodontic aligner therapy must be monitored by the dentist (usually every six weeks). None of this happens with DIY braces you get online.
While the mail-order / online company advertises that their aligner trays are made by Align Technology (parent company of Invisalign™), you should know it is a VERY different material. It's not the same thing. They are not Invisalign™ brand aligners. Though, that is not really the point here. The key ingredient to orthodontic treatment is the dentist, not the appliance used. With DIY braces, the actual professional service is absent.