Dental profession calls out harmful aligners

‘As a dental profession we need to unite and create awareness’: Following the increasing demand for direct-to-consumer aligners, three dentists address the dangers of this treatment and how the profession should approach the issue. 

The dangers of direct-to-consumer aligners have been flooding social media this past week.

This comes after the continued growth of this orthodontic treatment, particularly following the ‘Zoom boom’ which heightened the demand for orthodontics.

As a result, many dentists have called out the danger of direct-to-consumer aligners.

Here, three dentists discuss the dangers of this orthodontics treatment, the importance of raising awareness, and how dental professionals should approach the issue.

Dr Chetan Sharma

Online clear aligners, also known as direct-to-consumer (DTC) aligners, are a growing trend in orthodontic treatment. These aligners are designed to be worn by patients at home, rather than being adjusted and monitored by a dental professional.

While patients feel these aligners can be convenient and cost-effective, they also carry huge detrimental risks.

Firstly before any orthodontic treatment, a comprehensive examination and extensive health assessment is required by a dental professional. Bypassing this means that serious oral health problems such as gum disease, dental decay and abscessed teeth can be overlooked and even worsen.

Unfortunately, I have previously consulted a patient where periodontal treatment was indicated before orthodontic treatment. However, the patient had evaded this and gone ahead with direct-to-consumer clear aligners without the correct assessment.

As a result, their teeth became mobile and resulted in the ill-fated loss of their teeth. The patient now requires gum surgery and lifelong care.

Other risks involved in DIY online clear aligners include the lack of proper monitoring and adjustments throughout the treatment process. Clear aligners need to be adjusted from a dental professional at regular intervals to ensure teeth are moving at the safest and most optimal rate.

Without monitoring the progress of the treatment, teeth may not track and there may be very little or no tooth movement. If treatment does not go to plan, you may have to visit a dentist anyway. This will incur more costs further down the line.

On the contrary, tooth movement may be too fast resulting in potential tooth loss. I would strongly suggest to anyone that having no treatment is much safer than unsupervised treatment.

‘We need to unite’

In addition to the risks already mentioned, online clear aligners can only move your teeth by expanding your arch. This implies that you have very little control over the final position of your bite and whether your jaw will feel at ease in its new position. This can lead to long term TMJ pain and migraines.

Raising awareness about the dangers of ordering clear aligners online is important. It ensures individuals are receiving proper treatment and to prevent permanent damage to their teeth. Dentists and orthodontists can play a key role in raising awareness about the importance of seeking treatment from a licensed professional.

I truly believe as a dental profession we need to unite and create awareness campaigns through social media to educate the public about the dangers of online clear aligners. We can also participate in online discussions and forums to provide accurate information.

Together, we can advocate for stricter regulations on the sale of clear aligners online and for stricter guidelines for their manufacturing and distribution.

Ultimately, we all not only want to create beautiful smiles but also healthy smiles. Together as a dental community we are stronger, our voices louder, and the synergy of our actions are more powerful to educate the public on the dangers of online DIY clear aligners.

Dr Chinwe Akuonu

Teeth are a very precious asset and people, unfortunately, underestimate their importance  in comparison to other parts of the body. Most people think teeth are there to give you a great smile, but it definitely goes beyond that. Teeth are important for our chewing, our speech and our facial structure.

Dental professionals are teeth experts; we do not study for five years and specialise afterwards just for the fun of it. We know the implications of dental issues. That is why we recommend a detailed examination to be carried out prior to orthodontic movement, in addition to constant monitoring to be done throughout the process of treatment.

Personally, I am not aware of any dental professional who has not had a patient tell them a horror story of the results of online aligner treatments. Lately, I have received direct messages on instagram from patients asking if they should consider these offers. I have also had to dedicate a considerate chunk of my consultation sessions to educating patients on the harm that these unsupervised treatments could accrue.

I have even had patients whom, unfortunately, I couldn’t help because they required specialist intervention.

Gum disease, carious lesions, decay, tooth loss…

The most recent case I had was just last week. A young patient presented to me for a checkup while she was receiving ongoing treatment online. After a detailed examination, not only did I discover the presence of gum disease, but also that most of the teeth presented deep carious lesions and decay requiring urgent treatment.

Her aligners were provided without a detailed assessment. This has meant that the patient is currently at a high risk of losing her teeth if she doesn’t get them fixed as soon as possible.

I genuinely do not believe that patients are saving any money whatsoever by taking on these trends. Instead they are risking their oral health and it’s definitely not worth it.

Dr Chloe Harrington Taylor

Clear aligners are prescription devices which, if not prescribed correctly, have the potential to cause significant damage and harm. If forces are applied to teeth with underlying disease such as decay or gum disease, patients risk loosing teeth.

It would be like trying to build a house without stable foundations – the house would eventually fall down!

Dentists are experienced in delivering safe and effective treatment plans. Care and attention is put into planning to ensure that the forces being applied to the teeth are safe and tailored specifically for each individual patient.

The information used by remote orthodontic companies is insufficient to effectively treatment plan. A physical examination of the teeth and supporting structures is required. In addition, dental X-rays to show bone support and root anatomy are essential to ensure that patients can be presented with a safe and efficient plan.

Life changing consequences

Patients need careful monitoring, as not all movements prescribed will be fully delivered. Therefore, plans may need to be modified as treatment progresses.

Cases need careful selection for the use of attachments and interproximal reduction for space creation to help support and encourage movements. This is not a feature that remote aligner companies offer, and many cases can’t be completed successfully without these features.

I have seen first hand the damage and life changing consequences caused following the use of mail clear aligners. It may save money initially, but may also end up costing a lot more time and money in the long run to put things right.

What are your thoughts on this story? Let us know by emailing [email protected].

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