It’s not easy, navigating the clear aligner market nowadays. A lot of new clear aligner brands have popped up in the last few years. It’s difficult to tell which ones are worth your time and which ones aren’t. SmileDirectClub, Strayt, Byte, and SnapCorrect are just a few of the new at-home clear aligner brands that I’ve seen appear recently. These brands (particularly SmileDirectClub) have done a brilliant job marketing themselves as current, trendy companies that can give their customers straight smiles overnight.
For some people, these brands, or any of the other at-home clear aligner brands, work wonderfully. They go through the treatment, paying in monthly installments, and end up with a beautiful smile. But, for a lot of people, these companies are unable to deliver on their promise of a healthy, straight smile. It’s not because the aligners aren’t high quality (a lot times, they are). It has to do with not being under a doctor’s care.
Just because you have misalignment that you want to correct doesn’t mean you’re a perfect candidate for clear aligners. I give all of my patients who’re thinking about going into Invisalign a full exam. We do this exam to make sure their teeth and gums are healthy. If someone has cavities or needs an extraction, I want to do that before they go into Invisalign.
Extractions are particularly important because, when you get an extraction, the remaining teeth begin to move to fill in that gap. If a dentist extracts one of your teeth after your clear aligner treatment (and you don’t immediately get a dental implant or bridge), the time and money you put into your straight smile will go to waste. Within a year, the teeth will become misaligned again. If you go back to the dentist a year or so after an extraction and you want to get a dental implant, chances are you will have to go into a clear aligner again. Your teeth will have moved and there won’t be enough room to place a natural and long-lasting implant.
Making sure your teeth are decay-free before clear aligner treatment is important. However, it’s even more important to make sure your gums are healthy. A huge number of Americans have periodontal disease (gum disease) and don’t even know it. Periodontal disease occurs when bacteria gets underneath your gums, causing bleeding, inflammation, and, in severe cases, tooth loss. The bacteria encourages the gums to pull away from the teeth (gum recession), weakening the bond between tooth and gums.
When the gums become too recessed to hold onto the tooth, the tooth falls out. If someone with periodontal disease goes into clear aligners, they exponentially increase their chances of dental mobility (loose teeth). Clear aligners work by gently but persistently pushing teeth into the desired position. If the gums are healthy, this process works well. But, if the gums are already weak, the clear aligners will be too forceful. The teeth will become loose (and potentially fall out) instead of aligning.
This is an extremely dangerous consequence to at-home clear aligners. Even if you think your gums are healthy, please make sure to visit a dentist before starting treatment — or, better yet, get Invisalign. Dental mobility is frequently treatable but it isn’t something anyone would want to go through. Waking up to a loose tooth is terrifying. With Invisalign, a doctor will be monitoring your case, making sure everything is healthy and progressing correctly. Just having that peace of mind is, for most of my patients, reason enough to get Invisalign instead of an at-home aligner brand.
The first step when you’re getting Invisalign is either impressions or an Itero scan. Up to around five or so years ago, dental impressions were the preferred way to gather accurate 3D “images” of the teeth (which we need in order to create clear aligners). Taking an impression involves placing a putty-filled tray inside the patient and having them bite down and wait for the impression to set. It’s a difficult process that’s uncomfortable for the patient and only offers moderately accurate information.
This is why our office uses Itero scanners instead of traditional impressions. Itero scanners allow a dental assistant to quickly and easily digitally scan a patient’s mouth. The scan is an exact 3D image of the patient’s teeth which means it’s very, very accurate. When we send the scans to the Invisalign lab, we’re confident that the trays they send back to us will be perfect for the patient. The process is pain-free and takes less than a couple of minutes. The transition from taking impressions to scanning was truly monumental for our office. It made the orthodontic process exceedingly easier for patients.
If you do a 100% at-home clear aligner process, you will have to do your own traditional impressions. They will send you an “impressions kit” with the needed tools and instructions. Once you’re done, you will mail it back to the company’s lab. The lab techs will use those impressions to make your clear aligners.
On paper, all of that sounds fine. That is, until you begin to think about how difficult and uncomfortable it is to take an accurate impression. Offices train dental assistants (who still use impressions) to know exactly how to do a perfect or near-perfect impression. Expecting someone who’s never done it before to do it (with limited materials and instructions) is a little ridiculous and very risky. If the impression is done incorrectly, it could mean either a longer process for the patient or ill-fitting trays that only create further misalignment. A poor impression can mean, at the end of your treatment, having a smile that is less aligned than the one you started with.
Invisalign encourages all of its doctors to use Itero scans since it realizes the fallacies of traditional impressions. All those scans are done by a trained dental assistant in a dental office.
We know no one likes going to the dentist but, if you want a straight smile, it’s something you need to do. If you need a blood sample, you go to the doctor to do it. They don’t send a kit to your house and ask you to do it yourself because there are a host of risks involved in doing that. At-home clear aligner brands have made people feel like getting mail-delivered trays is the same thing as going to the dentist for treatment but it isn’t. It carries with it a lot of potential dangers like dental mobility and further misalignment.
Invisalign is the oldest and most highly-rated clear aligner brand for a reason. It allows the dentist to take an active role in the treatment process. This includes monitoring the patient’s progress and making tweaks along the way. At the end of treatment, the doctor can take a look at the patient’s mouth and recommend realignment (more trays) or a particular retainer to keep things straight. For at-home brands, you’re on your own a lot of the time which means you may not be able to keep your straighter smile for very long.