The risky business of mail-order aligners

Post by 
Dr. Justin Evans
n recent years a group of companies have appeared offering orthodontics by post or 'mail order aligners'. They claim to offer orthodontic treatment that can be done at home or by visiting a sales outlet, then using clear aligners posted to your home. These companies promote the cost and convenience of never having to visit a specialist orthodontist.

Does it actually work?

Unfortunately, there are a many risks to consider before pursuing this kind of treatment. The fact is patients never see a real specialist orthodontist and inevitably this can and will have consequences for your dental and medical wellbeing.

In a specialist practice the staff are specially trained and scans are supervised by an orthodontist. In these mail order outlets, there is no medical supervision.

Would you let your local coffee shop barista style your hair?

Why would you trust your teeth to someone with no dental experience?

For companies without outlets, you take impressions yourself at home with a putty kit. Getting an accurate mould of your teeth is a challenge even for trained dental assistants, doing them on your own mouth is much more challenging.

Beyond this, your treatment is 100% remote: your aligners are sent to you in the post and a dentist will inspect your teeth via remote video and attempt to determine if your treatment is working effectively.  The accuracy of the aligners is critically dependent on the quality of the initial set of impressions or scan. If these impressions are inaccurate, the aligners will not fit, or might move your teeth into an even more misaligned position. Unfortunately, there is no orthodontist to check before you get started.

The truth is teeth cannot be fixed by mail-order aligners.

Due to rising concern about the effectiveness of this style of treatment, the American Dental Association recently passed a resolution discouraging the use of mail-order aligners, and the American Association of Orthodontists issued a consumer alert, as well as filing complaints with the dental boards of 36 states against tele-dentists for irresponsible care.

The British Orthodontic Society have stated that “A full clinical examination by a trained clinician is necessary to decide if orthodontic  treatment is in the best interests of an individual the public that orthodontic treatment should always be provided”.

The legal position?

In the UK, regulation is clear; a person who is not a registered dentist or dental care professional is not allowed to practice dentistry.  Equally, if a dentist provides remote care without seeing the patient, they are liable for that care.  Additionally, informed consent must be obtained. Furthermore, it is also clear that the dentist who approves the treatment plan is liable for that care and is responsible for informed consent.