If you’re like many adults you may be thinking, are Invisible braces right for me? How much money will it save me? You see commercials and it looks so easy! We’re here to give you the expert advice and potential warning signs that you need to know before going online and ordering your new smile.

Dr. Mary Ann Lester interviewed Dr. RENÉE ROLAND, DDS, MS an orthodontist and colleague on the topic of online braces.


Recently I had the opportunity to ask one of my esteemed orthodontic colleagues Dr. Renee Rolland, Penfield, NY about what she thought of the online braces fad such as Smile direct club or others.

Dr. Roland and I work together and I highly respect her approach to orthodontic treatment in children and Adults. I was concerned about this online avenue of treatment as a number of my patients had asked me because the cost was less but I was also concerned about the periodontal implications of orthodontic forces in compromised teeth (teeth that have lost bone and recession of soft tissue).

Dr. Roland has given me some important insight about online braces vs comprehensive orthodontic care to share on my blog so our patients can make informed decisions.

Renee’s insight:

Invisible braces or aligners (like Invisalign® or Clear Correct®) have become incredibly popular in recent years. What is causing this boom in “invisible” type braces is the increased desire for adults to seek orthodontic treatment. A new company called Smile Direct Club® is offering what seems to be a more convenient and cheaper alternative than going directly to your healthcare professional.

How it works
You can obtain a digital scan of your teeth (if one is available in your area) or have an impression kit sent to your home. Your case is then reviewed remotely by a licensed dentist or orthodontist and voila! – retainers or aligners are shipped to your home to try to give you a perfect smile or bite.

Here’s what you should be aware of when choosing invisible braces:

  • They are only offered to adults and not children. Adult orthodontic patients are often some of the most difficult cases to treat on a daily basis and one of the biggest reasons is that adults have stopped growing and the bone that supports the teeth does not adapt as easily.
  • Another reason is that many adult patients commonly have fillings, crowns, root canals, gum recession, thin gum tissue or underlying periodontal disease. Many patients that present to an orthodontist for treatment need further evaluation by a dentist or other dental specialist before they are ready to begin orthodontic treatment. A clinical exam of the teeth and gum tissue is very different than just evaluating someone’s mouth by photographs or study models alone.
  • When it comes to shifting the position of your teeth there are many other factors you need to consider besides esthetics.  Long lasting beautiful healthy smiles can only be achieved with a balance of form, function and esthetics.  So in other words, straightening teeth is more than just shifting them around so they look good, they have to be able to have the proper alignment so you can chew without imbalances or pain. Unfortunately, some of these mail direct orthodontic programs are centered around esthetics and not necessarily achieving a harmonious and healthy bite which in the end is imperative to a good long term result.

Unwanted side effects:

  • Gum recession can occur (or increase) during orthodontic treatment.  This is one of the most common unwanted side effects seen when moving teeth in adults. Gum recession can lead to sensitivity of teeth or in some cases – loss of the teeth. The most common area you see this occurring is the front teeth because some patients have thinner bone and smaller roots. This can create many esthetic challenges and can be very difficult to treat if there is gum recession in your smile line.
  • In some cases, it could make it worse.  Invisalign® has become a good alternative to traditional metal or ceramic braces because of its research and design over the past 20 years. One of the biggest factors that have allowed Invisalign® to actually work in moving teeth is through the use of bonded attachments that are “glued” or bonded to your teeth by a dental professional. If these attachments are not there – the teeth will not move the way they are predicted to move. Smile Direct Club® or Direct-to-Consume orthodontic companies, cannot offer these bonded attachments.

Therefore – you may be paying for tooth movement in your mouth that is not possible. And you may end up spending thousands of dollars more to have it done again by an orthodontist who would actually be monitoring the progression of your case.

  • Unwanted gaps in gum tissue. Another common unwanted side effect from adult orthodontic treatment is the development of black triangles between the front teeth. These occur when overlapping or crowded teeth are aligned and the gum tissue does not fill in the gaps between the teeth. Gum tissue in adults does not respond the same as growing children’s gum tissue. These gaps look like someone has a poppy seed stuck in between the teeth. These are often fixed by re-shaping the teeth or slightly filing between them to eliminate the gap. This can only be done by an orthodontist or dentist and often needs to be done during orthodontic treatment.

In this day and age, many people are informed consumers and like to find solutions that are not only good choices but are also smart decisions monetarily. It is always a good choice to invest in yourself and in your health, these choices lead to long-lasting outcomes that can improve your life in many ways.

However, certain decisions should not necessarily be based on convenience and finances alone. Working with a trusted professional when it comes to your health is always going to be in your best interest. Treatment planning your case with an experienced clinician usually starts with good conversation to review all your options and ultimately helping you to form an educated opinion regarding the treatment that suits you.

Click here see below for a consumer alert statement from the American Association of Orthodontists. Thanks for reading.

In Good Health and Best wishes,
Dr. Mary Ann Lester & Renee L. Roland, DDS, MS

Call Now Button