I recently became aware of companies now providing “Straighter Teeth by Mail”, or “Do it yourself braces”. My immediate reaction was one of caution. I thought I should look into this.
The New York Times February 1, 2015 had an article on this (http://well.blogs.nytimes.com/2015/02/01/a-trip-to-the-mail-box-not-the-orthodontist/?_r=0). In addition to reading the Times blog, I also viewed a YouTube video.
The process involves an individual taking their own impressions of their teeth and sending those impressions to a company through the mail. The company creates clear, plastic trays and mails them back to the individual, who aligns the trays over their teeth. Periodically, new trays arrive and are used. Over the course of treatment the trays result in straighter teeth. Simple, right?
The only benefit of straighter teeth by mail is reduced cost, which can be half the cost of care from a professional (an orthodontist).
The New York Times accurately documents some of the legitimate concerns of this minimally supervised treatment.
- You never meet or speak with a professional.
- There can be oral health issues that can compromise orthodontic treatment.
- Aligners are not appropriate for everyone.
- You could be wasting your time and money trying to do something that is physically impossible (Dr. DeWayne McCamish).
- Patients who don’t see an orthodontist for regular checkups and/or for complete diagnosis are more likely to be harmed (Dr. Rolf Behrents, spokesman for the American Association of Orthodontists).
Now for my personal perspective:
The Cost
First, I can understand the concerns over cost. I suspect the average cost of orthodontic treatment, under the care of an orthodontist, could be $4000-6000. But we must put this in perspective. Americans spend an average of $30,000 to purchase a car. We spend an average of $5000/year on gas and maintenance of the vehicle. We keep a used car for an average of 4 years, and a new car for an average of 6 years.
The average American spent $2600/year on entertainment (2012).
The average American family of four spends about $5000/year vacationing.
The average annual cost of home repairs is $2000 (for a $200,000 home).
So to invest $5000 straightening your teeth, which you can keep your entire life, is a worthwhile and comparatively affordable investment.
The Risk of doing it yourself
As noted earlier in referencing The New York Times, the risks include compromised care, wasting time and money, and doing yourself harm.
In addition to the risks listed in the Times, I would propose the following:
- Tempero-mandibular joint (TMJ). Teeth alignment is a critical component of TMJ comfort. TMJ disease or pain may not present itself until years have passed, but the damage can be irreparable. TMJ disease and pain can also be debilitating and painful. I fear a “do it yourself” orthodontic service will increase the risk of TMJ disease and pain.
- A very limited definition of success. Orthodontists take into account profile, speaking, gums, jaw angle, as well as a number of other “normative” angles and measurements. Some of these factors require cephalometric x-rays, which are not possible with a mail-in braces service. People will not really achieve orthodontic success.
- Harm. Improper tooth position can introduce tooth mobility and even tooth loss. Supervision of treatment is a hallmark of traditional orthodontics.
I have personally received orthodontic care with Invisalign (clear, plastic) trays. I sought this care from an orthodontist, who took x-rays, visited with me about my goals and concerns, created a plan with me, was very experienced at taking impressions, and supervised every stage of my Invisalign treatment. To achieve our goals, a very small amount of enamel was removed from between my lower front teeth (something you could not do at home). At the conclusion of my treatment, some of the biting surfaces of my teeth required some simple adjustments called “equilibration”, again, something you could not do at home.
My case was a very simple, 6 month treatment. My wife said she didn’t think I even needed orthodontics. But the more I studied the benefits of teeth position, the more I knew orthodontics would benefit me overall. Despite the simplicity of my case, I still needed an orthodontist to supervise and provide treatment in order to achieve the best possible outcome. From my personal experience, and from my training as a dentist, I would highly recommend you avoid “do it yourself” teeth straightening. Evaluate how you can save money and pay for the best care, which is straighter teeth supervised by an orthodontist. Though I am not trained to provide this care, I can certainly refer you to an excellent orthodontist. I invite you to schedule an appointment to begin this exciting adventure! (801-292-3501).