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Mail Order Orthodontics – This Week’s Worst Impulse Buy

Which is the worst impulse buy: mail-order orthodontics, a hot air balloon kit, or a do-it-yourself in-ground pool? The game show contestant makes the right choice in “Impulse Buy,” the video that addresses risks associated with mail-order orthodontics and the importance of seeing an AAO orthodontist for treatment. 

It sounds almost too good to be true: the convenience of orthodontic treatment without ever having to leave your home or seeing an orthodontist or dentist in person (meaning no office visits), and it sounds considerably cheaper than in-person orthodontic treatment. What’s not to like? While advertisements and social media posts may make mail-order orthodontic treatment sound tempting, there is more to the story.  

Many mail-order orthodontic treatment companies portray orthodontic treatment (especially straightening only the front teeth) as just “cosmetic.” The truth is, moving teeth is a medical procedure that relies on complex biological processes and should be monitored in person by a trained dental professional. Did you know: 

  • Teeth are moved when any orthodontic appliance (like a clear aligner or braces) puts pressure on the teeth. The pressure causes necrosis (death) of the supporting structure around the tooth, allowing the tooth to move within its alveolus (bone socket), and bone then reforms around the tooth.   
  • Moving “just the front teeth” can have significant consequences on oral function and health. For instance, in one study of over 5,000 clear aligner cases, clinicians “frequently” reported the unintended consequence of an open bite—a condition where the back teeth do not come together. Open bite has been described as “one of the most severe” misalignments of the teeth, which can impair a patient’s ability to chew food.  

Some of the most important parts of orthodontic treatment for ensuring the treatment is safe and effective can only be done in-person. Far from “an inconvenience,” these evaluations that can only be done in-person to ensure your treatment goes as well as possible. For example: 

  • Obviously, x-rays can only be taken in-person. X-rays are the only way to see underneath the gums (digital scans and photographs, which mail-order companies rely on, can’t see under the surface of the gums). Without taking an x-ray, it is impossible to see anything the naked eye cannot see, such as the health of the tooth roots (moving teeth with unhealthy roots can cause loosening or loss of teeth) or an unerupted (impacted) tooth. 
  • Straightening teeth when the patient has poor periodontal (gum) health can lead to recession (exposure of the tooth roots), root shortening, or tooth loss. The only way to effectively evaluate gum health is in-person, such as through periodontal probing (checking the depth of the root pocket with a dental probe).  

These are just two examples of the evaluation and monitoring that can only be done by an orthodontist or dentist in-person. Experts have called in-person care “an irreplaceable cornerstone of orthodontic treatment” and stated that digital photographs “are never a substitute for careful clinical in-person evaluation.  

While game shows are fun, you should never play games with your teeth.