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Do-It-Yourself Orthodontics or Don't?

Recently a number of our patients have inquired about clear aligners that are mailed directly to them without any dental visits. The major company offering this service is Smile Direct Club. There are many questions surrounding controversial “do-it-yourself” dentistry or orthodontics and we hope to address some of our own concerns and advice when considering a product like this.

What is it?

Smile Direct Club offers a “Smile Guarantee” at a reduced price of what your orthodontist or dentist can offer you for clear aligners or traditional braces. They advertise simple steps to straighten your teeth and smile in roughly 6 months at about 60% less in cost. First, they mail you a do-it-yourself impression kit, making your own model of your top and bottom teeth, and request you take several photos of your teeth, bite and smile. They then use the information you send to them to fabricate the aligners that will ultimately move your teeth.

Does it work?

The aligners are designed to put pressure on your teeth in order to move them. Each aligner has a different fit to ultimately push your teeth into the position for optimal aesthetics. The simple answer is, yes, the aligners will move your teeth. But the question is are they moving your teeth according to plan and into proper alignment that guarantees optimal health and longevity for your teeth.

Possible Negative Outcomes

When an orthodontist or dentist recommends clear aligners or traditional braces, they are firstly and most importantly diagnosing your oral health status. A full set of x-rays is essential to determine if there is infection or risk of infection to the teeth and gums. We are looking to diagnose any dental problems that could affect the overall health of the mouth. This includes:

  1. Cavities
  2. Abcesses
  3. Gum disease
  4. Periodontal disease
  5. Oral Cancer
  6. Fractured or broken teeth
  7. Defective or broken fillings or crowns

If these are left untreated before clear aligners are used, a person is at risk for pain, infection, loss of teeth, or additional cavities and gum or periodontal problems. A thorough and complete exam is essential before use of aligners to ensure there are no dental or oral health issues. When using a mail-in product there is no guarantee that the mouth is in a healthy state to receive orthodontic treatment and benefit from it optimally and safely.

The actual dental impression of your teeth is also a major factor to determine a successful outcome. Dentists and orthodontists are trained to take an ideal impression, which takes years of training. You must also know what to look for in the impression to determine if it is a “good” dental impression. If there are any distortions, voids, bubbles, excess material, inadequate material this will effect the quality of your impression. These errors will lead to aligners that do not fit the teeth properly and can either be ineffective or move your teeth into an improper position. It is difficult to obtain a good quality impression without proper dental training and experience.

The Importance of Regular Follow-up

Another negative of a do-it-yourself or mail-in aligning products is there is no regular follow-up with a dental professional. When clear aligners are prescribed under the care of your dentist it is essential to be seen by him or her every 6-8 weeks. At these regular follow-up appointments your dentist is checking to make sure there are no dental problems and that the teeth are moving properly. If the teeth are not moving properly the treatment must be re-evaluated to determine the cause and to ensure proper steps are taken to correct the movement of your teeth. With the Smile Direct Club there is no follow-up or supervision during the treatment to ensure your teeth are moving properly, which can result in even more crowded, rotated, crooked teeth.


In conclusion, Smile Direct Club or other mail-in dental products have to be used with extreme caution. What may work for one individual, may cause harm and more damage to another individual. It is extremely important to talk to your dentist or orthodontist before considering any product that is DIY or received in the mail. We highly encourage everyone to ask your dentist about properly aligning your teeth and all the options that will best serve you individually.