Mail order aligners and home based ‘orthodontists’- when will it all end?

  Posted by: Dental Design      7th February 2020

Charlotte Gentry presents her opinion on a growing problem.

It seems that ‘selfie’ smiles have become a huge problem in the past few years. Members of the public are going to websites, sending photos to transatlantic companies and getting aligners made. Not only this, but I have seen concerned colleagues raising the issue that people are able to go to the high street – and even more shockingly people’s houses – for scans for aligners to be made. I myself couldn’t believe this hasn’t yet been addressed and wonder how these companies and individuals are allowed to be offering orthodontic ‘treatment’ to a patient.

I am no orthodontist, however, every GDP knows an orthodontic assessment is required, the patient’s entire dental health assessed and detailed treatment plan/plans for retention in order to provide optimum orthodontic treatment. Ultimately, these companies are providing medical devices to patients without detailed assessment, follow-up or maintenance.

Not only is there none of the above, even more concerning is that customers have to take their own impressions at home. Dentists went to university and studied for five years in order to be able to take good quality, accurate impressions and we still get it wrong sometimes. How can a customer be expected to provide an impression of a quality good enough for their orthodontic treatment?

In my opinion this practice must surely be illegal. In the USA steps have already been made to stop companies from being able to provide these aligners within several states. The American Dental Association have said: “Teeth are living organs. Moving teeth…is often a complicated procedure dependent on multiple individual variables. There really isn’t a ‘one size fits all’ methodology for providing competent, professional orthodontic treatment.”

I hope that soon our regulatory body will begin to address these issues in the same way they have addressed illegal tooth whitening. Their most important role is to protect the public and there is certainly a safety risk with these type of appliances.

Complaints have allegedly grown for many of these companies, and I have read that customers have had to sign disclaimers saying they won’t report the company to regulatory bodies before receiving a refund. This suggests to me they know exactly what they are doing is unacceptable – otherwise, why the fear of being investigated?

Not only is this clearly a risk to public safety, I feel that companies like this are undermining the work and training we’ve done as dentists. We spent five years of our life to qualify; orthodontists have spent years on top of that to provide orthodontic treatment to their patients. By providing this kind of treatment on the cheap, it does not paint a good picture to members of the public. We are already demonised by many as a profession for being too expensive – and by providing suboptimal treatment on the cheap it makes it appear that this is true. Not only this, but it undermines our qualification – if it can be done so easily, why do dentists need to do it and what was all that training for?

This piece only touches the surface and there is so much to say with regards to companies like this. However, I just really hope that with more awareness now, this is the beginning of the end and soon regulation will stop this kind of practice happening in the UK in future.