By: Dr. Ali Jones
Hi friends. I am going to go on a little professional rant here, so bear with me. In order to tell this story, I have to admit something to you all. I watch reality TV. I love The Real Housewives series on Bravo. I have been committed to the Bachelor and Bachelorette series since I was in dental school. I also follow plenty of reality TV personalities on my social media. It's just entertaining and mindless and sometimes after a full day of dentistry and thinking and deciding things and organizing and business-ladying and momming, I need mindless. Try not to judge. I call it my "laundry TV." With 4 little kids, I have ENDLESS laundry. So, at night after the little ones are tucked in to bed, I settle in with piles of clean clothes and the Housewives or the Bachelor or whatever reality crap du jour is on.
Here is how this slightly embarrassing admission relates to my little dental blog and my rant....
Because these reality stars have millions of followers on social media (Facebook, Twitter, Instagram, Snapchat) they get asked to endorse lots of products and services. I recently noticed that some of my reality TV faves have endorsed a newish service called "Smile Direct Club." I have seen it come up several times with different reality stars taking selfies and proclaiming they are getting straight teeth with this "convenient, affordable, invisible option that you can do from home." So, of course, I checked it out.
In the simplest terms, it is DIY, mail order orthodontic treatment. People who want their teeth to be straighter and prettier and never pursued traditional orthodontic treatment or need a "refresh" after their teeth have shifted again, can fill out a 30 second smile assessment to see if you're a good candidate for their service. Wait, what?? Stop right there. THIRTY SECONDS? Ummm, no. If you came here to my office and I asked you some very basic questions that took thirty seconds and I never even looked in your mouth or took an xray and did not take a thorough medical or dental history, and from that I determined if you should have orthodontic (or any dental) treatment, I hope you would walk right out my door and not look back. The first thing you need before you decide to do any medical or dental procedure is for a professional to evaluate the many aspects of your case using all of the training and experience they have to offer. So already, big fail...a 30 second online questionaire is not enough to tell you if you are a candidate for moving teeth.
As if that isn't enough to stop you from pursuing mail order dentistry, let me tell you what you do next. You know those impressions of your mouth we take at our office to make models of your teeth? They mail you the stuff to do it by yourself at home. You guys, I know we make it look easy (wink, wink), but there is an art to a good dental impression. It's actually kind of a tricky process. And, even as dental professionals, we often do retakes on impressions because the first or second was not absolutely perfect. And if you don't take good impressions, you get inaccurate models. And if you have inaccurate models, you have inaccurate treatment. How can you possibly have a good outcome when you start with something totally inaccurate in the first place? You can't. And when was the last time you mastered something on the first or even the second try? I mean, maybe you're that good, but I'm not. It takes me a lot of tries to get really good at something and it takes even more to get it "perfect." So, guess what y'all? You're not going to take a perfectly accurate impression of your own mouth at home. You're just not. I wouldn't take an impression of my own mouth and I'm a dentist. The only way to do it right is for someone who knows what they are doing to take impressions for you and evaluate their accuracy.
And then you mail the impressions to the Smile Direct Club. Even if you got the perfect impression at home, it probably won't be by the time it gets to them. Impression materials are highly susceptible to expansion or shrinkage with time and environment. ONLY the very, very expensive, technique sensitive materials that we use at the office can retain their accuracy long enough to be sent to a second location. Oh, and the mail always takes very good care of packages with no concern of damage or exposure to extreme heat, cold, humidity, dryness or other climate factors. I am just sure that the impressions will be sent in a temperature and humity controlled environment with kid gloves. (Insert eye roll.)
If you're lucky to live in a city near an actual Smile Direct Club store, you can go in and have a technician do a 3D image/scan of your teeth. While the technology is pretty awesome, remember that humans are operating them. And if humans running the 3D scan don't know what they are doing and haven't been doing it long enough to have a lot of experience, they may not get the optimal scan. Again, education, training and experience is necessary for a good outcome on this procedure. This could lead to the same model you get from your at home impression - inaccuracy leading to a potentially questionable result. I'm not sure about this, but I'm going to guess that the technicians are not from a dental background with education and training on head and neck anatomy and dental morphology, etc. Plus, who knows how your actual experience will be. I read reviews of people feeling like the tech was rough and hurt their mouths while doing the scan. And, oh yeah, I am sure there is no turnover for a job like this. I am sure these are seasoned professionals who are highly trained with good compensation and wonderful benefits and really take pride in their job. (note: heavy sarcasm) Finally, there is NOT a DENTIST in the store to monitor the evaluations and scans they do. As far as I can tell, a dentist is not involved in the process at all. Hmmmm....
Have you had enough? I could go on with the rest of the process and continue to poke holes in it. There are SO many more reasons why NOT to do mail order dentistry. If you are dying to hear me go on....call me, email me...I can tell you the rest. Seriously, please don't do DIY dentistry or orthodontics, or any other medical procedures without professional supervision. I promise this is not making me fired up because it's taking business away from me. Guess what? I don't even do orthodontics in my practice, so I don't lose a dime from patients choosing to use this service. I just simply can't stand the deception of a huge marketing budget telling you that you can have perfect teeth by mail. Moving teeth is far to complex and important to trust to customer service representatives.
I mean, for Pete's sake, we trust our hair, our nails, our skin, our eyebrows only to our favorite professionals. We are willing to pay for highly skilled, trained and experienced people to do these services for us. Dentists and specialists like orthodontists go to school for a long, long time and continue to seek education throughout their career so they can do what's best for you and keep you safe and healthy and comfortable. So, when it comes to moving teeth, please don't mail it in, folks.
Ali Jones, D.D.S. - Dentist