Smile Club Direct in Big Trouble

One of our forum members thinks Do-it-Yourself orthodontics is a great idea. I have posted why it is not so.

Colleagues have been tell me that these shysters were in trouble, close to bankruptcy. Now comes the word that the Attorney General of Washington DC is suing them over insistence to sign non-disclosure statements to get refunds.

Read about it here. Also included are many of the adverse outcomes I have seen from patients visiting my office.

Here we find a familiar pattern in corporate America- Invent a hare-brained idea, publicize it to the uninformed masses on TV, draw max cash out of it, then get out before the whole thing collapses, leaving late investors to take the loss.

I am not a fan of nda for normal business transactions.

Just reading the agreement Smile Defect Club makes you sign before they take your money should scare the bejeebers out of any potential patient. They give a long list of bad things that can happen, but folks just think it won’t happen to THEM. But it does.

Personally I think dumb uneducated people might as well be fleeced. If corporate dental shysters don’t hose them, other shysters will. Fools and their money are soon parted.

Yet they partner with dentists…which then makes them perfectly fine.

Not very often. Let me tell you about that.

The are offering very small sums to dentists to “participate” in care. A few starving young prostitutes with high student debt bite on it. But very, very few times do dentists actually partner with these shysters.

They essentially function as sacrificial lambs for the company when something goes wrong. Smile Defect Club can then say, “Look, we had a dentist managing the case. He is the one to blame.”

Prime example: There was a case where excessive force from an aligner caused a tooth pulp to die and the patient needed a root canal. The patient was very angry. Instead of suing Smile Defect Club, the patient now can go after the dentist for malpractice and negligence. (And they are probably encouraged by SDC to do this .)

Net result is the same crummy treatment with the same substandard results is delivered, but there is now a dentist to blame if something goes wrong. We talk about this a lot of dentists’ forums.

Not every case is a clear aligner case. In my practice, only about 20% of cases are treated by aligners. Aligners exert extremely high force compared to say nickel-titanium arch wires. Excessive force doesn’t move teeth faster, it destroys them.

I’m not a dental expert but aren’t they good when only minor corrections are needed ?

Minor corrections in fully erupted teeth with enough space for movement with thick enough attached gingiva and good patient cooperation.

The drawback is you cannot change course in treatment easily if you need to do that.

Of course, a technician in Costa Rica who never saw the patient in person, does not have a lateral cephalometric x-ray, and is on commission for production, will always decide the case is an aligner case.

So I have two kids that went to the same pediatric dentist their entire childhood. For my oldest, the dentist strongly recommended the $5k braces and his teeth were in need of some help so we went that route and it turned out great. For my younger son, we approached him about Smile Direct and he had no objection to try it and then he monitored the results over time and it also turned out great, at a cost of less than $2k.

Dentistry is no different than any other industry in that extremely high cost will drive innovation…some good…some bad. We are seeing the same thing in the hearing aid industry.

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Is this something like Invisalign. I had traditional braces when I was in high school and like many people of that generation I was told that I only had to wear my retainer for a few months. Consequently my teeth shifted a little over the years and twenty years ago I went to a local orthodontist to correct that. He had a private practice but got the braces from Invisalign even though he did all the measurements and treatments himself. At that time there were very few orthodontists who were doing Invisalign and it was more expensive than traditional braces.

How did you measure “great?” By how straight the front teeth looked to you? You can move front teeth anywhere. To move them to a stable position in which they stay is another thing entirely. As a layman, you think you can analyze the final lineup of posterior teeth and see how stable a position they are in?

Without interproximal reduction in most cases, the only way to create more space with aligners is to flare front teeth forward and back teeth toward the cheek. These movements are usually unstable.

To create space in the upper arch, palatal expansion is required This is impossible with aligners.

I wish orthodontics were as simple as what you imagine it is.

No, it is nothing like Invisalign or other types of prescribed clear aligners. The patient is expected to take accurate impressions at home. No professional examines the patient for thickness of gums, jaw alignment, or anything else. Technicians in another country merely scan DIY impressions and program machines to move teeth anywhere, no matter what the position. It is a prescription for disaster.

Had a patient with enormous pain in her upper front teeth. She was crowded and needed more space. She did Smile Defect Club. The aligners put enormous force on the teeth, but they could not move for lack of space. If allowed to continue, it would have resorbed the roots or killed the pulp.

There are many legitimate aligner companies that fabricate aligners for dentists. Invisalign is the most expensive and not superior to the rest. Personally I think Invisalign’s owner, Align Technology, is a con artist and I never would pay their $2000 licensing fee to use them. More and more dentists are scanning teeth, using their own programs to design aligners and fabricating them via 3D printing on premises. This is the future, not DIY orthodontics.

Butler said that his kids’ pediatric dentist monitored the results. I would guess that his dentist is qualified. Shouldn’t you be directing your question to his dentist?

Hi, BM. Just curious, but how have things turned out since then? Do you still need to wear any type of retainer now?

I ask because I am curious to compare your experience to both mine and my daughters. Six years ago I had braces at age forty-nine, and I have been wearing a retainer nightly ever since. I know two people who told me they had braces as adults and quit wearing their retainers only to see their teeth slide back. I definitely don’t want that to happen with me, and as I understand I will have to wear the retainer until I either pass on or my teeth fall out, whichever comes first, in order to avoid this.

My teen-age daughter also had braces a few years ago and is wearing a retainer now. As understand, she has been told that she has to continue to wear it, and she has been good about that so far.

wmj - When I was finished with the Invisalign treatment the orthodontist made me a final set that was a stronger plastic than the other aligners that I am suppose to wear for the rest of my life. However, I will occasionally not wear it, especially if I am not feeling well, and they still fit which means they have probably not moved.

The problem I have now is that I have tried many ways to clean the retainer and after a while you can’t get them as clean as they should be. The orthodontist that I used has retired but my regular dentist also does orthodontics and he will make a new one for me.

I’m not qualified to measure the results …his pediatric dentist did that. I can only tell that my kids now have great teeth alignment. Both are now with adult dentists and the braces and SD solutions have achieved the desired result. We would not have pursued the SD approach if his dentist was not supportive. After spending $5k+ on the first kid it was nice to save some on the second kid

If his results were great, it would be a rare one turning out well. DIY aligners have a prayer if someone actually accurately scans the teeth digitally instead of trying to take an impression by themselves. Taking accurate impressions using a thick putty that takes 4 minutes to fully set is a daunting tasks for the average patient.

Incidentally, aligners in general usually don’t work well in very young patients. Not sure how old your child was. Problem is, tooth length is short in tweens and teens and the aligners do not have enough surface area to grip.

You should consider yourself very lucky.

Gtk. I think that’ll be very helpful for people

Still, care must be exercised even if dentists do it. For example if a patient has an implant and implant crown, force must not be applied to it in setting up the aligners. Even an orthodontist in my area has made that mistake and jeopardized implants. No chance some technician in Costa Rica would know which tooth has an implant underneath from a DIY impression.