How Do-It-Yourself And At-Home Orthodontics Can Go Wrong
By Dr. Emily Watson
Straightening teeth isn’t as easy as some people seem to think.
At Warsaw Orthodontics, we use both traditional braces and Invisalign to help patients achieve the smile they desire, but all of this takes place under the care and guidance of a medical professional and a trained staff.
Throughout the treatment, the patient is monitored – and monitored some more.
Check the news, though, and you will see that sometimes young people try a do-it-yourself method where they attempt to straighten their teeth on their own. Other people sometimes rely on mail-order products that sidestep any regular visits to a doctor who can observe and check the progress as the teeth move almost imperceptibly into the desired position.
Both of these at-home methods can have unfortunate repercussions and provide case studies of DIY orthodontics gone wrong.
Let’s start with the most obvious. A few years ago, the news was filled with tales of teenagers who somehow decided it was a good idea to try to straighten their teeth using some variation of homemade solutions. Rubber bands. Paper clips. They seemed to use anything, individually or together, that they thought could get their teeth moving and result in the perfect teeth they were after.
This was a disturbing trend because, rather than the desired results, you risk significant damage to your teeth if things go awry. And the odds of something going awry are fairly high when you try to make significant changes to your teeth on your own, outside the guidance of a medical professional.
Presumably, these teens who did give it a try thought that straightening out their smiles simply meant forcing teeth to move in the direction they wanted them to move. Apply a little pressure, they likely figured, and voila, the teeth would do what they wanted them to do as if by magic.
What the teenagers didn’t realize was that, yes, the braces and aligners that orthodontists use do accomplish their goal through pressure that causes the teeth to move, but that is done in a precise and measured way. This is not a haphazard method. It is not a best guess. Using X-rays, scans, and impressions, an orthodontist can create a plan for you that is based on your teeth. A different patient would have a different plan based on their teeth. The braces or aligners are put into play with that specific plan in mind.
As Dr. Alexander Pozoki of Johns Hopkins Medicine told one news agency, “”You wouldn’t try to give yourself a nose job and by the same reasoning you shouldn’t try to fix your own teeth.”
What About Mail-Order Aligners?
Perhaps not quite as frightening, but still concerning, is that a number of companies offer a mail-order or in-home version of orthodontics to help people straighten their teeth with aligners that are sent to the person’s home. In most cases, the customers don’t see an orthodontist in person at all.
Instead, here’s how it typically works. The customer orders a kit that arrives in the mail. Using that kit, the customer takes impressions of their own teeth and mails the impressions back to the company. The company then creates aligners and a treatment plan and mails those to the customer.
In some cases, instead of taking their own impression, the patient might go to a center where someone with the company scans their mouth to get the impression that way. Perhaps a doctor looks at that scan, but if so, the patient never sees the doctor.
Essentially, the patient does not have X-rays taken. They never have an office visit. They never do the many, necessary things that happen when you are under the care of an orthodontist. The trade-off from the customer’s standpoint is that the mail-order method is less expensive than the personal care an orthodontist gives, but that trade-off can be more than they bargained for.
As the American Association of Orthodontists so wisely and succinctly puts it: “Quick and easy is rarely better.”
When All Is Not Well
I can attest to that. I’ve had patients come to me after they tried one of these at-home methods with unfortunate results.
One patient, a teenager who was using one of the mail-order company’s aligners, had a cyst growing in his jaw the whole time he was going through the process. If he had been under the care of an orthodontist in person during that time, the cyst almost certainly would have been detected much earlier.
Instead, by the time the cyst was discovered surgery was required to remove it and the young man’s jaw bone had been badly damaged. He had to sit out a year of high school sports because if he had been hit in the mouth, the blow could have easily broken his weakened jaw.
Another patient who was going through one of the mail-order companies ran into a problem with a tooth that was stuck. The patient came to me for help, but needed to be referred to an oral surgeon for the problem to be resolved. By then, the patient had already paid the mail-order company a few thousand dollars.
Other Potential Problems
So clearly, it does matter that you see a doctor in person who takes X-rays, takes an impression or a scan, monitors your progress, and is there in case some unrelated problem emerges, as happened with the teenager with the cyst or the teenager with the “stuck” or impacted tooth.
As the American Association of Orthodontics points out, orthodontics done incorrectly can result in “potentially irreversible and expensive damage, such as tooth and gum loss, changed bites, and other issues.”
The association suggests that anyone considering one of these at-home services ask the service these key questions:
Is an orthodontic specialist supervising your treatment?
How customized is your treatment?
Perhaps the mail-order aligners can work well with mild cases where there are no complications. But complications aren’t something you can always predict.
When they arise, it’s best to have an orthodontist you can call who knows your case, already has a good grasp of your treatment needs, and understands how to modify the treatment if that’s necessary.
This is not a situation where you want to go it alone.