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Invisalign vs. Smile Direct Club

Many patients who need orthodontic treatment already know that they would prefer Invisalign or a clear option to straighten their teeth. I understand why an adult or even a teenager would want to have clear trays versus metal brackets in their mouth. I was actually one of these cases. I was in college when I had braces and searched the internet for someone who did Invisalign. Unfortunately, at the time, I was not an Invisalign candidate. If you have searched for a clear aligner option, then you are likely familiar with Invisalign and Smile Direct Club. But what is the difference and what do you need to know before starting?

I’m going to use a patient that I saw for a consultation to illustrate. Chris came to me for a consultation and was not interested in braces at all. He also had some very nice gold restorations done by his general dentist. For certain cases, like these, Invisalign is actually my preferred method for straightening teeth. I discussed with Chris, that his bite fit together really well in the back and I didn’t want to change that at all. He had more crowding with his lower teeth than his upper teeth. We would either have to do what is called IPR (inter-proximal reduction) to relieve crowding on the lower or open up spaces in the upper to relieve excessive force on his front teeth. We also discussed the height discrepancy between his two front teeth and what we could do after his Invisalign treatment was complete with his general dentist.

Chris' Smile Direct treatment.

*Note all of his back teeth are touching

I didn’t see Chris for about a year and a half after this appointment. Chris called back and said he saw us a couple of years ago and was concerned with the price of Invisalign. He had decided to try Smile Direct Club. He shared with us that it was a “disaster and completely messed up his bite.” When I saw him again, he continued to tell me he could chew on his right side, but he does so very carefully and cannot chew hard. He brought his “retainers” to me but they did not fit at all. He said his retainers did not fit and when he tried to wear them, if he left them out for a period of time he could feel his teeth shifting. He said he was afraid to bite down because he thought he might break a tooth.

We updated his photos and noticed several things. Are his teeth relatively straight? They are straighter than when he started, but at what cost? Functionally, his bite does not fit together anywhere. He does not know where to bite. He has gum recession present in areas where he did not have it previously. This has resulted in him having to see a periodontist for grafting of his tissue in order to correct the recession.

Chris' Smile Direct journey

*Note: Teeth do not fit at all in the back or front. Patient was afraid to bite down for fear of breaking a tooth. Not all rotations corrected. He now has gum recession on some teeth.

Seeing an orthodontist is a lot more expensive than going to a “smile shop,” where there is not a doctor present to even look at your teeth. There is a reason that Smile Direct Club claims their fee is 70% less than traditional orthodontics. Let’s take a look at the differences:

Initial Visit

  1. Orthodontic Specialist: A trained assistant will take photos and a 3D xray. The orthodontist will do a thorough exam of your teeth, review the xray we took, and discuss your treatment options. If you are an Invisalign or clear aligner candidate, a trained assistant will scan your teeth for the trays.
  2. Smile Shop: An assistant scans teeth, no xrays are taken, no specialist evaluates or communicates the findings with the patient.

Second Visit

  1. Orthodontic Specialist: Delivers the trays and bonds attachments to the teeth. What are attachments? They are tooth colored filling material attached to your teeth so that the orthodontist can more precisely move the teeth to the desired point. The orthodontist checks the fit of the trays to make sure that they fit over the attachments well, fit the teeth well, and are not irritating the gum tissue, lips or cheeks.
  2. Smile Shop: There is no second visit. Trays arrive in the mail and the patient begins wearing them.

Third Visit

  1. Orthodontic Specialist: We see patients about 4-6 weeks after the delivery to ensure they are wearing the trays correctly and that the teeth are moving in the direction we want and according to the treatment plan
  2. Smile Shop: There are no visits and no specialist to see even if you visit the store front.

All Subsequent Visits

  1. Orthodontic Specialist: Depending on the case, an orthodontist will see patients every 6-10 weeks to review how the case is progressing. An orthodontist will typically do what are called “refinements” or additional scans for more trays to fine tune and get the teeth in the final position where we want them.
  2. Smile Shop: Again, no additional visits. The patient will wear all trays mailed to them and move into retainers once they have worn all of the trays.

Below are some cases I have treated/ am treating with Invisalign. Please note, the most important thing for these patients, is they have a FUNCTIONAL bite, in ADDITION TO perfectly straight teeth.

Invisalign treatmentInvisalign treatment

Before InvisalignAfter Invisalign

Before InvisalignAfter Invisalign

If you are interested in Invisalign and want to know if you are a candidate, you can send your pictures through our virtual consult portal and we will be happy to let you know! Drop your photos here. Happy Friday!