According to the Consumer Affairs Journal of Consumer Research, roughly 17 million people have used clear aligners like Invisalign since their introduction in 1999. The popularity of this teeth-straightening method stems from its convenience and comfort. Unlike traditional orthodontia, the clear plastic trays are barely noticeable and can be removed while eating and for short periods of time whenever the patient wants.
Invisalign is a brand offered by dentists and orthodontists, but several direct-to-consumer products are also available. These mail-order aligners allow patients to straighten their teeth at home without the need for in-person dental appointments.
There has been a lot of debate in recent years about the safety and effectiveness of orthodontics without the guidance of a dental professional. We’ll explore why people might opt for this method of getting straighter teeth and whether or not it’s a good idea.
Straightening Teeth Without a Dentist
While many people think of all clear plastic aligners as “Invisalign”, it’s important to note that like other products (for example Kleenex or Band-Aid) Invisalign is a specific brand name. Unlike some over-the-counter (OTC) aligners you must see an orthodontist or dentist for Invisalign.
In this article, we will address at-home, do-it-yourself straightening aligners. Several brands follow the mail-order aligner business model. Some of the most popular include:
- byte
- ALIGNERCO
- NewSmile
- Strayt
- CandidPro
Here’s how they work: Individuals who want straighter teeth sign up online. The company sends an impression kit allowing the user to make a mold of their upper and lower teeth at home. These molds are mailed back to the company and a dental professional creates a treatment plan that includes a series of aligner trays. The customer wears each set of trays for approximately two weeks, and over time, the teeth move gradually into their desired alignment.
Some companies with OTC aligners have locations similar to retail shops. Patients can go to have 3D images taken of their teeth with an intraoral scanner instead of creating their own impressions. These locations may have a dental professional on staff, but most send the images off-site to be reviewed by a dentist or orthodontist. Other aligner companies may rely on phone calls, emails, or teledentistry appointments to communicate with their customers.
Advantages of Mail-Order Aligners
In general, there is very little difference in most aligners. They are made of similar plastic with some slight variations in thickness and texture. They all offer the clear, nearly invisible appearance that has made them so popular.
The main advantages of trying do-it-yourself or OTC aligners over seeing a dentist for Invisalign are convenience and cost. Some people find it more convenient to handle their own treatment instead of scheduling numerous dental appointments throughout the process.
At-home aligners are also significantly cheaper than Invisalign. Invisalign can cost between $2500 and $7000, while most direct-to-consumer treatments can be purchased for around $1800 to $2500.
Disadvantages and Things to Know Before DIY Teeth Straightening
Each patient must weigh the pros and cons of at-home treatment for themselves. While the savings are appealing, there are trade-offs when getting aligners without a dentist. Here are some things to consider:
Aligners Aren’t For Everyone
Aligners are best for straightening teeth with mild to moderate crowding or crookedness. More serious issues, especially malocclusions (overbite, underbite, or crossbite), often get better results with traditional braces from an orthodontist.
Your dentist or an orthodontist can provide an honest assessment of what method of straightening will work best for your particular situation. You can also discuss how different options might fit with your lifestyle and budget.
You Shouldn’t Skip the Dentist Entirely
Mail-order aligner companies typically suggest you see a dentist for a checkup before starting treatment, but they have no way of knowing whether or not you’ve completed this important step.
If you decide on mail-order aligners, it’s best to see a dentist to make sure you have a healthy mouth before getting started. Not only will the dentist clean your teeth, but an exam will include X-rays to find any underlying problems that should be corrected first.
Good oral hygiene and dental care are important during treatment too. The dentist can keep an eye out for cavities, gum disease, receding gums, bone loss, or even TMJ that may result from wearing aligners.
Accurate Impressions Are a Must
Aligner trays are custom-made based on molds or images of your teeth. The measurements must be accurate to provide the kind of snug fit that’s necessary to move the teeth properly. There is a lot of room for error when you’re handling messy dental putty to make your own impressions at home.
Getting OTC aligners from a company that has a physical location is better, but depending on where you live, this might not be an option. If you see a dentist for Invisalign, you can leave it to the professionals who use state-of-the-art equipment to do this every day.
Some Teeth Need Additional Help
Sometimes teeth may need to be shaved or filed to give them space to move with aligners. Or teeth may need small attachments to help guide the aligners and keep them in place.
These additional steps are not possible with DIY aligners. If yours is a difficult case that requires them, it is likely better to see a dentist for Invisalign.
How Will You Know If It’s Working?
Patients check in with direct-to-consumer aligner companies to monitor progress, either by video chat or by sending images via email or an app. It may be easy to see that the treatment is working, but subtle changes will be harder to see on a screen than in person. If the desired movement isn’t happening, a change in treatment—including new impressions—might be necessary.
If you’re getting dental checkups every six months as recommended, be sure to tell the dentist you’re using OTC aligners. They will be able to let you know your teeth are getting straighter.
Who Will You Call If There’s a Problem?
One common criticism of mail-order aligners is how the various companies respond to problems. Significantly, users are often referred to as customers rather than patients. Indeed, issues are generally handled by a customer service line or by communicating through an app.
Dedicated patient care is a definite advantage of going to a dentist for Invisalign. If the aligners are causing pain or one breaks, help is just a phone call away. Many dentists can squeeze in patients for emergency care whenever necessary.
Experts Weigh In On At-Home Aligners
The American Association of Orthodontists and the American Dental Association have concerns about direct-to-consumer orthodontics. In addition to all of the points listed above, they point out the numerous customer complaints about companies like the now-bankrupt SmileDirect Club. Lawsuits have been filed over the fact that OTC aligners are provided by dental technicians without the same professional credentials as their Associations’ members.
Like SmileDirect Club, byte’s parent company has also experienced problems recently. In October 2024 the company abruptly stopped shipping and processing orders, leaving patients without support or guidance. Their sales and production are on hold pending a review of regulatory requirements by the FDA.
The possibility that an aligner provider could halt operations without notice is a valid concern. Customers may find themselves left high and dry in the middle of treatment. On the other hand, those seeing a dentist for Invisalign or braces can likely find another provider nearby if their dental practice can no longer serve their needs.
What Patients Have to Say
The National Library of Medicine’s PubMed Central conducted a study called Direct-to-Consumer Orthodontics: Surveying the User Experience. They found that the vast majority of people with mail-order aligners were happy or somewhat happy with their results, especially when using them to correct crowding or close gaps. Those with bite issues were less satisfied, confirming that malocclusions have better luck with braces.
The study also found that 6.6% of users experienced pain and other side effects that were serious enough to have them make an appointment with their family dentist.
Very few respondents tried to contact their company during treatment. Those who did reported receiving an online message rather than a personal interaction. As for overall customer satisfaction, most would recommend their aligners, but 44.5% said they wish they had received treatment from an orthodontist or dentist instead.
Choose the Treatment That’s Best For You
Moving teeth to get a straighter smile is a popular cosmetic procedure. When weighing the options, the best treatment is one that will fix the problem safely and effectively while not breaking the bank. Before you choose, see your dentist. They will be able to guide you to the best straightening method for your unique case—whether that’s braces, Invisalign, or direct-to-consumer aligners.If you’re interested in finding the orthodontic option that’s right for you, use our online search tool for a dentist or orthodontist in your area.