SmileDirectClub has filed for Chapter 11 bankruptcy and is facing an uncertain future after failing to corner the market of at-home teeth-aligners.
However, their DIY, clear-plastic, removable aligner system has been a concern for dental professionals across the world since they began in 2014, facing years of legal battles, criticism, and concerns regarding their safety and effectiveness.
But where did the concerns come from?
Lack of in-person consultations and the risk of misdiagnosis
SmileDirectClub, and other at-home aligners, primarily relies on remote consultations and at-home impression kits for customers to create their treatment plans. However, it is incredibly important when starting any orthodontic dental treatment that you are seen by a professional dentist, in-person, so they can assess your oral health and correctly provide an accurate treatment plan. This is because some cases are complex, and require advanced orthodontics that may only be achieved with a fixed brace.
“Moving someone’s teeth without in-person supervision can lead to ‘irreparable’ harm,” Chung Kau, chairman of Orthodontics at the University of Alabama in Birmingham, told NBC in a report about the at-home aligners that claimed it led to “painful problems for some people.”
What do we say at Bespoke Smile about this?
Before beginning orthodontic treatment, your teeth and gums need to be healthy, otherwise this can cause risks when moving the teeth. A qualified dentist needs to be able to assess your specific needs and determine the safest and most effective treatment option. Orthodontic treatment is a medical procedure, and patient safety is always our first priority.
Limited supervision during treatment
Another cause for concern is that the SmileDirectClub will post you an impression kit with instructions to take your own impressions. Immediately we see an issue with this, as the impressions you take may not be accurate, as you are not a dentist or medical professional with any official training. Medical professionals and dental practitioners, like the ones we work with at Bespoke Smile Academy, are extensively trained on how to create accurate and reliable impressions; this isn’t something we believe can be done well at home.
Once you’ve taken your impressions, you would then post the impressions back to the SmileDirectClub for them to manufacture your aligners. Once the aligners are made, they are posted back to you with further instructions on how to wear the aligners and how long you should wear them for; you are left to continue the treatment without any assistance or monitoring from a dentist.
SmileDirectClub claim that each patient’s treatment plan is “reviewed, approved and prescribed by a registered dentist or orthodontist.” and backed by their Smile Guarantee; however users have stated online that they haven’t been able to contact a dentist throughout their treatment.
“I have asked 3 times via emails [to] speak to my SDC (SmileDirectClub) dentist to explain, it is only this problem area I want sorted, but I feel like I’m being fobbed off ‘Send your photo as and you can talk to dentist (done and I still couldn’t) I will pass your info on to our case team’ blah blah.
I have already done a year of these and then a touch up. I really don’t want to wear another 6 months worth if they can’t get rid of the gap. How can I get in touch with [my] SDC dentist to explain this?”
What do we say at Bespoke Smile about this?
There are a multitude of issues with having dental treatment without the supervision of a dentist! One key issue specifically, is that because the aligners have been posted directly to you, a dental professional has not checked if the aligners are fitting you correctly.
This can cause long-lasting issues with your bite, and teeth alignment. Aligner systems also need to be closely monitored to ensure that the teeth are ‘tracking’ to plan, and moving in the correct way.Dr Lydia Sharples, MChD/BChD, Bsc High Quality General Dentistry (UK)
Have we ever seen a patient at Bespoke Smile to help them resolve a Smile Direct issue?
Yes, we have seen a number of patients who have used the SmileDirectClub aligner system and have unfortunately had negative experiences resulting in needing correctional, and sometimes more extensive, orthodontic treatment to correct the issues.
We have seen issues with the teeth being moved incorrectly, causing the patient to have further problems and insecurities with their teeth which resulted in them needing to start a new course of aligner treatment to correct the issues.
Another patient had experienced their teeth being over-moved, meaning they were moved into the correct position but due to the patient not being monitored by a dentist, he continued to wear his aligners and the teeth had continued to move past the correct position. This, again, resulted in an extensive orthodontic treatment plan to move them back to the correct position, an issue that would have been avoided if a dentist had regularly monitored the patients, and tracked the movements of the teeth.
These are all real patients we have seen at Bespoke Smile, and we urge anyone suffering with similar issues from using online, at-home aligners to contact our team of professional cosmetic dentists.
So, why do people continue to use SmileDirectClub if they are frowned on by so many dental professionals, and are known to cause so many issues?
The at-home aligner company, which filed for chapter 11 bankruptcy in October 2023, relied on using attractive costs and the convenience of their at-home, DIY system to attract new customers. However, what they do not advertise is the complications that can occur during their treatment, causing them issues with other businesses, advertising standards, and even federal courts.
The National Advertising Division has challenged their advertising numerous times due to false claims, Align Technology filed a lawsuit against them in January 2023 for false advertising and the Australian Federal Court ordered “Aus Pty Ltd and its US parent company, SmileDirectClub LLC (together SmileDirectClub) to pay penalties totaling $3.5 million and to compensate customers” for misleading claims.
Why are SmileDirectClub aligners so much cheaper than what you would pay in a dental practice?
When you visit a dental practice, you are not only paying for their service but also the many years of experience the dentist is bringing to your treatment, as well as the dental professionals’ time and expertise. With the SmileDirectClub, you really are left to DIY, and there is a distinct lack of dental supervision during your treatment.
There is also the issue of the quality of the materials. When comparing the SmileDirectClub aligners with other suppliers used by us and by dentists worldwide, you can feel the difference in quality.
These factors all reflect in the attractive price set by SmileDirectClub and unfortunately in the quality of the dental work received by those purchasing the at-home aligners. This leaves real people to suffer, like Jamie, who spoke to the BBC after turning down an initial quote of £4,000 – £6,000 for traditional orthodontics. He instead opted for £1,800 SmileDirectClub aligners instead “all without the need to see a dentist in person”.
However, “I can’t bite into an apple because I can’t trust that my front teeth are strong enough any more,” he said. “One of my front teeth has become wobbly, my enamel feels all funny, like the aligners have rubbed some of it off, the aligners have made my gum recede making it agony.”
Final thoughts from the dental professionals at Bespoke Smile
“The quality of care you receive from the SmileDirectClub is so minimal compared to when seeing a dentist in person, and it’s reflected in the cost of the treatment.”
“Orthodontic treatment is a medical treatment and should always be performed by a dental expert to achieve predictable and long lasting results. As a patient you deserve to be treated and cared for by a dental professional who really cares about your end results and by someone who is dedicated to their patients to get them there.”Dr Sam Jethwa
SmileDirectClub, once valued at $9 billion, may now leave patients in the middle of a treatment stranded if they’re no longer able to deliver on the remainder of their course of aligners. The company borrowed $255 million last April, with $138 million now left on the loan.
But what does this mean for patients? Those who thought they were once getting a ‘cheap deal’ may now be paying more for corrective work due to aligners over-correcting misaligned teeth, or teeth that have been moved incorrectly. Similarly, those who now have to stop treatment part way through will now need to continue said-treatment with a reputable dentist anyway, at an additional cost to what was already paid to SmileDirectClub.
We urge those considering any sort of at-home, DIY aligners to speak to a professional dental practitioner to avoid these kinds of issues happening in the first place. While it may seem like you are ‘getting a good deal’, the likelihood of you having to pay extra expense for corrective work after is high. A study published by the National Library of Medicine discovered that some participants “mentioned significant harm from aligners; one had “lots of damage to fix” costing “$11,500 and counting” and another needed an orthodontist to “fix the bite issues and pain that the at-home aligners caused.”
At Bespoke Smile, we are recognised as an Invisalign Elite practice, and our dentists have advanced knowledge of planning and monitoring clear aligners. We have experience recognising complications before they become a complication, and offer 100% assistance throughout your journey, adapting the treatment if needed. If we feel we can get better results by making extra aligners, we will do this for no extra cost. For upper and lower Invisalign we charge around £4000* depending on the patient’s personal case.
Our dentists are also experienced in training other dentists to plan and monitor their patients using clear aligner systems and have high expectations for their patients results. When planning patients’ cases, they will incorporate smile design principles taught to them at the Bespoke Smile Academy, and will not approve aligner manufacturing until they, and the patients, are 100% happy with the digital simulation.
If you are currently undergoing treatment with the SmileDirectClub and are experiencing complications with your treatment and want some advice, we are able to help you. You can call us on 01628 488538 or complete the online form on our website.