“My teeth are crooked-can I get them straightened at Walgreens or do it myself?Why do I need to go to an orthodontist-they are so expensive.”Consider this: An orthodontist trains for 11 years to be able to straighten teeth and fix smiles. A periodontist trains for 11 years. A dermatologist trains for 12 years. A cardiologist trains for 14 years. Do you really think that there are short cuts to becoming a board certified specialist? Let me tell you…there are not. Patients seek the care of a specialist to receive top notch medical care from highly skilled professionals to get the most predictable long term outcomes possible.
“But they are just crooked teeth. My regular dentist says they can straighten them. Or, I see on line there is a company called Smile Direct and both of them say they can straighten my teeth. What is the difference?”Ok, here is the difference. If you go to a board certified orthodontist you will get a complete examination including a proper analysis that includes models of your mouth and a special x-ray called a ceph to evaluate the bone structure of your face and possibly a CT scan to check your airway, your TMJ and the bone structure around your teeth. Then you will get a diagnosis based your tooth positions, facial bone structure, and the overall health of your foundation. The diagnosis is the basis for a proper treatment plan. Would you let someone you don’t know, someone whose qualifications you can’t check – pack your parachute, remove a skin cancer, or place your heart stent? Would you buy a “do-it-yourself kit” and mail it in for one of these procedures? If not, why would you ever want a do it yourself home tooth straightening kit? Would you let your dermatologist put in a heart stent? Why not? They both went to medical school. Now, some Walgreens stores are offering the Smile Direct straightening. Some patients are going there and some are going straight to Smile Direct. What they do is the following: They make an image of your mouth either from a scan of your teeth or from a mold of your mouth that you create at home using their at-home impression kit. Next, a dentist or possibly an orthodontist will make the clear aligner trays that will move your teeth.This will be done without the benefit of the completed exam and x-rays as described above. “OK so now I understand that it is not the same but all I really want is straight teeth for the lowest cost and I want it to be convenient. Are there any downside risks with the short cut approach to straightening my teeth?” Yes, there are. I am glad you asked. Any tooth movement can put you at risk for moving teeth outside of the bone foundation and that will cause your gums to drop and will expose the soft roots to the sugars and the acids that cause decay. Roots are not supposed to be exposed in the mouth. They decay easily and also wear away easily when exposed. When this happens sometimes gum surgery can fix it and sometimes it can’t. Also, if your jaws are not properly aligned and if you move the teeth to try to make the jaws lineup instead of dealing with the jaw issues this can also affect your jaw joints causing painful TMJ issues and help create severe headaches from misaligned bites. Now, please consider this if you decide to use an at home do it yourself kit:
- NO one has examined you.
- NO one has seen x-rays of your teeth and jaws.
- NO one has determined if you have foundation issues and whether your foundation can withstand teeth being moved safely. If not, you will lose gum and bone and weaken your teeth.
- NO one has evaluated your TMJ health.
- NO one has looked at your airway
- Without a complete and thorough exam and without proper x-rays you may have foundation damage that is worsened by moving the teeth that cannot be corrected afterwards.
If this kind of treatment is predictable and if it is truly in your best long-term interest then I am a one legged parrot. Anyone see me with a crutch and a cracker? I don’t think so!
THERE IS NO SUCH THING AS A FREE LUNCH.
8 things to check out before you MOVE your teeth:
- Measurements for bone health
- Gum health measurements including any exposed roots (recession) and any signs of bleeding/inflammation
- Cephalometric x-ray and evaluation of the facial bones
- X-rays of the bone foundation around the roots of the teeth
- Cone beam scan if needed
- TMJ health
- Airway evaluation
- Education and qualifications of the person(s) responsible for moving your teeth