A critique of SmileCareClub for straightening teeth

The SmileCareClub company was founded in 2013, and provides what amounts to do-it-yourself Invisalign treatment.
The concept is the same as Invisalign. You wear a series of clear plastic aligners, changing them every three weeks (as opposed to two weeks for Invisalign). At the end of the treatment period (from 4 to 14 months), your teeth are straight.

Another company, Crystal Braces, offers a similar service.

Does it work? It appears to. Is it a good idea? I’m skeptical, but will try to be open-minded.

Yes, you do save quite a bit of money over Invisalign from a dentist. And it looks like, for the majority of patients, it could work out just fine. But there are things that can go wrong during Invisalign treatment, and this is where I think the system breaks down.

The biggest issue, in my opinion, is gum disease. If a patient has gum disease and then gets these clear braces, that’s going to aggravate the gum disease. Can the dentist tell, just from the photos submitted, whether or not a patient has gum disease? Dr. Son Tran, the founder of Crystal Braces, when asked about this, said that he could tell, from the photographs submitted by the patient, if they had gum disease. I question that. It really takes a good set of x-rays as a starter, and probing of teeth to diagnose gum disease. And I’m skeptical that the photographs submitted by patients are really going to show the molars clearly. Yes, they employ dentists to review these pictures and the cases, but I think the pressure is on them to put the cases through. As a dentist, I would be able to tell certain cases of gum disease from the photographs, but not all of them, and if the evidence isn’t clear it would be easy to just approve it.

There are other problems that could arise during treatment. In some cases, teeth need to be shaved on the sides to make room for crowded teeth to straighten. They have you go to a dentist to have this done, but this is a dentist who then isn’t invested in the case, and I know from doing this myself that it can be a little tricky to get the right amount of enamel removed and maintain the proper shapes of the teeth.

And then there can be teeth that are supposed to rotate but don’t, or other things that could go wrong. So yes, in most cases it could work out just fine, but I’m not sure enough about this treatment to recommend it for anyone. I think there needs to be closer monitoring than just by phone and texted photos.