I have questioned this “SmileDirectClub” from the beginning. You have probably seen their ads on TV that promise that you can get your teeth straightened without going to a dentist. You go to a local Smile Shop where you get your teeth scanned, or you can order one of their “take your own impression at home” kits and mail that impression in to their headquarters. A dentist will look that over and then they’ll send you back a set of aligners which you will use over a period of 6 to 10 months and voilà, you now have a gorgeous, straight smile.
People who read this blog know that I am a staunch advocate for patient rights and have no problem with confronting the dentistry establishment. But I will tell you that I have so many problems with this SmileDirectClub that I question how it can even be legal. And if you dig to find truly independent reviews you’ll find some ugly stories. I could go on for pages here with negative patient experiences. But let me just start with three major problems I have just knowing the system.
First, full-blown orthodontic treatment is being started without a complete examination. There are no x-rays, no dental exam, no checking for periodontal disease, TMJ problems, decay, whatever. When I was in practice, I eagerly took the Invisalign training and signed up to provide invisible braces treatment for my patients. Every case was started with a full mouth series of x-rays and a comprehensive dental examination. To me it is an unacceptable shortcut to skip that step.
Second, there is inadequate monitoring of the progress and follow-up. In the Invisalign cases that I did, there would often come up some issue during treatment. Teeth didn’t move as we thought they might and we needed to make a little more space, or bond a little button onto a tooth, or there would be a lost aligner, or something.
Third, most cases required making some extra space in order to straighten the teeth. Most tooth mal-alignment is because of crowding. So to get the teeth to straighten, some additional space should be created. In some cases this needs to be done by extracting some premolar teeth. Often, there doesn’t need to be that much space created and I could do just a little shaving on several teeth. If that isn’t done, the arch needs to be expanded to correct the crowding. While that can result in straight teeth, it isn’t the healthiest option or necessarily the most aesthetic. Since there is no personal contact with a dentist involved in the SmileDirectClub system, they have to shortcut that process also.
Oh, and I almost forgot to mention the “take your own impression at home” deal. When I did an Invisalign case, I had to be so careful to get an accurate impression of the teeth, with no bubbles, tears, or other defects, that I could not have that taken by any of my assistants—I had to do it myself. I can only imagine the compromises they have to make in order to accept a do-it-yourself impression.
With that introduction, it’s not surprising to read all the negative patient reviews. Let’s get into those.
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Be wary when you look for online reviews. Some of them are on sites that appear to be sponsored by the SmileDirectClub. But I found a website, www.highya.com, that has a number of reviews posted. I looked at the last eight posted. Three of them were two-star and the other five were one-star. Here are excerpts from these patient experiences. (I have paraphrased some of the comments to condense them and make them easier to read and understand, but all of the sentiments are accurate. Go to the website if you want to read the full stories of these people.)
June 2020 Update on Reviews
I went back and looked at this Highya review site and a curious thing began to happen after January when I published this post. All of a sudden there are a much larger number of positive reviews, and I see that now SmileDirectClub is getting involved in responding to reviews on this site. As a veteran internet marketer, I can easily guess what is going on. Stung by the negative reviews, SmileDirectClub is now trying everything they can to manage the process. I believe they are pushing satisfied customers to leave positive reviews. And I am questioning whether we really know if these reviews are all genuine. Fake reviews are a serious problem on many reviews platforms, and I don’t know if Highya has robust mechanisms for detecting those. Yelp does, but Amazon and Google don’t have good systems for detecting fake reviews. To help insure you’re seeing unsolicited and honest reviews, I’d stick to reviews that were posted before February 2020.
Here Are the Earlier Reviews
Note that I didn’t cherry-pick reviews. I looked at the last eight reviews left as of the day I checked—January 9. Three were two-star and five were one-star.
Dana from Wilmington, in a Jan 6 one-star review:
“SmileDirectClub is a NIGHTMARE! They don’t know what they are doing! I followed instructions to a ‘T’ and my teeth are still crooked! Their screw-ups never stopped!”
Jen from New Brunswick, in a Jan 6 one-star review:
“I have had receded gums and a very expensive dentist bill thanks to SmileDirectClub”
Brooke from Georgia in a Jan 7 one-star review:
“I bought the aligners as a gift for my boyfriend.
“They send you a video showing what your smile will look like when they’re done, and his front teeth were pulled together leaving a big gap between the front teeth and the back teeth. We wondered about that but I guess we were naive. Now that he has gone through all the aligners, that’s what his teeth actually look like!
“Also, during the treatment, one pair of aligners was too tight. We contacted customer service. They said they’d need pictures. What! We thought, you’re the ones who made the mistake, you should fix it!
“Then, during the 4th month, they sent us one with sets of tops only.
“What a rip-off!”
Sarah from Colorado Springs in a Jan 7 one-star review:
“After my experience with SmileDirect, I definitely would have opted to pay more money for better quality service with a different company or orthodontist. In my opinion, SmileDirect needs sanctioning from a business regulatory agency or a class action suit to get them to change.”
Lana from Des Plaines, IL in a Jan 7 two-star review:
“I finished my 6 months treatment, but only the upper teeth straightened—not the bottom ones. . . .
“This is ridiculous! I want my money back.”
Rose from Colorado in a Jan 8 one-star review:
“Their customer service team is a joke. They have no idea how to solve the problem.”
Tara from Atlanta in a Jan 8 two-star review:
“Pay close attention to how they always refer to your teeth as your “smile” and talk about your “new smile,” because that is secretly all they can fix, meaning in my experience, they will not do anything with your back teeth.”
Cathy from Oregon in a Jan 8 two-star review:
“Retainers are a fiasco – my advice is to order them 3-4 months in advance to account for their inefficient system.”
I have long said that dentists on the whole are a very ethical lot. Though there are some dentists who are focused on just making money, most have a genuine focus on taking care of their patients. But when a company like SmileDirectClub takes so many shortcuts to what their dentists know to be quality care while at the same time making huge profits, I seriously question their ethics. I’m not surprised at all the negative patient experiences.
Yes, Invisalign is pricey. The lab fees charged by Invisalign are high. There are, however, competing laboratories that are driving the laboratory costs down. It’s tempting to want to cut out the dentist in order to get a discount fee. However, there are risks in doing that—you need that personal, professional attention to your case.
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About David A. Hall
Dr. David A. Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does advanced internet marketing for dentists.