Mail-Order orthodontic aligners (also known as direct-to-consumer or do-it-yourself aligners) have made a big splash in recent years. No matter where you look, we are bombarded by ads from various aligner companies promising the same results as orthodontists, only faster, cheaper, and more convenient (you don't even have to go into an office). While it is theoretically possible that some orthodontic problems can be fixed using mail-order aligners, here are five things you will not get if you choose to go that route:

A Local Orthodontist
Your body is a complex machine. It is made up of many coordinated systems that work together to keep you alive and happy. Although it may seem possible to program a computer to anticipate everything that could happen during treatment, the body does not always respond as predicted by software algorithms. If you order aligners from a mail-order company, you won't have a local specialist to examine you in-person, fit your aligners, coach you throughout treatment, monitor your progress, nor stand behind your final result. A customer service number is not a very good substitute for a local orthodontist.

Evaluation of Your Bite, Profile, or Gums
While it may be possible that direct-to-consumer aligners could close a gap or straighten some teeth, they are not designed to correct "the bite." The bite is determined not only by how the teeth are aligned, but also how they meet together when you chew. Knowing they can't correct or even prevent changes to it, mail-order companies require patients to sign a waiver stating they are not responsible for the bite. Did you know that aligners, any aligners, can make your bite worse? Additionally, mail-order aligners do not address your profile nor the health of your gums after tooth alignment.

Multiple Treatment Options
Local orthodontists have many tools available to give you the smile you want. After discussing your goals with your doctor, he or she may recommend braces, expansion, tooth removal, jaw surgery, or yes, even clear aligners. If you trust your treatment to an online aligner company, however, the only treatment option they can offer is aligners, whether or not they are the right tool for your condition.

In-Person Supervision
Orthodontic treatment is a dynamic, always-changing process. Along the way, an in-person doctor evaluates your progress and modifies your treatment plan to address the changes he or she observes. If you are wearing braces, your orthodontist can alter your treatment by moving brackets, changing wires, or adding rubber bands. If your doctor is straightening your teeth with aligners, he or she will adjust your final tooth positions by performing "refinements" (additional aligners). While some mail-order companies may provide refinements, the number of trays they provide may be limited and they can't switch you to braces if your teeth do not move as planned.

Retention of the Result
Getting the teeth straight is only half the battle. The other half is keeping them straight. There are many types of retainers used by local orthodontists. They can select the best retainers for you based upon your initial malocclusion and then monitor their effectiveness after your treatment ends. Direct-to-consumer aligner companies cannot offer the same level of care in the retention phase of treatment.

While mail-order aligners may claim to be faster, cheaper, and more convenient than conventional orthodontic treatment, there are some significant differences in how treatment takes place and the results that are achieved. You only have one smile. Shouldn't you trust it to an orthodontic specialist?

NOTE: The author, Dr. Greg Jorgensen, is a board-certified orthodontist in the private practice of orthodontics in Rio Rancho, New Mexico (a suburb on the Westside of Albuquerque). He was trained at BYU, Washington University in St. Louis, and the University of Iowa. Dr. Jorgensen's 28 years of specialty practice and 10,000 finished cases qualify him an expert in two-phase treatment, extraction and non-extraction therapy, functional orthodontics, clear aligners (Invisalign), and multiple bracket systems (including conventional braces, Damon and other self-ligating brackets, and lingual braces). This blog is for informational purposes only and is designed to help consumers understand currently accepted orthodontic concepts. It is not a venue for debating alternative treatment theories. Dr. Jorgensen is licensed to diagnose and treat patients only in the state of New Mexico. He cannot diagnose cases described in comments nor select treatment plans for readers. The opinions expressed here are protected by copyright laws and can only be used with the author's written permission.