It’s been a long time since I have written a blog post. No excuses. Life is busy with family and other concerns, and I’ve not been inspired… until now.
Many of you may have already heard about online companies offering do-it-yourself orthodontic clear aligners. For many of us, the instinctive reaction is to scoff or laugh at such a silly notion. Some will dismiss the news and suggest that P.T. Barnum had it right about a “sucker being born every minute.” I suppose the consensus might initially be summed up with the single-worded vernacular, “WhatevAR!” What’s next? Do your own crown preps? Tele-crowns?
I submit that we not make such assumptions about the public who decide to go down this path. To be clear, this article is not intended to impugn the folks that pursue a course of self-treatment. Rather, I suggest we do our best to educate them, realizing that it may fall on deaf ears with assumptions about our efforts being self-serving. It’s simply human nature to jump to that conclusion.
No worries, right? If you visit this consumer review webpage and see their clients’ “before & afters,” you’ll likely be quite amused at the “results.”
Of course, we have many well-founded clinical concerns and objections to the concept of self-diagnosis and self-treatment. No need to review them. As dentists, we know what they are. Smile Direct Club (SDC) claims that each case is “reviewed” by a licensed dentist. The clients send in cell phone selfies of their smiles and self-administered impressions from the kit sent by SDC. That’s it. Consider the standard of care here. How many of us would recommend orthodontic appliances for patients without a comprehensive examination prior to treatment? These “hired guns” are approving cases based solely on selfies and models (of dubious quality)? No x-rays? No perio evaluation? Caries or defective restorations identified? Fixed bridges or splinted crowns? Implants? Retained deciduous teeth?
Can you imagine what might happen to any of us practicing dentists who did that with patients of record? If any of us started moving teeth without any attention to those details, we’d be practicing below the standard of care and at great risk for liability. It would be indefensible in court. Yet, these “tele-health” companies get away with it. But, the real point is that it’s detrimental to the “patients.”
Best Frenemies Forever?
Recently, Align Technologies (Invisalign) purchased part of SDC and is making their aligners for them. The folks at Align tried to assuage the concerns of dentists by claiming they just want to be “ahead” of the trend (of self-treatment or “tele-dentistry”) and that the aligners they make for SDC are not the same technology as Invisalign brand aligners. Furthermore, in the merger announcement, Align said, “30% of Smile Direct Club’s interested customers do not qualify using the Smile Direct Club protocols.” Yeah… Remember that 68% of all statistics are made up 93% of the time. 😉 Looking at the RealSelf.com SDC page, I’m hard-pressed to find a SINGLE CASE that was turned away by SDC.
SDC claims that every case is “reviewed” by a licensed dentist. Word on the street (DentalTown) is that they hire dentists in each state to look at the selfies and impressions (remotely, I assume) for $50 a pop. Fifty bucks. Wow. I wonder if there is an incentive to “approve?” Do the dentists get paid the same measly $50 if they use their judgement and reject a case? Who takes on the liability if / when the case goes south and the “patient” is looking for compensation or reparations?
It’s the same thing!
The problem with that is that SDC will certainly market this as “made by Invisalign,” and consumers will perceive it to be the same.
To wit… Continue reading
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