Dr Ronald Sluiter struggles to understand why anyone would take on teeth straightening treatment without an in-person examination with a registered specialist orthodontist or dentist before undergoing treatment.
He is referring to the growth in companies offering teeth straightening using clear aligners – but with no in-person examination with a New Zealand- registered dental professional before undergoing treatment.
That practice, he says, can result in expensive complications if the patient was not actually a candidate for teeth straightening to begin with.
Sluiter, a specialist orthodontist based in Christchurch and a provider and key opinion leader for Invisalign NZ, says the rise of clear aligners has been spearheaded by companies like Invisalign. However, it requires full involvement of a registered specialist orthodontist or dentist before beginning treatment and relies on such specialists to prescribe and deliver a customised treatment plan for each patient.
However, other companies have entered the orthodontic market in recent years: "Some of the direct-to-consumer brands have jumped on the bandwagon but do not include an in-person examination before treatment," says Sluiter – who received no compensation in relation to this article.
Clear aligners are an orthodontic medical device used to straighten teeth; their popularity comes from the clear trays which fit over the teeth; they are more comfortable and less intrusive than braces* – and some say they look better than a mouth crammed with steel or ceramics, as in conventional metallic or ceramic braces.
Sluiter estimates over 50 per cent of patients at his practice opt for clear aligners over braces and other methods. He expects that to increase to 60-70 per cent in coming years.
"I don't want to give the impression that clear aligners are some kind of silver bullet. As orthodontists, we have to find the best way to help our patients and get results – and each case depends on the patient and their particular circumstances and requirements.
"We have a treatment plan and an objective plan and we use whatever tool is needed to achieve those objectives. In some instances, an old-fashioned tool like fixed appliances [braces] may be better for certain patients than clear aligners – and vice versa."
However, he and other orthodontists and dentists around the world are alarmed at the rise of some DIY clear aligners that enable people to treat themselves at home without ever having an in-person consultation with a dental professional.
Registered specialist orthodontists and dentists are an essential part of the process not only during treatment but, importantly, before treatment is begun, Sluiter says. Highly trained professionals can uncover other problems the patient may not be aware of or are not visible through a scan – and which may affect the treatment.
X-rays are essential because registered specialist orthodontists and dentists need to check important matters like how much bone or root is under the gum – as too little can cause problems like teeth becoming loose when they move, he says.
"Teeth straightening is a medical procedure – not a self-care, at-home treatment. Suitably qualified, experienced and experts registered in New Zealand need to be part of the care throughout the patient's procedure. It's concerning to see a trend towards some consumers thinking they can choose and administer treatment on their own."
In a press statement, Invisalign says teeth straightening is a medical procedure that moves teeth through bone. It is important consumers understand the differences in treatment options and are better informed when doing their research – knowing the facts, what to ask and what they are getting. To help, the company has launched a Be Clear on The Facts guide and checklist.
If you're thinking of straightening your teeth, it's important to have an in-person examination before commencing treatment. Your New Zealand-registered specialist orthodontist or dentist will be able to tell you about your oral health and recommend if you are a good candidate for teeth straightening. Invisalign treatment is a series of clear plastic removal orthodontic aligners that gently move patients' teeth. Invisalign must be administered by a healthcare professional. You should always read and follow their directions for use.
Dr Ronald Sluiter is an Invisalign provider; the opinions expressed are his own. *David White et al., Discomfort associated with Invisalign and traditional brackets: A randomised, prospective trial. Study sponsored by Align Technology, Inc.