Direct to Consumer Orthodontics: Buyer Beware

Three female orthodontists posing together

You may have already seen the television advertisements on American channels for Smile Direct Club. They make orthodontic treatment sound so simple. All you have to do is take a selfie, take an impression of your own teeth with the material they’ll send you or have your teeth scanned at a brick and mortar location (coming soon to Canada). Next, you receive aligners by mail and after a few short months - straight teeth! Awesome right? And it’s so inexpensive, what else is there to think about?

Before you decide on direct-to-consumer orthodontics, I encourage you to consider the following important factors:

  1. In almost all instances direct-to-consumer orthodontic treatment does not involve any in-person contact with an orthodontist or anyone else for an evaluation/ exam/ consultation. Consider what accountability someone or a company might have to someone they’ve never even met. Also consider what important information about your health you might not disclose to an unknown entity and how this information may be protected.
  2. Comprehensive records like x-rays are not taken for the purposes of providing a thorough diagnosis of your case. The standard of care in Ontario for dentists/ orthodontists providing orthodontic care is to assess patients with complete records before proceeding with treatment (more limited records for limited cases). This is to ensure that the right treatment is determined for your set of issues and that any reasons for not proceeding or needing to alter the plan are uncovered.
  3. There is no one to go and see if you have an issue with your aligners, never mind an emergency. You can call the customer service line the company provides and speak with someone without any dental education/experience to see if they can help you.
  4. Only one type of treatment is offered; aligners. It may be that aligner treatment is not appropriate for your case and other options are better alternatives for your specific issues. An orthodontist has an array of treatment options and can counsel you on making the best choice for your case.
  5. Direct-to-consumer orthodontics treatments ONLY improve the alignment of teeth and have no regard for fitting the bite or how your upper and lower teeth may fit together worse than before.
  6. Only you are responsible for detecting any issues that may arise during your treatment because no one else is supervising your case.
  7. Smile Direct Club uses an off the shelf material that delivers forces that are often too aggressive and have a shorter range of movement, also only a maximum of 20 trays are permitted per treatment hence the short treatment times. Invisalign utilizes a patented “Smart-Track” material that delivers a lower insertion force and longer range of movements. The number of trays your treatment requires is the number of trays you’ll receive.
  8. If you are injured or have a dispute involving your orthodontic treatment who will be accountable and what right do you have against the company involved with your orthodontic treatment?

Some people may argue that this appears like another fight over interference in a
previously monopolised industry like Airbnb vs. hotels, Uber vs. taxis, or Amazon vs. retail shops. So, is orthodontics just another product worth saving money on? Well, I impress upon you that it is not just a product, it’s medical care. Consider what other transforming medical treatment you’d be prepared to undergo without an in-person, pre-treatment evaluation or on-going in-person supervision from a qualified medical professional?


For more information, contact Dr. Virginia G. Luks, B.A., D.D.S., M.S.D., F.R.C.D(C) at 416-481-4040 or

About the Author

Dr. Virginia Luks

Dr. Virginia Luks wanted to be an orthodontist like her father since she was a child. In 1997, after extensive training and accreditation, she joined her father's practice at Luks Orthodontics. She became one of the youngest orthodontists to attain Diplomate status in the American Board of Orthodontics and the first woman to be elected to Ontario's Dental Licensing Board, the Royal College of Dental Surgeons of Ontario. Dr. Luks thrives on clinical practice and creating new smiles every day. So for over twenty years, that’s what you’ll find her doing.

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