“Caveat Emptor”

Author: Dr. David Dickerhoff, DDS, MAGD, FOCOI

I know that you have seen those advertisements on television and other modalities that advertise moving your teeth with aligners where you can get comfortable orthodontics at half the price of traditional orthodontics. They are primarily put forward by a company called Smile Direct. The American Dental Association has raised concerns with Congress about the prudence of this company marketing directly to the public and was met with some pushback from congress members. Congress is extremely sensitive to restraint of trade issues and was hesitant to back the ADA is their efforts to raise concern about direct marketing to the public for orthodontic services. The ADA has since initiated a citizen’s petition to lobby congress to intercede on the citizen’s behalf. The ADA filed its citizens petition with the FDA (Food and Drug Administration) on April 25, 2019 , stating that SmileDirectClub is placing the public at risk by knowingly evading the FDA’s “by prescription only” restriction which the agency (FDA) has placed on teeth aligning materials. This petition is still active and in place even though public statements from SmileDirectClub have stated otherwise.

SmileDirectClub requires customers to self-report their dental condition. As the ADA explains in its citizens petition, customer self reporting does not meet the applicable standard of care because it does not satisfy a dentist’s requisite professional due diligence. The ADA believes this to be deceptive under Section 5 of the Federal Trade Commission Act. While you may say this is dentist’s being territorial of their turf and only wanting to guard the profits they achieve through traditional orthodontic work. And while moving teeth without knowing all aspects of a patient’s oral condition is possible with changes in today’s technology (digital scanning and software programs that artificially move teeth), this effort holds the potential to cause bone loss, lost teeth, receding gums, bite problems, jaw pain and other issues. The stomatognathic system (jaw joints, muscle, bone, ligaments and nervous connections) is very complex and still being studied aggressively in an attempt to treat and understand “TMJ problems”.

Our patients need to understand that orthodontic movement and problems of malocclusion basically come in two flavors. Tooth malocclusion, crowding and esthetic shortfalls versus skeletal or bone problems. You cannot move teeth where there is no bone. Sometimes the solution is to move the bones first before tooth aligners are used to correct the initial problem. Additionally, all of this has to be done in concert with harmoniously placing teeth and bones in a place where they do not disturb joint or nerve function. And so I say to my patients, “Caveat Emptor” which is Latin for “Buyer Beware”. The ADA understands that this is a very complicated issue and the professionalism of an expert opinion matters when you are talking about orthodontically moving teeth. Spring Lake Dental Group works in conjunction with Dr. Thorpe Whitehead, a board certified orthodontist who offers free consults on Wednesdays and Saturdays. He will agree with me when I say that all potential good we can create for our patients is through sound and effective treatment planning which is based on meticulous data gathering and analysis. Don’t sell you oral health short. Invest appropriately in yourself. Caveat Emptor.