By now, you’ve probably seen that newest internet sensation, the video of the grad student who did his own clear aligner orthodontic therapy (i.e.”Invisalign”) to straighten his front teeth. No doubt, it looks like something that’s simple to do and from the comments I’ve seen from his video, it seems like most of the general public is a bit perplexed about why treatment that seems so easy should “cost so much” in an orthodontist’s office. His own words “…stick it to the dental appliance industry” underscore a lot of the sentiment behind his publication of this technique.
At first gloss, one really has to give kudos to the student for reading an orthodontic textbook, figuring out the basics of CAD/CAM clear aligner design and for experimenting on himself to see what would happen. Yes, he experimented on himself. He had an idea of what he thought he could do, but he really didn’t know if it was a biologically attainable result. As an orthodontic professional with 4 years of dental school and 30 months of specialized orthodontic training, I can tell you that he got lucky. His was seemingly a very easy case but one misstep could have led to disastrous results.
But you may say: “Doc, lighten up. You’re just an orthodontist concerned about keeping your profession alive and you’re worried about the financial ramifications of the public being able to do their own braces.” That’s a fair statement, IF my primary concern with this whole issue were money, which it isn’t. I can promise that no orthodontist feels threatened financially or professionally by someone who did their own braces or that suddenly that everyone will start doing their own braces. However, we often need to bail out folks who tried some form of DIY braces from something they learned on the internet or a general dentist (someone far better trained than a layperson) who didn’t realize the complexities of straightening teeth until they got in “over their head”. We see people lose teeth (or worse) because of stupid suggestions that are easily avoided by simply seeing an orthodontist.
If the teeth in the case we’re discussing had uncontrolled tipping causing root torque that led to a dehiscence in the bone, it would have required extensive periodontal surgery to correct. Don’t understand the mumbo jumbo I just discussed? Neither did the student doing his own treatment but it’s braces 101. I applaud him for realizing he didn’t know enough and reading a 1000 page textbook (and still getting lucky), and it underscores that moving teeth requires extensive education in the biology of bone physiology and its response to treatment effects.
Simple clear aligner therapy needn’t be super expensive but it should be left to orthodontic professionals who understand the pros and cons of treatment. There are people we see shoot a puck into a goal at a break in a college hockey game and win free tuition, but we’d be foolish to believe that anyone should think that luck like that is the way to pay for college. Let me reiterate that this guy got lucky with his treatment outcome AND he had access to some seriously sophisticated machinery. Maybe 10 people online could get lucky doing this, maybe 100, but I guarantee you that nobody is going to post the case that had them running to the dentist when their front gums became tender and puss started flowing because they violated a basic biologic rule. It’s not worth it.
For those of you out there who have made the investment to see an orthodontist who changed you life by helping you smile again, you understand that having a specialist who can handle every contingency is worth it. Fortunately (or unfortunately) like a Steph Curry 3 point shot with defenders racing toward him, we make tooth movement look easy because as orthodontists, we’re masters of what we do and we’re supposed to make it look effortless.
- Looks easy, huh? Bet we could all do that if we practice enough, right?
There’s a great quote from Dr. Ian Maxwell (Jeff Goldblum’s character from Jurassic Park) that “online novice orthodontists” should heed:
“If I may… Um, I’ll tell you the problem with the scientific power that you’re using here, it didn’t require any discipline to attain it. You read what others had done and you took the next step. You didn’t earn the knowledge for yourself, so you don’t take any responsibility for it. You stood on the shoulders of geniuses to accomplish something as fast as you could…you were so preoccupied with whether or not you could that you didn’t stop to think if you should.”
Wishing you the best,
Glenn
The Dental Sherpa 
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