Online Orthodontics

By: Laura Sheppard, CDT, TE

Orthodontics is one of the latest areas to enter the digital space by utilizing clear aligning dental trays that are manufactured and worn as a graduated series of corrective arches. This form of treatment has become very popular and can be successful if prescribed by an experienced provider. However, the availability of this orthodontic alignment via mail-order may be risky business.

When considering unsupervised, mail-order or DIY orthodontics, you may be thinking that straight teeth is all you need. But orthodontic treatment is more than moving chess pieces around on a chessboard. Did you know that the unseen roots embedded into your upper and lower jaw bones are longer than the teeth you see in your mouth? And, as you move teeth, you are also moving the roots within the bone? Further, in a non-growing adult there is no new bone growing around teeth to hold them in place. As such, recently straightened teeth will relapse and return to their original positions after treatment. To prevent relapse, lifetime retainers are required.

And what about function? The main function of your teeth is to bite and eat. To do this, your upper and lower back teeth should always fit together on the biting surfaces when eating. The high points and shallow areas should all fit like puzzle pieces, like locking your fingers together. If you’re considering orthodontics without close professional supervision, you may dismantle your bite relationship, causing functional problems much worse than what is gained in appearance improvement. Straight teeth do not serve you unless they are also stable, with the upper and lower jaws working well together, and not causing you future bite or TMJ problems.

A ‘stable’ orthodontic outcome can be thought of simply as the ‘foot and the shoe’. A correct dental bite has the cheek-side cusps of the upper teeth covering and protecting the lower teeth when biting. So, the lower arch fits into the upper arch like a foot in a shoe. Establishing a good bite and balanced profile early in childhood leads to better growth outcomes later. For example, a narrow upper jaw may not accommodate a larger sized lower jaw. What happens when your shoes are too small for your feet? A small upper jaw not only causes crowded teeth, but also constricted airways that complicate growth patterns, brain function and sleep patterns. This can also lead to mouth breathing and tongue thrusting.

Then there are crossbites. The most common crossbite is when one or more lower teeth are outside of the upper teeth when biting. Sometimes, the lower jaw is so small it fits entirely inside the upper jaw. Or, conversely, it can be so large, the upper jaw can fit entirely inside the lower jaw. Additional challenges can occur from periodontal problems, bruxism, TMJ disfunction, age, lessening bone density, habits and diet.

Finally, from an aesthetic point of view, look at your facial profile. If you are one of the lucky few who have a balanced face and bite (known as a Class I profile) with only minimal to moderate dental crowding or rotations, then invisible correctors or aligners can provide a successful result. For the many of you that are ‘experienced’ orthodontic patients, don’t lament the money your parents spent; or the time, pain and agony involved in early orthodontic treatment. Likely, your orthodontic headgears, brackets, expanders, springs, screws and elastics were implemented to correct or prevent a future overbite (known as a Class II profile); essentially the profile appearance of a short chin. This overbite scenario is often illustrated as “bucky”, “Dopey”, or “ET”. Or, the opposite, an underbite (known as a Class III). This profile has the lower jaw leading the race. Don’t get me wrong, I love Jay Leno. But not everyone wants to grow up with their chin entering the room before they do.

So, if you’re considering online orthodontics, be aware of what it is you’re trying to achieve. Straight teeth may not give you the results you want if you have severely crowded teeth, crossbites, overbites or underbites. Be realistic, you can spend a lot of money on dressing the inside of a house, but if the roof and foundation are sagging, you may be wasting your investment. Before seeking treatment to only move teeth, ask an orthodontist or dentist experienced in orthodontics, to be sure your foundation is solid and only needs an alignment.

Laura Sheppard is the owner and managing member of Device Masters Dental Laboratory in Traverse City, Michigan, providing devices for dental sleep medicine, TMJ dysfunction and orthodontics.  A practicing dental technician since 1979, Laura holds an Associate’s Degree in Dental Technology and a Bachelor’s Degree in Allied Health Teaching. She is certified in Orthodontics, Crown & Bridge and Complete Dentures.

Laura spent many years as Director of Training, Quality Systems and Regulatory Affairs.  She has earned multiple DAMAS lab certifications for conglomerate laboratory companies, successfully coached many technicians to achieve certification and was instrumental in the invention, patent and 510(k) submission process of several successful proprietary Class II medical devices.  Laura has been manufacturing dental sleep devices since 1988 and has been an active participant with the AADSM since 1991.

Laura served on the NADL Board of Directors and is the Past-Chair of the National Board of Certification. In 2011, she was named one of the Top 25 Women in Dentistry by Dental Products Report. Laura lectures for both, the dental practitioner and dental technician communities, and is well published having written numerous articles for JDT, IDT, DPR, DLP, LMT, DSP and Sleep Review magazines.