Online orthodontic services have been causing a lot of buzz lately, thanks in no small part to their large advertising budgets. They pitch a simple and time-saving treatment. All you have to do is make an impression of your teeth, or take a picture or scan and send it in. Before you know it, a package with alignment devices is mailed to your front door. After a few months of use, you have perfectly straight teeth. What could be easier?

There are a few things to consider before signing up with one of these services, however. The American Association of Orthodontists (AAO) recently released a flier with a list of questions to ask and factors to consider. The main drawback with direct-to-consumer orthodontic companies is the lack of an in-person evaluation before treatment and supervision during treatment. These are very important because a beautiful smile involves more than just the visible parts of your teeth.

Irreversible damage is possible with orthodontic treatment when not properly done. Some consumers have reported tooth loss, gum erosion and changed bites among other issues.

If you are looking into getting your orthodontic treatment online, here’s a list of questions you should ask according to the AAO.

Ask Questions, Get Answers

As part of your treatment, are comprehensive diagnostic records like x-rays taken before your treatment?

YES

• Does the treatment and fee include x-rays of your teeth and jaws?
• Does the treatment and fee include a clinical examination of your jaw alignment, teeth, bite, and the relationship of your teeth to the skeletal structures?
• Does the treatment and fee include taking photographs of your face, facial profile, mouth, and teeth?
• Does the treatment and fee include taking digital scans or other impressions of your teeth?

NO – are you comfortable starting orthodontic treatment without comprehensive diagnostic records? If you still want comprehensive diagnostic records taken, are you all right going to another dental professional to take them? If yes, what will that cost?

As part of your treatment fee, do you receive any in-person visits to a dentist’s or orthodontist’s office during your treatment?

YES

• How many?
• What occurs during these in-person visits?
• Is there a licensed dentist or orthodontist in the office to supervise the visits?

NO – are you comfortable with orthodontic treatment that does not involve any in-person visits with a dentist or orthodontist?

If a dentist or orthodontist is involved with your treatment, do you know the name of the dentist or orthodontist who will be specifically involved with your case (for example, is it available on the company’s website or elsewhere)?

YES

• What are his or her education and credentials?
• In what state is he or she licensed?
• In what state does he or she practice?
• What do other patients being treated by him or her have to say?

NO – are you comfortable not being able to research your dentist’s or orthodontist’s background, credentials, patient reviews, etc. before you begin treatment?

Is only one treatment type offered (such as invisible aligners or a certain appliance)?YES – how do you know that is the best treatment option for you, given your unique situation and oral condition, compared to other treatment models (such as braces)?

NO – how is the decision being made for the best treatment model for you, and who is making that decision?

How do you know if your teeth and gums are healthy enough for orthodontic treatment?

• Who is making that decision and how is it being determined?
• If the decision maker is a dentist or orthodontist not associated with your treatment, who pays for that assessment?

What are the possible risks (financial, health, etc.) associated with your orthodontic treatment?

Who can you speak with at the online orthodontic company about your orthodontic treatment?

• What is his or her education, background, qualifications and/or experience with orthodontics?

Who is responsible for detecting any issues that may occur during your orthodontic treatment?

• Is it you?
• If it is a doctor not associated with your treatment, who pays for those check-ups?

If an issue arises during your treatment, how will it be handled and who will be responsible for handling it?

If a doctor is involved with your orthodontic treatment, how can you contact him or her over the course of your treatment? How can you contact him or her if an emergency arises?

If an emergency arises, does the company have a dentist or orthodontist in your area that you can see in-person? If not, who would cover the costs associated with seeing a dentist or orthodontist in your area? 

If you are injured or have another dispute involving your orthodontic treatment, how is it handled (litigation, arbitration, etc.)? State dental boards have their own complaint processes for patients who have had issues with orthodontic treatment. Contact information for your state dental board can be found at https://www.aaoinfo.org/aao/state-dental-board-info.

If you are injured or have a dispute involving your orthodontic treatment, what rights do you have against the person or company involved with your orthodontic treatment?

• Are you asked to sign any forms that seek to release them from liability?

Does the treatment model comply with the dental laws in your state?

• To check your state’s dental laws, click https://www.aaoinfo.org/state-laws-and-regulations
• Information for your state dental board can be found at https://www.aaoinfo.org/aao/state-dental-board-info.