Why To Avoid Direct-to-Consumer Aligners: Understanding the Gap Between Orthodontists and Direct-to-Consumer Aligners"

April 22nd, 2024

In the pursuit of a straighter, more confident smile, individuals today are presented with many different treatment options. From traditional metal braces to innovative aligner treatments, the landscape of orthodontic care has evolved significantly. Among these choices, two prominent paths emerge: seeking treatment from an orthodontic specialist, seeking treatment from a general dentist performing orthodontic specialty work, or opting for direct-to-consumer aligner products when patients are. While both avenues promise results, the distinction between them is substantial and warrants careful consideration. In this blog post I will go into some of the critical differences between these two approaches.

or the purposes of this blog, a Direct-to Consumer aligner company is one where you taking impressions of your own teeth and send it in to get aligners for your teeth without the intervention of a dental professional or you visit a "Scan Shop" where a representative will take some type of model of your teeth and you will be sent aligners to straighten your teeth.

At Strouse Orthodontics, I design every aligner treatment plan that we provide our patients. First comes a complete diagnosis of your face, your jaws, and your teeth, the presentation of treatment options, and a final custom treatment plan to address your specific situation.

Aligner design requires an understanding of 1) the patient’s final goals, 2) the sequence and speed of tooth movements, 3) the biomechanics(how the teeth move) that must be built in the prescription to achieve the desired results, and 4) the additional features that are required for difficult tooth movements. Most direct-to-consumer aligners as designed by computer algorithms and then approved by “dental professionals.” Although there may be a dentist’s name on the aligner packaging, he or she had nothing to do with designing your aligners. General dentists(non orthodontic specialists) often do the same, doing little to no analysis or modifications to a patients treatment plan. There are several issues that can occur with a Direct-to Consumer Orthodontic plan.

No Visits

A huge selling point for DTC aligners is that no orthodontic visits are necessary. However, this is also the biggest red flag. You won’t see a orthodontist or even a dental professional at any point in the process. It may not seem like it, but moving your teeth into more optimal positions will impact your entire mouth. Even in simple cases, straightening the teeth will affect the health of your teeth as well as the gums, bones and roots. An orthodontist is trained to ensure all of these are healthy before and during the treatment process to produce safe movement of the teeth.

No Attachments

With Direct To Consumer "Orthodontics" no attachments are placed on the teeth. This is because there is no involvement of a dental professional. Due to the shapes of teeth, as well as the tooth movement being completed, there may be a need for tooth-colored attachments made of dental composite be attached to your teeth. Patients are not able to bond attachments to their own teeth. While there are some tooth movements can be occur without them, there are many tooth movements that may not be able to be predictably achieved without attachments.

Your Teeth Might Not Move the Way They Should
It is important that the teeth move the way the the orthodontist is intending over the course of treatment. If there are problems with how the teeth are movement for any reason(lack of attachments, wrong staging of tooth movements, wrong speed of tooth movement, poor compliance with aligner wear), with a Direct To Consumer Company, there is no way to have your progress evaluated. With an orthodontic specialist, you will be able to have your progress evaluated and be given instructions for how to handle a problem that arises during treatment.

No Rubber Bands

Both braces and aligners can both be straighten the top and bottom teeth individually. When modifications with the bite are needed in the bite however, orthodontists typically prescribe rubber bands connected between the top and bottom teeth to make these changes. Direct-to-consumer companies do not utilize rubber bands with their treatment. Furthermore, they typically have consumers sign a waiver that they understand that the aligners from their company will not improve their bite. This is similar with orthodontic treatment with a general dentist. While they are able to prescribe rubber band wear, they often lack the orthodontic knowledge to correct more advanced malocclusions, sometimes without informing the patient there are any bite issues present at all.

By seeing a specialist in orthodontics for orthodontic care(braces, Invisalign), you can feel confident that an expert is prescribing, planning and monitoring your care. An orthodontist will be able to monitor your teeth, discuss treatment goals, review various options for treatment and be able to provide the necessary in office adjustments that are not possible with a Direct-to-Consumer aligner company. You only get one set of teeth. Trust your smile to an orthodontic specialist.

Cost of Orthodontic Treatment

April 3rd, 2024


As you delve into the world of orthodontic treatment, understanding the financial aspects is just as crucial as understanding the clinical ones. While the cost of treatment can vary significantly based on the complexity of your case and other factors, it’s essential to consider additional factors that may affect your out-of-pocket expenses.

Insurance Coverage and Financing: Navigating Your Benefits and Making Treatment Affordable

For many patients, insurance coverage and financing options play a significant role in making orthodontic treatment more accessible.

Insurance Coverage: Some dental insurance plans offer orthodontic coverage, which can help offset a portion of the expenses. However, it’s important to note that coverage levels and limitations vary widely among insurance providers and individual plans.

Before beginning treatment, it’s advisable to review your insurance policy to understand the extent of your orthodontic coverage. Your orthodontist’s office can also assist you in navigating your benefits and determining how they apply to your treatment plan. While insurance coverage can help reduce costs, it’s essential to be aware of any deductibles, copayments, or exclusions that may apply.

Financing Options: For patients concerned about the financial aspect of orthodontic treatment, many orthodontic practices offer flexible financing options to make treatment more accessible. Interest-free financing plans allow you to spread the cost of treatment over manageable monthly payments, making it easier to fit orthodontic care into your budget.

Orthodontic financing plans typically offer competitive terms and can be customized to suit your individual needs. By taking advantage of these financing options, you can focus on achieving your dream smile without worrying about the upfront financial burden.

Consultation: Your First Step

Before diving into the specifics of cost, the first step in your orthodontic journey is a consultation with a qualified orthodontist. During this initial appointment, the orthodontist will conduct a thorough examination of your teeth, jaws, and overall oral health to assess your individual needs.

The consultation allows the orthodontist to develop a personalized treatment plan tailored to address your specific concerns. It also provides an opportunity to discuss your treatment goals, ask any questions you may have, and address any financial considerations.

Understanding Phase One Orthodontics

Phase one orthodontics, also known as early or interceptive orthodontic treatment, is aimed at addressing orthodontic issues in children at a younger age, typically between the ages of 7 and 10. This early intervention helps guide the growth and development of the jaws, creating a more favorable environment for the eruption of permanent teeth and correcting certain bite problems.

The cost of phase one orthodontics can vary depending on the complexity of the treatment and the specific needs of the child. While it typically ranges between $2000 and $4500, it’s essential to consult with your orthodontist to get an accurate estimate based on your child’s individual case.

Comprehensive Orthodontic Treatment

Comprehensive orthodontic treatment, often referred to as full treatment, is typically initiated when all permanent teeth have erupted, usually around the ages of 11 to 13. This phase of treatment focuses on achieving optimal alignment of the teeth and bite, resulting in a straighter, healthier smile.

The cost of comprehensive orthodontic treatment also varies depending on factors such as the complexity of the case, the type of braces or aligners used, and the duration of treatment. On average, comprehensive treatment ranges between $5000 and $7000. However, it’s important to remember that this is just a general estimate, and the actual cost may differ based on individual circumstances.

Conclusion

Orthodontic treatment is a valuable investment in your oral health and overall well-being. While cost is undoubtedly a consideration, it’s essential to prioritize quality care and the expertise of a qualified orthodontist. Your orthodontist will work with you to develop a personalized treatment plan that meets your needs and fits your budget, ensuring you achieve the smile you’ve always wanted. Don’t hesitate to discuss any questions or concerns you may have about the financial aspects of treatment. With the right guidance and support, you can achieve the smile you’ve always wanted while staying within your budget. Remember, the first step is scheduling a consultation to discuss your options and get started on your journey to a confident, beautiful smile.

All About Interproximal Reduction

March 7th, 2024

In orthodontics, the quest for a beautiful harmonic smile often involves various intricate techniques and methods. While braces or Invisalign can make the teeth straighter, in most cases, an orthodontic specialist has many variables to consider and a complex diagnosis and treatment planning is done behind the scenes. Some of these considerations involve a patients skeletal pattern, analysis of several radiographs, the patients facial profile and balance, symmetry, as well as the macro and micro esthetics of the teeth.

This post will focus on the last point. The macro esthetics encompass the relationships of the teeth to the face, lips and gums and the micro esthetics involve the individual tooth size, shapes and shades. There are many misconceptions about interproximal reduction, many of which come from General Dentists who have the best intentions, but are ill-informed, as well as social media. It is important to remember that Orthodontists are specialists in tooth movement and what is needed to obtain the best smile and proper bite relationship.

The size and shape of the teeth play as large role in the appearance of the smile as anything that an orthodontist does with braces or Invisalign. If the teeth have irregular size or shape sometimes the teeth themselves need to be altered in order to obtain an ideal bite as well as an optimal esthetic result. Interproximal reduction, or IPR, is a technique that can be utilized in order to obtain the best orthodontic outcome.

Interproximal reduction is a simple procedure in which the size and shape of the teeth are adjusted using precise diamond embedded instruments in which minute amounts of enamel are removed. This is typically done in between the teeth where they touch one another, known as the contact point. There are several reasons why this is done:

  • Tooth Size Discrepancy: The set of upper and lower teeth are like a puzzle and the individual teeth have ideal sizes in order to fit together properly. If the upper teeth are too big or the bottom teeth are too narrow in comparison, a patient will present with upper crowding, an excess overbite or spacing of the lower teeth. On the other hand, if the top teeth are too small or the lower teeth are too wide, there will be spaces on the top or crowding on the bottom. Through extensive orthodontic research, it was discovered that there are ideal proportions of the upper and lower teeth. If the upper and lower teeth do not match due to the tooth size, it is known as a "Tooth Size Discrepancy". On occasion, reduction of the upper or lower teeth is a solution.
  • This is a quick, safe and pain free procedure. Tooth enamel can be as much as 2.5 millimeters thick and Interproximal reduction typically involves no more than 0.2-0.4 millimeters. After IPR, there is plenty of excess enamel to keep the teeth healthy and strong, which has be shown in countless orthodontic research. IPR does not increase the risk of cavities. Research has shown that dentists are less comfortable performing IPR routinely and orthodontists who are more likely to have researched the long term effects of IPR on the teeth are more comfortable performing the procedure. Because of this, dentists will often inform patients and their families that IPR is unsafe, will damage the teeth or other statements that are incorrect, and not backed by scientific research.

  • Anatomy: Sometimes the shape of the teeth is such that an esthetic improve can be made by removing some excess enamel in order to improve the shape of the teeth or how to teeth connect to each other in order to obtain a more esthetic final result.

  • Black Triangles: Sometimes due to the shape of the teeth, how they connect to each other or due to gum recession, the appearance of what are known as black triangles occur. It is noticed as triangluar "spaces" close to the gum-line. While there are not actually spaces between the teeth, if the teeth are only touching at the tips and not up to the gums, a dark triangle will apear. On occasion, IPR can reshape these teeth and reduce the size and appearance of the black triangle once the space is closed.

  • Crowding: Another reason for using IPR is due to crowding of the teeth. Significant amounts of space can be created by removing very small amounts of enamel in between some of the teeth. If there is crowding between the teeth, but not enough crowding for the removal of permanent teeth, IPR can be used to create enough space for all of the teeth. In addition to create space, IPR also creates flat surfaces between the teeth which helps improve the stability of teeth to keep them straight after orthodontic treatment is completed.
  • Conclusion and Considerations: IPR is a safe procedure and extensive research shows that there is no increased decay after IPR, there is improved stability of the orthodontic results after IPR due to the improved contacts, and there is no increase in sensitivity when the amount of enamel removed is within proper limits.

The author, Dr. Eric Strouse DMD MDS is a specialist in orthodontics in the practice of orthodontics in Spring Hill and Lecanto, Florida. He was trained at Muhlenberg College for his Bachelors Degree where he competed on the track and field team. He completed his dental training at the University of Connecticut School of Dental Medicine, earning a Doctorate of Medicine in Dentistry(DMD). He completed a one year General Practice Residency at St. Luke's Hospital in Allentown, PA and his specialty training in Orthodontics and Dentofacial Orthopedics at Rutgers University where he also completed a Masters in Dental Science. Dr. Strouse has been published in several Dental and Orthodontic Journals. Dr. Strouse is an expert in two-phase orthodontic treatment, phase 1 interceptive treatment, extraction and non-extraction treatment, Invisalign clear aligners, and multiple bracket systems(custom braces, self ligating braces, conventional braces). This blog is for informational purposes only.

Community Spotlight: Brooksville, Florida

February 21st, 2024

Brooksville, often hailed as the "Nature Coast," offers a delightful blend of old-world charm and modern amenities with a wonderful community of families we are privileged to serve at Strouse Orthodontics. Steeped in history, this picturesque city invites you to explore its quaint downtown adorned with historic architecture, charming boutiques, and cozy cafes. Take a stroll down its tree-lined streets, and you'll find yourself immersed in the beauty of Southern hospitality and small-town allure.

But Brooksville isn't just about its nostalgic charm – it's also a haven for outdoor enthusiasts and nature lovers. From the breathtaking landscapes of the Withlacoochee State Forest to the crystal-clear waters of Weeki Wachee Springs State Park, there's no shortage of natural wonders to behold. Whether you're kayaking along scenic rivers, hiking through lush forests, enjoying a Historic Walking Tour or simply enjoying a picnic in the park, Brooksville offers endless opportunities for adventure and relaxation.

At Strouse Orthodontics we understand the importance of a healthy, beautiful smile. Led by experienced orthodontist Dr. Eric Strouse, our practice is committed to providing personalized care and innovative treatments that achieve exceptional results. From traditional braces to Invisalign® clear aligners, we offer a comprehensive range of orthodontic services tailored to meet the unique needs of each patient, for both children and adults.

What sets us apart is our dedication to excellence and our genuine passion for enhancing smiles. We combine state-of-the-art technology with a compassionate approach to ensure that every patient receives the highest standard of care in a comfortable and welcoming environment. Whether you're seeking orthodontic treatment for yourself or your family members, you can trust that you're in good hands at Strouse Orthodontics.

Join Our Orthodontic Family in Brooksville

Conveniently located in the heart of Brooksville, our practice is proud to serve patients from Brooksville and the surrounding communities. Whether you're a longtime resident or just passing through, we invite you to experience the difference at Strouse Orthodontics. Our office has convenient locations in Citrus and Hernando County, in Lecanto and Spring Hill. We provide the highest quality orthodontic care, with custom orthodontic braces and Invisalign in a friendly and welcoming environment. Schedule your consultation today and take the first step towards achieving the smile of your dreams in the charming backdrop of Brooksville, Florida.

At Strouse Orthodontics, we're more than just orthodontists – we're your partners in oral health and happiness. Come and discover the beauty of Brooksville, and let us help you achieve a smile to be proud of! Your journey to a confident, radiant smile begins here!

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