Fake Orthodontics Gaining Ground
(And the Culture of False advertising)
As a practicing Orthodontist I meet with dental specialists regularly for continued education, review of difficult cases and overall health of the profession; I have done so regularly for the last 23 years. Now, at the middle of my career as a Board certified specialist, I feel somewhat qualified to reflect on the state of dentistry, and specifically specialty dentistry, in today’s marketplace.
Although politics has focused on medical insurance and general healthcare (for better or worse) there has been a curious lack of attention to engage the field of dentistry in the negotiations. This has allowed dental related companies to hide in the shadows as they promote their own profit based treatments directly to the public, many now advertised as not even needing the doctor (and certainly not needing the specialists). This phenomenon is a result of very large companies combined with social media campaigns that inundated the public with the company’s own agenda, directly to Facebook and other email lists. Nowhere has this been more harmful than to the field of Orthodontics.
As the reader, you may ask “how can a company dictate dental care without doctors?”; you may even ask “aren’t there laws to prevent practicing without a license?”
In response, it has been a slow but deliberate strategy by certain unethical, profit hungry groups that employ un-ethical dentists and specialists to push them into the range of credibility. Behind the scenes, there is a battle over standards of care but ultimately dentistry is a business and many succumb to the notion that if you don’t feel you can beat them, you have no other choice but to join them. This is in fact exactly how Fake Orthodontic Companies like Invisalign (and their subsidiary Smile Club) have become the juggernauts in the room. Currently there are nearly one hundred lawsuits by national and state dental organizations, boards and individual Orthodontists in the courts against Smile Club and other aligners, but they take time and they get buried by google ads paid for by …. you guessed it, Invisalign.
As a history, the idea of clear aligners was not a new one; many of us used clear aligners (made in-house) to hold and correct small rotations or mild relapse after treatment even 35 years ago. However we all recognized and experienced the extreme limitations of removable plastic trays. Also at that time, few dentists tried to perform orthodontics without specialty training; in fact family General Dentists would refer complex cases readily to their specialty counterparts/colleagues including surgery to Oral Surgeons, tough root canals to Endodontists, extensive gum disease to Periodontists, kids to Pedodontists and orthodontics to the Orthodontist. This provided the environment for the General Dentist to become an expert in restorative care as well as the gatekeeper to more advanced treatments that required a higher level of training.
“Behind the scenes, there is a battle over standards of care but ultimately dentistry is a business and many succumb to the notion that if you don’t feel you can beat them, you have no other choice but to join them. This is in fact exactly how … Invisalign [and other “Fake Orthodontic” clear aligner companies] have become the juggernauts in the room.”
So what happened?
As competition heated up in larger urban areas, we started to see general dentists pushing the limits to treat more complex issues to avoid losing the income stream from what they perceived as more profitable procedures (more “profitable” because they generally required specialty training to adequately and predictably treat). Soon, there were whole groups of general dentists claiming specialty status to the public simply because they had seen what they felt like was a significant number of patients. Of course they were learning on those very patients and were undoubtedly repeating the same mistakes over and over on those same [unsuspecting] patients.
Many would then teach other non-specialized dentists so it became a cycle or grey area in dentistry. But dentists far outnumber specialist by the definition and specialists had little power to dissuade the American Dental Association (the parent organization of all dentists including specialists) from allowing this progressing breach of standards and ethics. It is now not uncommon for untrained newly graduated general dentists to see patients already in treatment and then question these cases that they don’t even have the records for and certainly not the training to fully understand. This sews more discontent and distrust in the public as patients start hearing multiple stories from different doctors and it only serves to confuse patients and leave them open to professional advertising by companies directly.
What is the current state of the specialty of Orthodontics?
Today, Orthodontics has become synonymous with Invisalign (by their design, not ours) to new generations through social media and false advertising that would have never been allowed in traditional media. Add to this a new generation of unethical dentists (and now Orthodontists) driven by pure profit, doctors that know very well they are not offering or providing the best care available (or sometimes even proficient/adequate care without introducing more problems).
As these general dentists stopped referring patients to the Orthodontists, the very Orthodontists began to move toward Invialign based practices. They have done this despite the research that clearly and unequivocally proves Invisalign and the other dozen aligner systems far inferior to traditional braces. But the public continues to be bombarded by advertising to the point now that Invisalign has purchased other companies like Smile Club that push aligner treatment with no dentist at all. Ironically, now the general dentists are trying to fight the doctorless trend even though it is they themselves that are funding the company via their own Invisalign cases.
Clear aligner treatment; straight teeth but with no posterior contact; good luck chewing that steak!
“Straight” teeth from clear aligners with little to no contact and recession across the arch.