Can you trust braces for sale on the internet?

BrITISH dentists face a threat from a U.S. web company that promises a Hollywood smile via personalised — 3D printed — invisible braces sold over the internet.

The SmileDirectClub claims it can straighten the teeth of people with mild to moderate problems for a fee of £1,499, which compares with about £4,800 for the dentist option of Invisalign braces. There is also a 12-month instalment payment option for the service, which includes a teeth-whitening kit and access to a qualified British dentist online.

The company claims its service, which normally begins with a 3D scan of your teeth in a High Street shop or pharmacy, could make straight teeth affordable to the four in ten Britons who are unhappy with their smile.

The treatment, which typically takes about six months, poses a major threat to mainstream dentists, particularly given the difficulty patients have in getting appointments that fit around the working day.

Just as many thousands of Britons now buy cheap spectacles or contact lenses via web stores, so the U.S. company says people can make huge savings by purchasing personalised invisible clear plastic teeth aligners in the same way.

However, the British Dental Association (BDA) has warned people against opting for this type of internet dentistry rather than having a face-toface consultation.

Eddie Crouch, vice- chairman of the BDA, said: ‘We advise people to think twice before going ahead with any treatment that is carried out remotely, without a consultation or via the internet.

‘ The best starting point for orthodontics should always be to see a clinician who has the appropriate training and experience. They can advise you about the different types of orthodontic appliances available, the advantages and risks associated with each, and the one most suited to your needs.

‘Seeing an experienced clinician will allow treatment to be carefully monitored and ensure that if any problems arise, these are addressed. If the treatment isn’t monitored over time, you may not get the best outcome, and there is a risk of causing permanent damage to dental health.’ CLEAR plastic Invisalignstyle braces are said to have helped people, including the Duchess of Cambridge and Hollywood A-listers such as Tom Cruise, develop the perfect smile. However, the high cost means they are unaffordable for many people.

SmileDirectClub, which already treats people in the U.S., Canada and Australia, is opening nine shops in london, Manchester and Birmingham, and another four in Cambridge, Newcastle, Cardiff and leeds, as part of a partnership with Well Pharmacy, the UK’s thirdlargest pharmacy chain.

Customers visit the shop, where a 3D optical camera, which captures 6,000 images a second, creates an interactive 3D image of their smile, including the teeth and gum lines.

This image is then emailed to one of the company’s registered dentists and orthodontists in the UK to determine whether the service will work for the customer.

Alternatively, customers can send off for an at-home impression kit, costing £39, which is returned to the company for an assessment.

Assuming people are suitable, they are sent a box of personalised 3D printed aligners, which are tailored to them and are normally changed every week as the teeth are moved and straightened.

The clear plastic aligners, normally for both the top and bottom teeth, are shipped to the UK from the U.S. and there is, typically, a wait of four to five weeks from the patient agreeing to go ahead.

The company says customers can have periodic consultations with a UK dentist via email, web chat or voice calls to see how the aligners are working. There is also a 24-hour call centre for people to raise urgent issues and ask for advice.

The company’s chief clinical officer, Dr Jeffrey Sulitzer, says all the experts assessing UK customers are fully qualified and registered by the General Dental Council. ‘They are excited to be involved in using this new technology to improve access to care,’ he says.

He adds that people with complex issues which cannot be resolved by its service will be referred to a conventional dentist.

Dr Sulitzer said the company has faced objections from dentists in the U.S., adding: ‘Any time you are a disruptive technology you face these kind of barriers.

‘But we try to educate organised dentistry about what we do and, most of the time, they understand how the model works and the safety and efficacy.

‘This is doctor-prescribed, doctordirected and doctor-managed. It is very similar to, and consistent with, traditional practice.’