As an orthodontist, people are always telling me about their friends who are getting Invisalign, and often it is being done by a general dentist.  Whenever I hear such a story, I mention that I hope the person at least got the opinion of an orthodontist before starting treatment.  And my question usually elicits surprise – what’s wrong with a dentist doing Invisalign?  What could go wrong?

A lot can go wrong, actually. Invisalign is just a tool to straighten teeth and, like any tool, what matters is the skill and training of the user, not the tool itself.  Many people don’t realize that in order to become a certified Invisalign provider, all a dentist needs to do is complete a single, 10 hour course.  That’s it!  And even if dentists take a few continuing education courses in Invisalign, they still have nowhere near the training of an orthodontist, who has trained for over 3000 hours in the use of braces and Invisalign even before graduating!

“Ok”, you might ask, “dentists are not as trained as orthodontists.  But Invisalign is Invisalign, right?  What’s the difference if I get it from my dentist or my orthodontist?”  And the answer is that there is often a huge difference in the quality of the result, depending on who does the treatment.  Because in order for Invisalign to properly correct your teeth and bite, the treatment needs to be planned by a doctor who understands orthodontics.  If not planned properly, the Invisalign will not move the teeth as predicted.  What could go wrong?  Patients can end up with un-esthetic results – protrusive teeth, asymmetric teeth, teeth that won’t fully straighten, etc.  Patients can end up with gum disease, jaw aches, and unstable results.

I’ll give you an example from my own practice.  I recently got a referral from a general dentist who offers Invisalign to his patients.  He had been treating this particular patient with Invisalign for almost 2 years, and he told me that somehow the teeth were just not behaving.  He had taken multiple moldings of the teeth over the years, and asked Invisalign for corrections, but the teeth were just not getting any better.  He hated how his teeth looked, and had difficulty chewing because his back teeth did not bite together properly.  This was how the patient’s teeth looked after 2 years of Invisalign.

Crooked upper teeth.
Slanted lower teeth.
Back teeth don’t touch when biting, patient had trouble chewing.

I told the dentist that this patient would require 1-2 years of braces to correct the problem, and that it was not correctable by Invisalign.  And the dentist was shocked.  He asked me “if this case was not treatable with Invisalign, why did Invisalign accept the case?” And my reply to him was, “because Invisalign is not the doctor, they are just the manufacturer.  They rely on us to tell them what to do, not the other way around.”

And this is what is so crucial to understand about Invisalign –

it is not a magical solution for effortless tooth-straightening.  It requires the skill and training of an orthodontist to tell the Invisalign company how to move the teeth.  Otherwise, the plan that Invisalign generates might not be realistic.

What can go wrong if your treatment is not done by an orthodontist?

You can potentially waste 2 years of your life, thousands of dollars, and end up with a worse problem than you started with, as this patient learned to his dismay.

Look on every street corner and you will find a general dentist with an Invisalign sign in the window.  But if you are hoping to get Invisalign, make sure that you choose an orthodontist.  Because Invisalign doesn’t straighten your teeth.  The doctor using the Invisalign does.  Your dentist is not an orthodontist….even if he does Invisalign.

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