Orthodontic Treatment Without an Orthodontist?

There has been a recent surge of companies in Alberta that are offering “at-home orthodontic treatment” to the public without the need for supervision by a certified orthodontist. This is accomplished by using clear aligners which fit over the teeth that push them into place over a period of months similar to the treatment rendered by a licensed orthodontist. This comparison marks where the similarities end and where the differences become apparent – and potentially dangerous! In this article, I review some of the common claims about this type of treatment.


Using at-home aligners to straighten your teeth is like telemedicine where doctors treat patients from a distance – Orthodontists just need to get with the times!

Let’s go through the steps of straightening your teeth using at-home aligners: You can obtain a kit to take an impression of your own teeth and send it to a company in the mail. Without ever seeing a licensed doctor or having x-rays, a periodontal evaluation, or an oral cancer screening, your “doctor” sends you aligners in the mail without ever meeting you. You are responsible for providing your own orthodontic treatment and retaining the result after your treatment is complete.

Teledentistry provides patients that are geographically unable to see a dentist an opportunity to have their records evaluated off-site by a licensed dentist prior to making a long trip to seek recommended care. At-home aligners eliminate the direct doctor oversight and follow-up that is provided by a trained orthodontic specialist making this healthcare model nothing like Teledentistry. This model not only limits the success of treatment but also potentially puts your dental health and overall wellbeing at risk if proper diagnostic data is never obtained or reviewed.


We only straighten teeth that are a little crooked – what’s the harm in that? 

Another thing companies will say is “we don’t take on hard cases” in order to validate their hands-off approach. However, case difficulty is based on more than the position of the teeth. Several other factors such as the relationship between upper and lower jaws, the stability of the temporomandibular joints, as well as lifestyle habits greatly contribute to the complexity of straightening teeth.

An orthodontist can give you the personalized care and specialized knowledge to address straightforward as well as complex issues, not just look at your teeth and say “you’re on your own!” like Dr. Cheap Smiles, an internet sensation.


“An orthodontist or dentist oversees your case”

One claim made by these companies is that real doctors “approve” the cases and allow the patient to receive treatment. To accomplish this, the dentist or orthodontist reviews the virtual movement of the teeth and if they feel it is acceptable they approve the case and the aligners are mailed to the patient.

At-home aligner companies fail to “oversee” treatment because they simply do not have the complete records necessary to make an accurate diagnosis. With no ability to assess progress there is too much risk inherent in this form of delivery of care to justify its use. Simply moving your teeth into a “better” position is not a replacement for comprehensive orthodontic care. If you don’t know where you want to go, any road will do!



We love market disrupting companies such as Airbnb and Uber for shaking up rigid industries and introducing new technology for consumers to use. Orthodontic care, however, is not like staying at a hotel or renting a cab – the only thing that is disruptive about direct to consumer tooth aligners is the disruption of quality results.

Only a licensed orthodontist can oversee your orthodontic treatment and make the adjustments necessary along the way to get you the results you desire. At True North Orthodontics, Dr. Harfield and myself are involved at the beginning, middle, and end of treatment and even after during the retention phase. It is our absolute privilege and pleasure to work with you along your journey to a better smile – but don’t try this at home!

Dr. Colby Gage
Dr. Leagh Harfield



Dr. Cheap Smiles is the creation of Dr. Zach Nelson, an Orthodontist in San Marcos California. His favourite tag line is – I can save you cash!!! – check out his videos on YouTube! (https://youtu.be/zLie-7ilm6s)

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