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'Things didn't feel right': Some SmileDirectClub customers report problems

Anna Rosemond was drawn to the advertisements for SmileDirectClub, which promises to straighten teeth for under $2,000 — about a third the cost of traditional braces — in as little as six months and all from the comfort of home.

"It seemed like a really simple, easy way that they were offering people to straighten their teeth,” said Rosemond, of Richmond, Virginia.

Rosemond ordered one of the kits and took an impression of her teeth with the putty and tray she received.

To get started, SmileDirectClub customers either can get a 3D image of their teeth in one of their SmileShops or have an at-home kit sent to them. A few weeks later, she received dental aligners and followed the instructions to send in photos of her mouth every 90 days. SmileDirectClub told her the treatment would be reviewed remotely by one of its 250 dentists and orthodontists. All of her care was done online, she said.

After a year, Rosemond was in pain.

"I really noticed that things didn't feel right with the bite,” Rosemond said. “My head was hurting frequently."

She’d been assured that she’d be able to get in touch with her assigned dentist, but after multiple attempts, she said she was never connected, nor given contact information. So she consulted an outside orthodontist, who diagnosed her with a crossbite, or misalignment, possibly caused by the aligners. What’s more, her orthodontist said the crossbite was causing other symptoms: strain in her neck and jaw muscles, which led to migraines.

Rosemond, who says she tried SmileDirectClub because of the money she thought she’d save, wound up spending thousands on traditional braces to fix her teeth.

While SmileDirectClub, the largest at-home dental alignment company, and others promise to leave patients smiling, an NBC News investigation into a growing list of complaints found that this new trend in straightening teeth is leading to painful problems for some people.

The Better Business Bureau reports more than 1,800 complaints nationwide involving SmileDirectClub. Most of the complaints involve customer service issues — such as broken aligners, delivery issues and payment problems — but dozens describe concerns about treatment results: complaints like broken teeth and nerve damage.

Last month, nine members of Congress five of them dentists — asked the Food and Drug Administration and the Federal Trade Commission to investigate SmileDirectClub “to ensure that it is not misleading consumers or causing patient harm.”

SmileDirectClub calls the effort in Congress “the latest in a series of anti-competitive publicity tactics.”

And in January, in an effort to protect patients, a law went into effect in California requiring all teledentistry patients to get an X-ray or diagnostic bone scan before undergoing online aligner treatment. Virginia is considering similar rules.

Dr. Chung Kau, chairman and professor of orthodontics at the University of Alabama at Birmingham, said moving teeth without in-person supervision can lead to permanent harm.

Problems with a person’s bite aren’t just cosmetic. “If you can't get a proper bite, that affects the entire function of your jaw,” Kau said. “You could get migraines, jaw joint problems, disintegration of your joints.”

This harm is irreparable. I want to state that.

“This harm is irreparable. I want to state that,” he said. “It’s because things like bone loss, disease, loss of a tooth — you can't put it back in the mouth.”

That’s what happened to Tom Harwood, 40, of Winnemucca, Nevada. Harwood told NBC News that his dentist said the SmileDirectClub aligners moved his teeth so fast that it caused some of them to detach from the bone.

“Now I stand to lose two to three of my bottom teeth and two to three of my front teeth,” Harwood said. “Every day I wake up — it feels like I’m being punched. It’s just an all day type pain.”

Harwood said that he stopped his treatment after about 3 months, before the 90-day mark when customers are asked to send photos of their mouths to SmileDirectClub to monitor progress. He also said that he tried to get in touch with his assigned dentist, but that he was unable to do so.

It’s important for teeth straightening patients to see an orthodontist regularly to make sure their bite is correct and their mouth is healthy overall, Kau said.

Regular visits with an orthodontist help ensure everything is on track, Kau said. “Every visit that we spend with a patient, we're constantly making adjustments so we can get the best, optimal care for the patient,” he said.

SmileDirectClub said that they can't comment on individual cases like Rosemond's and Harwood's because of privacy concerns, but the company's chief legal officer, Susan Greenspon-Rammelt, said the company has helped more than 750,000 people with its network of licensed dental professionals. “They’re subject to the same standards of care that a doctor in a traditional setting is,” she said.

SmileDirectClub provided NBC News with a list of 21 satisfied customers. NBC News reached out to 13 people. Four responded.

Kaitlyn Laurel of Washington, D.C., and Donna Fontaine of Windsor, Virginia, both completed five-month treatments.

“It was a really big confidence boost,” Laurel said.

Fontaine said she was “pleased with the results.”

Jesse McCraw of Austin, Texas, told NBC News that he joined the program after seeing Facebook ads. After seven months, he said he developed a gap in his teeth and is now doing three more months of treatment to fix it. Still, he says he has “no complaints.”

All three, contrary to the company’s policy, said they were never told that they were required to see a dentist before starting the program.

The fourth customer, Delaney Peak of Tulsa, Oklahoma, said she was satisfied and didn’t remember if she was told to see a dentist.

“I never felt any issues,” Peak said.

NBC News also spoke with Dr. Gary Moore, a dentist who contracts with SmileDirectClub and is licensed in Colorado and Nevada. During the conversation, which was monitored by a SmileDirectClub media representative, Moore said he had worked with the company for four years and collects approximately $50 per patient after paying his costs for SmileDirectClub’s administrative services. He estimates he reviews eight to 10 cases a day and patients with questions can reach him through SmileDirectClub or speak with him directly if needed.

“I believe it is a viable platform to treat patients and talk to patients without the patient having to leave their home,” Moore said, adding, “Access to care is huge.”

Moore said he turns down about 30 percent of the people referred to him by SmileDirectClub because they aren’t good candidates for the program, a substantially higher figure than the 5 percent rejection rate Greenspon-Rammelt said the company averages.

Moore said he does not keep track of how many patients he has treated or their outcomes.

He said customers should contact a dentist if they experience “any pain lasting more than a couple days, trays cutting into the tissue, any teeth that feel too loose,” adding that he believes dentists and orthodontists who oppose SmileDirectClub are “angry because they think money is being taken out of their pockets.”

Greenspon-Rammelt said that SmileDirectClub's network of dentists, not the company itself, is responsible for treatment plans, but said that undesirable results could occur if patients aren’t adhering to the program correctly. “That could be because they weren't following the instructions for use, they didn't come in for a midcourse correction when they were advised to do that, they didn't follow up with the dental team," she said.

SmileDirectClub reviews all patient scans before sending the first treatment kits, and only sends them to patients that they think are good candidates, Greenspon-Rammelt said, adding that 95 percent of people reviewed for treatment are accepted. All customers are required to see a dentist within six months before starting, which Greenspon-Rammelt says offers proof that their teeth are healthy enough for the treatment.

But NBC News hidden cameras recorded employees at SmileDirectClub shops in Ohio, New Jersey and Alabama advising potential customers they didn’t have to see a dentist before starting treatment.

One employee said “it’s not mandatory” to see a dentist first. Another said, “that’s what the scans are for.” Kau, however, said the scans are just a map of the teeth and don’t provide a full picture of someone’s oral health.

“That may be a Smile guide who didn’t actually have or remember the proper training,” Greenspon-Rammelt said in response to the videos.

Another employee said that the home impression kits used by thousands of customers who never set foot in a SmileDirectClub shop may not be reliable, and that “anything could go wrong.” Greenspon-Rammelt characterized that statement as a “personal opinion” of the employee, not of the company.

If customers can show the treatment didn’t work and want a refund outside the return window, SmileDirectClub requires they sign a confidentiality agreement, raising the possibility that there may be more complaints than have been made public.

Greenspon-Rammelt responded that in many instances, by the time such customers are asked to sign the confidentiality agreement, "they’ve already gone out there, they’ve put this on social media, they’ve filed complaints,” Greenspon-Rammelt said.

Harwood refused to sign that confidentiality agreement and was unable to get his money back.

“It was basically like, here’s your money back, but you can’t ever talk about us,” he said. “It’s not right. There are so many people out there putting their trust in a company that should be doing right by you, and they’re not.”

Follow NBC HEALTH on Twitter & Facebook.

Vicky Nguyen

Vicky Nguyen is the investigative and consumer correspondent for NBC News. See her reports on "TODAY," "Nightly News with Lester Holt," and MSNBC.

Lauren Dunn

Lauren Dunn is a producer with the NBC News medical unit in New York.


Smile Direct Club With Veneers

On the left you’ll see my very small front snaggletooth, and on the right you’ll see how it was corrected using SmileDirectClub. The modification is minor, however I’m actually happy with it (Smile Direct Club With Veneers). Alyssa Powell/Business Insider I got my teeth aligned in five months utilizing SmileDirectClub’s invisible aligners. The expense of treatment is $ 1,895 plus $99 for retainers, regardless of how substantial your corrections are.

Update on December 27, 2019: A great deal of people have asked me if my bite was impacted by utilizing SmileDirectClub. To respond to simply: My bite remained perfectly aligned. However, it deserves noting that my treatment was really minimal. If you’re anything like me, you lost your retainers some odd years back after a painstaking and expensive course of orthodontics that you didn’t spend for yourself.

Turns out those braces your parents spent for were shockingly costly, and so is Invisalign, so you’ve relied on SmileDirectClub as a possible solution to your oral woes. This is exactly what took place to me, and regrettably, the area that was impacted most was my prime smile real estate. I ended up being uncomfortable about smiling big in images because I didn’t desire the light to capture my one tooth that had started slipping behind the others.

I’m also getting married next year, so the timing was perfect. Listed below I’m going to stroll you through whatever you need to learn about using SmileDirectClub– from how much they cost to how I handled eliminating my retainers all the time at work (spoiler alert: not with dignity). I will also attend to some of the worry about SmileDirectClub and teledentistry at large.

Because its creation, there have actually been interest in the teledentistry industry by dental experts. One such concern is that they do not examine an individual’s oral health in full prior to recommending treatment; SmileDirectClub and others like Candid do not take X-rays, which means they can’t represent the nerves, blood supply, or bone structure below your gums that may impact your treatment (which is why I highly advise talking to your dental expert or orthodontist before beginning with the service). Another such concern has appeared in the form of an official claim by a group of orthodontists and consumers who declare that SmileDirectClub has economically damaged oral companies by practicing dentistry unlawfully and misleading consumers.

Smile Direct Club With VeneersSmile Direct Club With Veneers

As far as client grievances go, in October of 2019, the Nashville Service Journal reported that, according to a news release from SmileDirectClub, “In the previous 3 months, SmileDirectClub has actually gotten more than 56,500 evaluations throughout nine evaluation channels, such as Yelp and the Better Service Bureau … with more than 49,000– or 86.9%– being positive.

Smile Direct Club With Veneers

I had a fantastic experience with the service, however my modifications were minor. If you’re interested in discovering more about the service, I have actually broken down everything you require to know, listed below. The first thing you’ll do is complete a really short survey on the SmileDirectClub site. It asks whether or not you have actually had braces in the past, what concerns you wish to handle (crowding, overbite, spacing, and so on), and how severe those concerns are.

The assessments and sets cost $45 each, however if it ends up that you’re not a prospect based upon anything they find, you’ll get a complete refund. The complete treatment strategy costs $1,895 (plus $99 for retainers) despite how substantial your corrections are. Prior to we go any further, it deserves keeping in mind that SmileDirectClub does not utilize X-rays of your teeth to determine whether you’re a prospect.

The consultation process will differ depending upon if you select to go into a SmileDirectClub workplace or do the impression package at home. Smile Direct Club With Veneers. I went to an in-person visit, so that’s all I can talk to personally, however the impression kit includes filling two trays with putty, biting down into them to leave an impression of your top and bottom teeth, and taking pictures of your mouth with a very funny tool that tucks into your cheeks and holds your mouth open.

Smile Direct Club With Veneers

The wand imaging innovation is so advanced that the photos even recorded small bits of food in my teeth. I probably should have brushed them in advance. Sally Kaplan/Business Insider The consultation was fast and simple. The dental professional ran a wand around the within of my mouth to take images of my teeth, which then got transformed into a design of my smile using innovative imaging innovation.

You’ll be able to verify that you enjoy with the plan and schedule the shipment of your aligners. My course was for 5 months, but yours may be longer– it varies from person to individual. Something that’s really fantastic about SmileDirectClub is that even if you have a permanent retainer that has yet to be gotten rid of, they’ll develop your aligners to fit without said retainer based upon the 3-D imaging or impression kit.

This time, I simply chose to treat my leading set of teeth. Dealing with just the upper or just the lower set of teeth can develop alignment concerns in the long-run, however wasn’t personally a problem for me since my modifications were minor. It’s definitely worth consulting your dentist about it in advance.

Smile Direct Club With Veneers

There’s a drawer underneath that holds your full course. Sally Kaplan/Business Insider The aligners will get here simultaneously in a box that also houses tools to help you fit them, plus an LED lightening set to keep your teeth great and brilliant. The baggies that your set of aligners can be found in will inform you what month and week you’re on (Smile Direct Club With Veneers).

They can be found in a long, linked string of bags marked in order that can each be detached and gotten rid of once you put your aligners in. But given that I just chose to deal with the leading set of teeth due to my irreversible retainer, it was hard to keep the bottom halves in their bags and not accidentally lose any of them.

You’ll wear three different aligners over the course of one month: the very first set for a week, the 2nd set for a week, and the 3rd set for two weeks (Smile Direct Club With Veneers). This gives your teeth the possibility to settle into place, and by the last week of the month you won’t really feel pressure from the aligners.

Smile Direct Club With Veneers

Truthfully, I didn’t follow either of these guidelines. At work, I ‘d frequently take them out in the restroom in order to eat my breakfast and forget to put them back in till after lunch, and my teeth turned out simply fine. But I advise doing as SmileDirectClub said, not as I did.

Everybody who found out I was using SmileDirectClub aligners asked me the very same question: Does it harm? The answer is that no, it does not injured, but it can be uneasy sometimes. There were a couple instances where I had to utilize the metal file on my Swiss Army knife to sand down little sharp bits that went into my gums, however that had to do with the worst of it.

These feel absolutely nothing like the excruciating tightening process of braces that you most likely experienced as a kid. I’ve also gotten a lot of concerns about whether my bite was impacted. Honestly, I have not seen any difference in my alignment, which is most likely due to the fact that my correction course was pretty very little.

Smile Direct Club With Veneers

Smile Direct Club With VeneersSmile Direct Club With Veneers

After you finish your course of aligners, you’ll desire to get a set of retainers to keep your new smile in location. They’re thicker than the aligners however only need to be used during the night, save for the very first two weeks when you’re expected to wear them all the time to get used to them.

I’ll update this evaluation in six months to let you understand how my own have worn down, and when I intend on reordering another. I’m hoping I can look after them well enough to keep it to once a year. No matter for how long your course is, everyone pays $1,895 for a set of SmileDirectClub aligners.

For contrast, that rate is only $5 less than Honest (which we have actually likewise examined), however about $1,600 less than the most inexpensive typical treatment from Invisalign, which can cost as much as $ 8,000. The difference is that Invisalign is done through your dentist’s workplace and, in many cases, receives oral insurance coverage.

Smile Direct Club With Veneers

They do accept HSA, FSA, and CareCredit as forms of payment, and they also offer a month-to-month payment strategy that involves a $250 deposit and $85 month-to-month payments for 24 months. Simply note that this will eventually cost you about $400 more with time. In general, I had a really terrific experience utilizing SmileDirectClub.

Smile Direct Club With VeneersSmile Direct Club With Veneers

Given, my changes were really minor so I can only speak from the point of view of somebody who didn’t undergo a significant change, however I’m delighted with how quick and simple the process has been. I suggest looking into SmileDirectClub, however not prior to you check with your dental professional to ensure you have the all-clear.

Hear what people are stating about their new smiles. Hear what people are saying about their brand-new smiles. DISCOVER YOUR FIT Begin now with our free-and-easy assessment.

Smile Direct Club With Veneers

Trying to find a sincere review of SmileDirectClub!.?.!? In this post, I share my first month of wearing my aligners and my honest ideas on the experience. Keep in mind: This post is sponsored by SmileDirectClub and consists of affiliate links. All opinions are 100% my own. Read our disclosure policy here. Back in December, I published an extensive post about my sincere experience with SmileDirectClub.

Much of you asked whether I had actually decided to go through with the SmileDirectClub treatment strategy. I more than happy to report that I developed the guts to move forward with getting the aligners. As I mentioned in my first post, I didn’t have braces as a kid. I typically wish that I had when I am doing live videos and I discover my jagged teeth.

My hope is that this honest evaluation will help those of you who have actually thought about attempting SmileDirectClub make an extremely notified decision. In addition, I want to assist some of you who are thinking about getting braces be motivated to check out a cheaper options. By the method, my treatment strategy is just expected to be 5 months total, if all works out.

Smile Direct Club With Veneers

I’m thrilled! If you missed that post, you can read it here. Here’s a fundamental recap of how SmileDirectClub works: so they can build a 3D impression of your smile. (You can see what the at-home impression set is below.), who will guide your new smile from starting to end.

Smile Direct Club With VeneersSmile Direct Club With Veneers

( other than for when you consume) throughout a 6-month procedure. You change these out every week or every other week throughout the procedure. (They send you texts to remind you when you need to alter the aligners). (Make sure use coupon code MSMDEAL to save an additional $100 off the cost of your aligners!) and they ask you to send regular pictures to help them make sure you are on track.

I had prepared myself that the first month was going to be rough. Kathrynne presently has braces and I saw her suffer through a lot of mouth discomfort for the very first few weeks after she got them. To my fantastic surprise, I’ve only experienced moderate discomfort with the aligners. I have actually follow their guidelines to put the brand-new set on prior to I go to bed.

Smile Direct Club With Veneers

When you first get your SmileDirectClub package in the mail with all of your aligners, you go in to their website and set up your strategy. You put in the day you began using them and then they send you email and text reminders when it’s time to change out aligners.

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What People Are
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Same Day Smile Transformation NEW Case - Composite Veneers Before and After // Dental Aesthetics

Recently, Smile Direct Club has been in the news because of the way it is disrupting the dental & orthodontics industry. The company (and other lesser-known companies like it) promise customers a “self-treatment” option for misaligned teeth using mail-order aligners. While the treatment can work for some people, it can cause significant harm to others.

Investigative reports from various news organizations, along with official complaints from industry groups like the American Association of Orthodontists, have raised questions about the safety and legality of this approach to orthodontics.

We here at Blackstone Family Dentistry are committed to educating our patients so that you can make wise decisions about your oral healthcare. We want to take the time to help you understand Smile Direct Club and other direct-to-consumer orthodontic companies, including what our position is on this business model.

What is Smile Direct Club, and how does it work? 

Smile Direct Club offers what can only be described as “online orthodontics.” Instead of visiting your dentist or orthodontist to have braces put in or a clear retainer molded, you handle everything over the internet and via mail.

Here’s how it works: once your application is approved, you can visit one of the Smile Direct shops to have a 3-D image made of your teeth. If you don’t live near a shop, Smile Direct Club will send a kit to make a 3-D mold of your teeth at home. A dentist then uses the mold to predict the ideal position for each tooth and create about 24 trays of clear plastic retainers or “aligners” that slowly move your teeth.

The aligners typically arrive in the mail within a few weeks. It can take anywhere from a few weeks to months to complete the process, depending on how severely your teeth are misaligned.

Dentists monitor each patient’s progress by looking at selfies you provide regularly.

Smile Direct Club typically charges $49 for the 3-D imaging process. That cost is refundable if the Smile Direct orthodontist determines that you are not a good match for their program. The invisible aligners cost about $1,900, with additional costs for retainers to wear after your aligner program is complete.

Concerns about Smile Direct Club and other direct-to-consumer orthodontic companies

While we are not entirely opposed to direct-to-consumer orthodontic companies, we do encourage people to proceed with extreme caution. It’s critical to be very aware of some of the risks and concerns related to this type of dental care. Here are some things to consider before you choose to use direct-to-consumer orthodontics.

It’s a profit-driven business

All businesses must make a profit to survive.  However, Smile Direct Club is a more profit-driven business than most local dental practices, which are often owned and operated by actual dentists or orthodontists (who are usually motivated more by a desire to help people and a passion for the profession than to make money).

The program does not require you to visit the dentist

What Smile Direct Club touts as a benefit to their program might be the most significant warning flag. Customers are not required to visit the dentist before beginning treatment (or at any point during the process).

Of course, Smile Direct strongly recommends you keep your routine cleanings and checkups and speak to your dentist if you have any problems or concerns, but in-person dental checkups are not part of their program.

Moving teeth impacts the entire mouth. Even mild teeth-straightening can affect the gums, bones, and teeth roots. Orthodontists are trained to ensure the gums, teeth, and bones are healthy throughout any treatment involving braces or aligners.

Most orthodontists take X-rays and do an extensive exam before, during, and after treatment to ensure your mouth stays healthy throughout the treatment process.

The lack of involvement by a licensed orthodontist is very concerning to dental professionals, especially as they see more people coming to their practices to fix issues caused by Smile Direct treatments.

Some customers were diagnosed with crossbites, misalignments, and other serious dental problems after using Smile Direct. These issues can lead to frequent headaches, strain in the neck and jaw muscles, migraines, difficult or painful chewing, and other issues.

Other Smile Direct customers have reported nerve damage and broken teeth from the aligner trays.

Sadly, many patients who initially choose Smile Direct in hopes of saving money on orthodontic treatments, end up spending thousands more dollars on fixing their teeth with traditional braces and other methods.

Smile Direct relies on a computer model to predict your entire treatment plan

The Smile Direct program uses a computer system to predict teeth movement and create the 24 aligner trays. This seems like a reliable model since we use computers for many other complex tasks. However, patients’ teeth don’t often follow the computer-predicted movement.

All the aligner trays are created at the same time, meaning if your teeth don’t follow the computer-predicted model, the trays won’t fit properly or work as they should. Without an orthodontist involved in the process, patients won’t know about this issue until it’s too late.

Smile Direct is only suitable for a small number of people

Imagine relying on WebMD to prescribe medications based on your description of your symptoms. Of course, there are some very mild medical questions or concerns for which WebMD provides adequate information and treatment plans. But, WebMD always recommends going to a doctor for individualized and accurate medical treatment.

Smile Direct is similar to WebMD in that it is suitable for a small percentage of the population who would like to make very minor adjustments to their smile. They assume their customers will continue to make good dental hygiene choices, receive regular checkups, and be proactive with their overall dental health, which is misleading considering one of their touted benefits is not needing to pay for regular visits to the orthodontist.

Industry response to Smile Direct Club

Smile Direct Club is not meant to be a more affordable alternative to professional orthodontic care. Their ideal customers are people who already had braces but didn’t wear their retainers, allowing their teeth to move out of alignment. Or, people who only need very small adjustments to their smile.

Most professionals agree Smile Direct Club is only able to accomplish mild adjustments safely. In reality, you will probably only pay a few hundred dollars more to receive personal treatment from a local, board-certified orthodontist.

The American Dental Association, the American Association of Orthodontists, and other medical organizations have filed complaints with the FTC, FDA, and at least 36 state boards, alleging that Smile Direct Club puts patients in danger.

Many orthodontists and dentists advise extreme caution when considering a service like Smile Direct Club. Many dentists say it’s unwise to rely on Smile Direct’s screening process to determine if you are a good fit for their service. Instead, it would be best if you asked your dentist to give you an informed assessment based on your oral health and specific needs.

Blackstone Family Dentistry’s position regarding Smile Direct Club and other direct-to-consumer orthodontics

While we are not entirely opposed to Smile Direct Club and other direct-to-consumer orthodontics, Blackstone Family Dentistry believes each person should consult with their dentist before making any decisions or beginning treatment.

There is a small portion of the population that can benefit from the services that Smile Direct Club offers. Still, it’s wise to involve your dentist in the process, from start to finish to avoid any complications.

If you are considering using a direct-to-consumer orthodontic service, we strongly recommend visiting your dentist for a regular checkup and an assessment to see if you are a good candidate for that type of treatment. Contact us with any questions, concerns, or to schedule an appointment where we can help you make an informed decision about your needs.



Veneers smile direct

Inside the battle between Smile Direct Club and ‘organized dentistry’

“We do not ask them to prove they’ve been to a dentist, but they attest that they have been,” Sulitzer said of Smile Direct’s patients. “In essence, they say, ‘Yes, I’ve been to the dentist within six months, and they check the box and say ‘Yes.’”

I didn’t get aligners, but weeks later I was still getting robocalls saying my new smile is waiting. So I asked Sultzer: How do you know for sure I’m a good candidate? Why not get my dentist, any dentist, to sign something saying I am? I told him that would probably silence some critics.

“They want to make it like the old model, ‘Yeah, get a signature, go to a dental office,” he said. “Does that make any sense? What you’re trying to do is you’re responding to naysayers that are dentists in the communities that are trying to come up with reasons of why we should fail.”

Smile Direct isn’t doctor-focused, he said, it’s concerned with the patient. Or, the customer. Sulitzer used the terms interchangeably as we talked. And, he said, anyway the company intentionally only takes on easy cases, just moving the front smile teeth. Dentists and organized dentistry just can’t stand all the winning.

“They’re so frustrated because it’s not failing. It’s not creating problems. It’s been so successful and efficacious,” he said. “They’re trying to figure out how they can slow this thing down. So that’s really what you’re faced with. And we’re not gonna put up barriers just because they’re not happy with our success. It’s not going to happen.”

Smile Direct is big on social media, and smiling customers speak for themselves, he said. Reputation is everything. 

“In our world, we don’t see bad outcomes,” Sulitzer said. “We have over 750,000 cases treated. When you look at the social media, the results are amazing.”

What the patients say

It’s pretty easy to find loads of real people posting online about their beautiful Smile Direct smiles. There’s a lot on Instagram, a bunch of unofficial Smile Direct Facebook groups. The majority of the posts are toothy selfies, grateful for Smile Direct’s transformation.

Orthodontics often isn’t covered by insurance. It’s clear Smile Direct makes the lifelong dream of straight teeth more affordable for more people.

But not everyone gets a happy ending. There are posts like this one from a young woman:

“Totally regret doing this, my bite has changed DRASTICALLY! Now I bite in the front middle of my mouth, my back teeth are tilting in and my bottom front are rubbing my top front.”

And others:

“My tongue and lips have been torn to shreds and now I feel like my two front teeth are caving in.”

“My top gums are inflamed and I was bleeding a lot. I’m scared to put them back in.”

People share symptoms and ask medical questions — things more suited to a dentist’s office than a Facebook group.  

“Please reassure me this is normal!”

A bunch of people do, but none of them are dentists. 

In theory, you can call your Smile Direct dentist to ask such things, but you have to get through customer service first. 

The worst cases sometimes end up walking into a brick-and-mortar orthodontist’s office.

‘They must be desperate’

I visit Joshua Davis’ orthodontics practice in Philadelphia, and ask how many such patients he sees each year.

“I mean, I’ve had two in the past week and a half,” he said.

Smile Direct customers will show up with misaligned bites, painful jaws, Davis said.

“I suspect it should pick up even more over time,” he said. “I think they do great at marketing. And I don’t think the patients are fully aware that it’s different than going to an orthodontist’s office.”

At his practice, Davis has a room with the same iTero machine Smile Direct has, but it’s not all he has.

“We take a panoramic X-ray, we take a cephalometric X-ray — can measure the bones,” he said. “Then we also have a cone beam CT scanner, where I can get a 3D image of the bones of the head and the teeth.”

None of this is cheap, and almost every orthodontist is also a small-business owner. They have to keep their practices afloat. So I had to ask: Is Smile Direct just winning too much? Cutting into profits, stealing patients. Davis said he has 80 more patients to see in the afternoon after we finish speaking.

So he, at least, isn’t feeling the squeeze. He said guys like him and Smile Direct can actually coexist, to a degree.

“I do think Smile Direct Club could offer a low-cost, retreatment option for that really slim segment of the population,” he said.

What’s retreatment? It’s what happens when your parents got you braces, but you couldn’t be bothered to wear a retainer, and now you need to tighten up.

“But they’ve taken it and tried to deliver that treatment to the masses,” Davis said. “And I think that that’s inappropriate and unethical.”

He said Smile Direct sacrifices safety to get the most paying patients/customers possible. But a dentist or orthodontist somewhere has to sign off, remotely, on every aligner.

“They must be desperate,” Davis said about those tele-dentists. “The business environment for them might be that they’re struggling. People do desperate things in desperate times.”

Many dental and orthodontics practices are independent businesses. Davis said that can be costly on its own before factoring in the enormous debt dentists take on in school.

He told me about a former patient who decided to follow in his orthodontist’s footsteps. First, he had to get his bachelor’s degree. 

“Which is like $90,000 a year or something like that,” said Davis.

Then, finally, another three years of orthodontics school, which can be even more expensive. 

“I don’t know the exact numbers, but he’s going to leave school with $1 million worth of debt, $1 million,” he said.

Paying that loan will cost $6,000 a month, for 25 years. Can you really blame some dentists for essentially driving a Smile Direct Uber for an hour here and there?

I asked Sulitzer for Smile Direct’s numbers on how many of its patients end up with complications or failed treatments, and have to see orthodontists like Davis. 

“Well, so let me ask you this: Where are those numbers in traditional practice? Do you have anything to compare them to?” Sulitzer said. “And that’s the answer. There aren’t any.”

He’s right, comparable numbers are hard to find. This is all pretty new.

But a couple of days after we spoke, Hindenberg Research, a market research firm, came out with a scathing report on Smile Direct Club called, “Moving Fast and Breaking Things in People’s Mouths.” It pointed to review-site horror stories, and warned that crippling state regulations are right around the corner. Far from the future of orthodontics, it warned Smile Direct was about to fizzle out. 

Smile Direct’s stock did take a hit, at first, but things stabilized and recovered pretty quickly in the end. There are even real competitors on the horizon. 

 Braces are still crazy expensive. People still want perfect smiles.

Direct Composite Veneers Smile Makeover Step by Step

Everything You Need to Know About Composite Veneers

What are composite veneers?

If you’ve always wanted to improve your smile, dental veneers might be a good choice for you.

Veneers are thin shells that fit over the front of your existing teeth to improve their appearance. Veneers are just one of several ways to alter the appearance of your teeth.

Tooth bonding and enameloplasty are other options, as well as crowns.

There are 2 main kinds of veneers: porcelain and composite. As you’d expect from the name, porcelain veneers are custom made of porcelain to fit your teeth. Composite veneers are often made from a tooth-colored resin, the same type of material used with tooth bonding.

There are pros and cons for both types of veneers, so it’s important to consider the level of the issue you hope to solve with veneers, as well as your budget.

Who can get veneers?

Dental veneers can cover up tooth imperfections and give you an even, bright smile.

Imperfections can include teeth that are crooked or misshapen, chipped, stained, or discolored, or maybe the enamel on your teeth has eroded.

Veneers cover part of your teeth but they’re actually different from crowns, which are thicker and cover an entire tooth — back and front. Crowns also tend to require more trimming of the tooth, which you may or may not need with veneers.

If your teeth are in relatively good shape, and you just want to change their appearance, including their shape or color, veneers may be a good choice.

Crowns are usually only used for teeth that are more damaged. For example, if you have a broken tooth or need a root canal, a crown may be a better solution.

Types of veneers

A dentist may offer you a choice between 3 types of veneers: direct composite veneers, indirect composite veneers, and porcelain veneers.

Direct composite veneers

Direct composite veneers are veneers made of a composite resin material applied directly to your teeth.

It doesn’t take very long for a dentist to prepare your teeth for application of the veneers, and the application process is considered minimally invasive.

Indirect composite veneers

The main difference between direct and indirect composite veneers is the application process — not the actual material used.

Your teeth are prepped as they would be for direct composite veneers, but the veneers are custom made ‘indirectly’ outside of the mouth in your dentist’s office or in a dental laboratory.

You’ll receive a set of temporary veneers until the indirect veneers are made. At the next appointment, the indirect composite veneers are applied on your teeth with a layer of adhesive.

Indirect composite veneers can withstand more abrasions and resist fractures better than the direct version. They tend to cost more than direct composite veneers, however.

Porcelain veneers

Porcelain veneers are custom made for your teeth out of porcelain.

A dentist will make impressions of your teeth, so the veneers can be made from the mold in the dental lab, a process that might take a week or longer. You’ll receive a set of temporary veneers while you wait, just like with the indirect composite veneers.

When ready, the dentist will cement the thin porcelain shells to the front of your teeth and shape them to look as natural as possible.

Composite veneers procedure

Your dentist will start the process by cleaning your teeth thoroughly and preparing them for the application.

Your dentist may have to remove a thin layer of your enamel to help the material stick to your teeth. Sometimes, your teeth don’t need to be cut if minor changes to shape or color are needed.

After, the process will differ slightly, depending on whether you’re getting direct or indirect veneers.

Before applying direct veneers, a dentist will etch the enamel of your teeth to help with adhesion.

Next they’ll apply an adhesive glue to help the composite resin material stick to your teeth. Lastly, very thin layers of the composite material are added to the surface of your teeth.

The dentist will “cure” or quickly harden the layers of the composite resin with a light.

You and your dentist are able to pick the shade or color you want for your veneers. Your dentist can mix composite resin colors to make your veneers look natural.

With indirect veneers, after the dentist prepares your teeth, they’ll take a mold of your teeth.

Indirect veneers are fabricated outside of your mouth. When the indirect veneers are ready, the dentist will apply them by etching your teeth and then applying a type of adhesive material to your teeth. This adhesive or bonding agent will help the veneers stay in place.

Then they’ll place the composite veneers onto your teeth. They’ll use a light to harden the adhesive and glue the veneers to the teeth. Afterward, the dentist will clean up any stray edges and polish everything up.

Many people don’t need anesthesia during the process. But if you do, once the anesthesia wears off, you should be fine to return to work or other normal activities.

How long do composite veneers last?

Composite veneers are considered more durable today than in the past. They can last 5 to 7 years, on average.

After that, you’ll need a replacement set of veneers. That’s a substantially shorter life span than a set of porcelain veneers, which might last at least 10 or 15 years.

You may be able to extend the life of your composite veneers by taking good care of them.

Embrace a routine of regular brushing with a nonabrasive toothpaste, and resist any urge to chew on ice and other hard objects with your front teeth.

Some dentists also suggest that you watch out for drinks like coffee or tea that might stain your new veneers.

Composite veneers before and after

You will notice a significant difference in your teeth’s appearance after the application of veneers.

Composite veneers cost

Cost is a factor that you’ll want to consider. Veneers aren’t inexpensive.

The application of veneers is a time-consuming process, for one thing. For another, you want high quality materials and high quality work that will last. After all, everyone will see the results as soon as you open your mouth.

Although less expensive than porcelain veneers, composite veneers can still be pricey.

The cost for composite veneers will vary, based on where you live, where your dental work is performed, and how many veneers you need.

Composite veneers could set you back between $250 to $1,500 per tooth.

Who pays? Probably you. If you’re just hoping to improve your smile’s appearance, you’ll probably have to pay the entire bill, since insurance often doesn’t cover cosmetic dentistry procedures.

However, if your tooth is damaged, your insurance may cover part or all of the cost.

If not, and the cost is a concern, speak to a dentist about setting up a payment plan. You might even get a discount for having a certain number of veneers applied at once.


If you’ve become self-conscious about your smile, dental veneers could be a great choice for you. They’re essentially a semi-permanent solution to imperfect teeth.

Since veneers — even composite veneers — are relatively expensive, take the time to explore your options and the pros and cons of each one before you decide. Talk to a dentist about the best choice, too.


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Walking into the park, Swan stuck the headphones in her ears and at full volume, turning on the music, so much so that her. Own thoughts could not be heard, this is what the blonde wanted, and began to jog. After the match, and even such a day, Emma practically did not have strength, but with her last breath she tried to run as fast as possible.

She wanted to run away from herself, from everything that had piled up in the last days, from these angry and furious feelings, thoughts of emotions.

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