Orthodontists warn of the dangers of clear aligners sold online

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The rise of the technique of transparent aligners, one of the most demanded orthodontic systems due to its advantages at the aesthetic level and comfort for the patient, has caused the proliferation of companies that advertise and market this treatment online, using methods “unorthodox” and that have an impact on the oral health of citizens, as warned by the Spanish Society of Orthodontics (SEDO).

This technique, controlled by the Spanish Agency for Medicines and Health Products (AEMPS), consists of removable transparent plastic splints made to measure for each patient, following the indications of an orthodontist, based on a correct diagnosis of malocclusion and planning the appropriate treatment for its correction.

Thus, orthodontists denounce that the marketing of transparent aligners so that the patient can perform the treatment at home, without the proper supervision of an orthodontist, poses a great risk to their health. Precisely, its indiscriminate use, without a precise diagnosis, as well as without the realization of an individualized treatment plan for the correction of the malocclusion, can carry risks due to an inadequate treatment, both at an occlusal and functional level.

“It should not be forgotten that transparent aligners are one of the alternatives for orthodontic treatment, and an orthodontic treatment can influence, not only dental aesthetics and occlusion, but even on functions as important as chewing, speaking, breathing or swallowing, without forgetting the aesthetics of the patient’s face “, they say from SEDO.


For this reason, SEDO has published an action protocol for the use of transparent aligners, which it has prepared in collaboration with the Spanish Association of Orthodontists (AESOR). In it, among other issues, it is recalled that the patient must undergo an orthodontic examination prior to treatment, which includes an exhaustive anamnesis; an intraoral, functional and extraoral oral examination; intraoral and extraoral photographs; X-rays (inexcusable orthopantomography, and a lateral skull x-ray) and impressions of the arches with silicone or with an intraoral scanner.

Furthermore, according to said document, other complementary examinations that the specialist deems necessary, in accordance with the previous findings, must be evaluated; such as articulator mounting, periapical radiographs, frontal skull teleradiography, CBCT scans, MRI or TMJ radiographs, as well as analytical determinations.

Based on these records, the orthodontist will make an accurate diagnosis of the patient’s malocclusion and draw up a treatment plan to correct the malocclusion. Likewise, the guidelines for changing the splints will be indicated by the specialist depending on the periodontal status, the difficulty and degree of expression of the movement, the technique and materials used, the prescription and the treatment phases.

According to the experts, it is also important that the splints are placed in the dental office, and that it is only the professional who marks the appropriate indications to the patient, reviews and progressively verifies that the programmed is being carried out and thus be able to make the appropriate adjustments in each phase of treatment.

As orthodontists reiterate, the follow-up is not restricted to the evolution of the dental alignment with the aligners, but must contemplate the early diagnosis by probing new cavities, inflammations and gingival recessions.

In addition, as with other orthodontic treatments, therapy with transparent aligners can present certain complications and risks: irritations of the soft tissues (cheeks, tongue and lips …), sensitivity, sores, specific discomfort in a tooth, etc. In addition, the continued rubbing of the appliances can have consequences on mucosa and soft tissues, for which face-to-face monitoring is required with special attention to the appearance of traumatic or premalignant lesions.

At the end of the active phase, as in any type of conventional orthodontic treatment, fixed and / or removable retainers will be placed and new follow-up appointments and control of the stability of the treatment and the dental, gingival, mucosal and bone status of the patient are essential. as well as that of the retainers themselves.

Finally, once the treatment is completed, the orthodontist must make new records (photographs, models and x-rays), to rule out the appearance of complications and, if necessary, determine the corresponding legal responsibilities.

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