Here’s What You Should Know About Those Mail In Braces Programs

If you follow any wellness influencers, trainers, or former Bachelor contestants on Instagram, chances are you've seen some of them touting invisible braces or retainers with some sort of promotional code. It's surprising that this orthodontic accessory has become trendy, but people seem to be into the concept, and it's almost impossible to ignore the ads.

The business model is more or less what would happen if Warby Parker and Invisalign had a baby. Here's how one popular company, Smile Direct Club, works: First, you're sent a kit to make a 3-D mold of your teeth, which is then passed to a dental professional who creates your retainer plan. They'll even show you a preview photo of what they say your new smile will look like. You pop into a dentist to get a quick checkup, and voilà — you get your set of retainers in the mail to start wearing.

Why not just go to an orthodontist and get traditional invisible aligners? Well, these are way cheaper (60% cheaper than traditional invisible aligners, according to the site) and you don't have to pay for regular checkups.

It's kind of obvious why some orthodontists would be wary about these services. But if they're half the price, does that mean they're only half as safe and effective as the traditional braces you'd get from a doctor? We asked a few orthodontists what they really think about these new mail-in services.

Do they work?

Scroll through any of the before and after photos on social media, and it certainly looks like mail-in aligners work. There are hundreds of glowing reviews on Smile Direct's website, with patients saying that they're "ridiculously affordable" and "efficient." One Instagram user posted a photo of her results, and said that she was able to close a gap between her front teeth in just four months of her six-month treatment. Another Smile Direct reviewer said that the "improvement was almost immediate." But other people left reviews saying that the aligners didn't straighten their teeth as much as they would have liked. One wrote, "I am not sure if saving the money was worth not being able to have access to a dentist to ask questions to."

Invisible aligners aren't always as effective as standard braces, though they generally produce positive results to patients using them under medical supervision, says Sunil Wadhwa, DDS, PhD, associate professor of dental medicine and director in the division of orthodontics at the Columbia University Medical Center. Orthodontists often make numerous refinements to make sure that the aligners are absolutely perfect, and in about 30% of cases, they have their patients also wear traditional braces to ensure the best alignment, he says — and that's an important difference from what you'll get in the at-home sets.

"We'll continue treatment until it's done appropriately, which will take as long as it takes," Dr. Wadhwa says. Most mail-in companies will give you between three and 10 months for treatment. "That's a huge thing: We're going to do it until it gets done, and they'll just give you a set amount, and whatever it looks like is what it looks like," he says.

Are they safe?

The American Association of Orthodontists takes a strict stance against DIY braces (using a rubber band to fix a gap, 3-D printing a retainer, or MacGuyvering metal braces from a clothes hanger, for example) — but that seems pretty obviously unadvisable.

And ordering retainers online isn't doing it yourself. Smile Direct Club products, for example, come from a "licensed dental professional in your state who reviews your case," according to its site. It adds that "top dentists and orthodontists" create and prescribe treatments for its patients — but the company also makes it pretty clear that it's not practicing medicine. Still, "There are very few things that could harm your dental or general health," Dr. Wadhwa says.

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There are some risks associated with having crooked or incorrectly straightened teeth, which is why Dr. Wadhwa says it's important to see an orthodontist for the safest fix. With mail-in retainers, "it's just a computer doing the [straightening], so it assumes that the bone will grow with the teeth, but that's not necessarily happening," says Jing Chen, DDS, PhD, assistant professor of dental medicine at the Columbia University Medical Center. Braces are technically a medical appliance, and should be used under the supervision of a professional, she adds.

How much will it cost?

"The biggest negative effect would be money, and I think it could be a waste of your money," Dr. Wadhwa says. For some perspective, metal braces can cost between $3,000 and $7,000, and invisible aligners from an orthodontist typically cost between $3,000 and $6,000, according to the Consumer Guide to Dentistry. This price can vary a lot, depending on the type of insurance you have, but if you use insurance and a flexible spending account with Smile Direct Club, you could only pay $750 for the mail-in version. Ultimately, you have to decide whether you're willing to pay that much money for a potentially imperfect job, or just shell out your money and time to go to an orthodontist.

Should you try them?

Mail-in aligners might seem like a good option for a slight fix. But keep in mind you're not the expert on how minimal a fix your teeth need. "It's difficult to go from something that's 90% good to make it 100% perfect; in my experience, I find that these are the harder cases," Dr. Wadhwa says. The results of using invisible aligners can be extremely unpredictable, because some people respond well to them and others won't. "It's very hard to monitor this by yourself, because — like everything in medicine — not everybody responds the same," he says. The real difficulty comes with figuring out how to correct your smile if you're not responding correctly to the retainers, he says.

The bottom line: You get what you pay for, Dr. Wadhwa says. "If you're okay with it not being perfect or not lasting, that's fantastic," he says. That said, treatment from traditional metal braces doesn't necessarily last forever, either. Unless you wear a retainer, your teeth will naturally relapse and move toward the middle of your mouth, Christine Hong, DMD, MS, assistant professor of orthodontics at UCLA School of Dentistry told Refinery29 in April. Be an informed customer, and ask your dentist or orthodontist if they think this at-home version would be a good idea for you.

And as with any #sponcon, just because a celebrity claims that something worked for them, does not necessarily mean that it will work for you — especially when that "something" is a medical device.

Slideshow: Does Lasik Surgery Hurt? Plus, 10 More Of Your Biggest Questions

  • Slide 1 of 12: <p>If you wear glasses or contact lenses, chances are you've wondered about Lasik surgery at some point in your corrective-vision lifetime. Maybe you've routinely slept in your contact lenses. Maybe you've broken your glasses one too many times. Or maybe you've done something like lost a contact lens on a hiking trip and spent the afternoon in a nature-filled haze, which drove you to consider a permanent fix. These are all very valid reasons.</p><p>But, if the thought of shooting laser beams into your eyeballs to forever change your eyesight is just plain scary to you, you're not alone — it's totally normal to have questions. The good news: Ronald Krueger, MD, an ophthalmologist at Cleveland Clinic. Not only is it a common procedure, but large analyses have shown that 91% of patients will achieve 20/20 vision after an initial surgery, Dr. Kreuger says.

    Still have questions? Here are 10 more answers to Lasik questions you've probably wondered about (and Googled). First thing's first: No, it doesn't hurt, but more on that ahead.

    " data-src='{"default":"//img-s-msn-com.akamaized.net/tenant/amp/entityid/AAmw3Qc.img?h=373&w=624&m=6&q=60&o=f&l=f&x=595&y=439"}' role="presentation" src="http://www.msn.com//static-entertainment-eus-s-msn-com.akamaized.net/sc/9b/e151e5.gif" title="If you wear glasses or contact lenses, chances are you've wondered about Lasik surgery at some point... - Refinery29">
  • Slide 2 of 12: No, according to <a href=Kraig Scot Bower, MD, associate professor of ophthalmology at Johns Hopkins University. Lasik surgery is considered an outpatient procedure, and most doctors will give you a dose of Valium in addition to numbing drops with novocaine beforehand, so you won't feel a thing.

    "Once the drops and the Valium kick in, there's no pain at all during the procedure — maybe a little pressure," Dr. Bower says." data-src='{"default":{"load":"wait","src":"//img-s-msn-com.akamaized.net/tenant/amp/entityid/AAmvTXj.img?h=373&w=624&m=6&q=60&o=f&l=f"}}' role="presentation" src="http://www.msn.com//static-entertainment-eus-s-msn-com.akamaized.net/sc/9b/e151e5.gif" title="No, according to Kraig Scot Bower, MD, associate professor of ophthalmology at Johns Hopkins Univers... - Refinery29">
  • Slide 3 of 12: Yes, but there's really no reason to worry about that — though it's understandable if the thought of having to
    "The patient is awake, but has had Valium, so it takes the edge off," Dr. Krueger says. "It doesn't knock you out, but makes you not care, so you're just like, Cool, I'm having a laser." Cool, cool, very chill." data-src='{"default":{"load":"wait","src":"//img-s-msn-com.akamaized.net/tenant/amp/entityid/AAmvMIR.img?h=373&w=624&m=6&q=60&o=f&l=f"}}' role="presentation" src="http://www.msn.com//static-entertainment-eus-s-msn-com.akamaized.net/sc/9b/e151e5.gif" title="Yes, but there's really no reason to worry about that — though it's understandable if the thought of... - Refinery29">
  • Slide 4 of 12: Two lasers, actually, Dr. Bower says. After the drugs have kicked in, the doctor will bring you under the first of two lasers. A suction ring is placed over the eye, which presses on the surface of the eye. During that time, a laser delivers millions of pulses, which cut a flap on a layer of the cornea, he explains. <br><br>Then, the doctor will put something on your eyelid so you can't close it, and then bring you to the second laser. With the flap lifted, the second laser reshapes the cornea and vaporizes the tissue on it. After that, the doctor closes the flap and you're done.
  • Slide 5 of 12: You might. "The large majority of people are glasses- or contact lens-free afterwards," Dr. Bower says. <br><br>Some people might need to use glasses for driving at night or reading, he says, but for most of the day, they can be glasses-free. However, many years after your laser surgery, you may need to get glasses for reading, because your eyes naturally change as you age, Dr. Kreuger says. "You can always go back and get touch-ups," he says.
  • Slide 6 of 12: It doesn't really matter how bad your eyesight is, as long as you have healthy eyes (meaning: you don't have cataracts, chronic dry eye condition, or glaucoma), Dr. Bower says. Lasik is very customizable, so you can get it if you're nearsighted, farsighted, or have an astigmatism. You'll work with your ophthalmologist to figure out what the best plan is for your eyes. <br><br>There's even new technology called
  • Slide 7 of 12: Usually not, since Lasik is considered an
    Dr. Bower suggests you set aside flexible spending account dollars (if you have them) to pay for it. Typically, the procedure costs around $2,000 to $2,500 per eye." data-src='{"default":{"load":"wait","src":"//img-s-msn-com.akamaized.net/tenant/amp/entityid/AAmvZ3q.img?h=373&w=624&m=6&q=60&o=f&l=f"}}' role="presentation" src="http://www.msn.com//static-entertainment-eus-s-msn-com.akamaized.net/sc/9b/e151e5.gif" title="Usually not, since Lasik is considered an "elective cosmetic" surgery, says Dr. Bower. It's a bummer... - Refinery29">
  • Slide 8 of 12: Nope! You'll see the results a few hours after the procedure, Dr. Krueger says. The whole process is relatively fast for a surgery, and you can expect to be at the doctor's for about two hours, and in the actual operating room for a half hour, he says. <br><br>Immediately after you get Lasik, you'll be able to see things at a distance that before you couldn't see without glasses.
    For a few hours after, your eyes can sting, or feel light-sensitive or gritty, but after you take a nap (remember, you're on Valium), you can wake up and see. "When you wake up from that nap, it really is miraculous, because you can see and your eyes feel comfortable," Dr. Krueger says." data-src='{"default":{"load":"wait","src":"//img-s-msn-com.akamaized.net/tenant/amp/entityid/AAmvZ3s.img?h=373&w=624&m=6&q=60&o=f&l=f"}}' role="presentation" src="http://www.msn.com//static-entertainment-eus-s-msn-com.akamaized.net/sc/9b/e151e5.gif" title="Nope! You'll see the results a few hours after the procedure, Dr. Krueger says. The whole process is... - Refinery29">
  • Slide 9 of 12: Overall, age doesn't matter. The ideal candidate for Lasik is someone in their 20s or 30s, and technically the FDA stipulates you have to be 21 or over, Dr. Bower says. By this age, your prescription is usually stabilized, which means it hasn't changed in at least three years or has only changed slightly in the past 12 months, Dr. Krueger says. <br><br>Doctors have even developed strategies to treat people in their 50s, who may need bifocals.
  • Slide 10 of 12: It sure does, and Dr. Krueger says to look for three things when choosing a provider: a facility or doctor with a great reputation and lots of experience; the latest technology, meaning they use two lasers; and a doctor who you can continue to see afterwards. <br><br>
    You've probably heard or seen advertisements for Lasik sales or discounts, but be careful with those, because most people won't qualify for those discounts and they don't include a post-op plan, he says." data-src='{"default":{"load":"wait","src":"//img-s-msn-com.akamaized.net/tenant/amp/entityid/AAmvRAP.img?h=373&w=624&m=6&q=60&o=f&l=f"}}' role="presentation" src="http://www.msn.com//static-entertainment-eus-s-msn-com.akamaized.net/sc/9b/e151e5.gif" title="It sure does, and Dr. Krueger says to look for three things when choosing a provider: a facility or ... - Refinery29">
  • Slide 11 of 12: Besides vision improvements, you might experience dry eye symptoms for the first few months after surgery, but it probably won't become a permanent thing, Dr. Bower says. Immediately after surgery, you'll start a very aggressive artificial tear drop regimen, and you'll have to use them for at least three months after the surgery. The drops help to heal the flap on your eyeball, and prevent bacteria from getting inside and causing an infection. <br><br>
  • Slide 12 of 12: The best thing about Lasik is that it's close to impossible to screw up, Dr. Bower says, because they use such high-tech machines. In other words, a doctor can't flinch and make a permanent mistake (like a tattoo artist). <br><br>
    The Valium you take beforehand ensures that your eyes won't tense up and your eyelids won't close. When you're under the second laser, you have to look at a blinking light, and doing so adjusts the laser to the correct position, he says. "Even if you were to sit up and move, which you can't really because of the Valium, the laser can't fire the pulse of the laser if you're not positioned properly," he says." data-src='{"default":{"load":"wait","src":"//img-s-msn-com.akamaized.net/tenant/amp/entityid/AAmvWyk.img?h=373&w=624&m=6&q=60&o=f&l=f"}}' role="presentation" src="http://www.msn.com//static-entertainment-eus-s-msn-com.akamaized.net/sc/9b/e151e5.gif" title="The best thing about Lasik is that it's close to impossible to screw up, Dr. Bower says, because the... - Refinery29">
>Full screen 1/12 SLIDES © Refinery29

Does Lasik Surgery Hurt? Plus, 10 More Of Your Biggest Questions

If you wear glasses or contact lenses, chances are you've wondered about Lasik surgery at some point in your corrective-vision lifetime. Maybe you've routinely slept in your contact lenses. Maybe you've broken your glasses one too many times. Or maybe you've done something like lost a contact lens on a hiking trip and spent the afternoon in a nature-filled haze, which drove you to consider a permanent fix. These are all very valid reasons.

But, if the thought of shooting laser beams into your eyeballs to forever change your eyesight is just plain scary to you, you're not alone — it's totally normal to have questions. The good news: "Lasik is the most frequently performed elective procedure in the world, and the success rates are greater than 95% in terms of satisfaction for patients," says Ronald Krueger, MD, an ophthalmologist at Cleveland Clinic. Not only is it a common procedure, but large analyses have shown that 91% of patients will achieve 20/20 vision after an initial surgery, Dr. Kreuger says.

Still have questions? Here are 10 more answers to Lasik questions you've probably wondered about. First thing's first: No, it doesn't hurt, but more on that ahead.

2/12 SLIDES © Refinery29

Does it hurt?

No, according to Kraig Scot Bower, MD, associate professor of ophthalmology at Johns Hopkins University. Lasik surgery is considered an outpatient procedure, and most doctors will give you a dose of Valium in addition to numbing drops with novocaine beforehand, so you won't feel a thing.

"Once the drops and the Valium kick in, there's no pain at all during the procedure — maybe a little pressure," Dr. Bower says.

3/12 SLIDES © Refinery29

Are you awake when it's happening?

Yes, but there's really no reason to worry about that — though it's understandable if the thought of having to "hold still" while people shoot lasers into your eyes makes you panic.

"The patient is awake, but has had Valium, so it takes the edge off," Dr. Krueger says. "It doesn't knock you out, but makes you not care, so you're just like, Cool, I'm having a laser." Cool, cool, very chill.

4/12 SLIDES © Refinery29

Will they actually shoot a laser into my eye?

Two lasers, actually, Dr. Bower says. After the drugs have kicked in, the doctor will bring you under the first of two lasers. A suction ring is placed over the eye, which presses on the surface of the eye. During that time, a laser delivers millions of pulses, which cut a flap on a layer of the cornea, he explains.

Then, the doctor will put something on your eyelid so you can't close it, and then bring you to the second laser. With the flap lifted, the second laser reshapes the cornea and vaporizes the tissue on it. After that, the doctor closes the flap and you're done.

5/12 SLIDES © Refinery29

Will I still need glasses?

You might. "The large majority of people are glasses- or contact lens-free afterwards," Dr. Bower says.

Some people might need to use glasses for driving at night or reading, he says, but for most of the day, they can be glasses-free. However, many years after your laser surgery, you may need to get glasses for reading, because your eyes naturally change as you age, Dr. Kreuger says. "You can always go back and get touch-ups," he says.

6/12 SLIDES © Refinery29

How bad do my eyes need to be to get it?

It doesn't really matter how bad your eyesight is, as long as you have healthy eyes (meaning: you don't have cataracts, chronic dry eye condition, or glaucoma), Dr. Bower says. Lasik is very customizable, so you can get it if you're nearsighted, farsighted, or have an astigmatism. You'll work with your ophthalmologist to figure out what the best plan is for your eyes.

There's even new technology called "topographic guided laser surgery," in which doctors download a map of the front surface of your eye and tailor the lasers to your unique eye shape, Dr. Krueger says.

7/12 SLIDES © Refinery29

Does insurance cover it?

Usually not, since Lasik is considered an "elective cosmetic" surgery, says Dr. Bower. It's a bummer, but the only people who can really have a case to negotiate with insurance companies are professional athletes, fire fighters, performers, and people who serve in special forces, because they can argue that they need it for work. (Definitely don't bother trying to lie to your insurance company; it's not worth it.)

Dr. Bower suggests you set aside flexible spending account dollars (if you have them) to pay for it. Typically, the procedure costs around $2,000 to $2,500 per eye.

8/12 SLIDES © Refinery29

Does it take a while to kick in?

Nope! You'll see the results a few hours after the procedure, Dr. Krueger says. The whole process is relatively fast for a surgery, and you can expect to be at the doctor's for about two hours, and in the actual operating room for a half hour, he says.

Immediately after you get Lasik, you'll be able to see things at a distance that before you couldn't see without glasses. "It's still hazy and fuzzy, like you're in a blizzard or underwater," Dr. Krueger says.

For a few hours after, your eyes can sting, or feel light-sensitive or gritty, but after you take a nap (remember, you're on Valium), you can wake up and see. "When you wake up from that nap, it really is miraculous, because you can see and your eyes feel comfortable," Dr. Krueger says.

9/12 SLIDES © Refinery29

Can you be too old for Lasik?

Overall, age doesn't matter. The ideal candidate for Lasik is someone in their 20s or 30s, and technically the FDA stipulates you have to be 21 or over, Dr. Bower says. By this age, your prescription is usually stabilized, which means it hasn't changed in at least three years or has only changed slightly in the past 12 months, Dr. Krueger says.

Doctors have even developed strategies to treat people in their 50s, who may need bifocals. "We can take the strongest of the two eyes and correct that for distance, and leave the other one as a near-sighted option for computers," Dr. Krueger says. "It's a really practical option for people over 40."

10/12 SLIDES © Refinery29

Does it matter where I get it done?

It sure does, and Dr. Krueger says to look for three things when choosing a provider: a facility or doctor with a great reputation and lots of experience; the latest technology, meaning they use two lasers; and a doctor who you can continue to see afterwards.

"Some will make it an assembly line, so you see the surgeon for the first time on the day of surgery," he says. "You want a personalized touch so you can go back and make adjustments or check up on your eyes months after the fact."

You've probably heard or seen advertisements for Lasik sales or discounts, but be careful with those, because most people won't qualify for those discounts and they don't include a post-op plan, he says.

11/12 SLIDES © Refinery29

What are the side effects?

Besides vision improvements, you might experience dry eye symptoms for the first few months after surgery, but it probably won't become a permanent thing, Dr. Bower says. Immediately after surgery, you'll start a very aggressive artificial tear drop regimen, and you'll have to use them for at least three months after the surgery. The drops help to heal the flap on your eyeball, and prevent bacteria from getting inside and causing an infection.

"Like any surgery, it's not guaranteed to be risk-free," Dr. Bower says. "We treat complications on a case-by-case basis, but dry eyes is the most common complaint."

12/12 SLIDES © Refinery29
The best thing about Lasik is that it's close to impossible to screw up, Dr. Bower says, because they use such high-tech machines. In other words, a doctor can't flinch and make a permanent mistake (like a tattoo artist).

"You could lose vision [after getting Lasik], but you could also lose vision from wearing contact lenses," Dr. Bower says.

The Valium you take beforehand ensures that your eyes won't tense up and your eyelids won't close. When you're under the second laser, you have to look at a blinking light, and doing so adjusts the laser to the correct position, he says. "Even if you were to sit up and move, which you can't really because of the Valium, the laser can't fire the pulse of the laser if you're not positioned properly," he says.

12/12 SLIDES

Source : http://www.msn.com/en-us/health/healthtrending/heres-what-you-should-know-about-those-mail-in-braces-programs/ar-AApTlR0

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