Not too many weeks ago the highly advertised “Smile Direct Club” DIY orthodontic firm went bankrupt. Left in its wake were unstable teeth, root canals, root resorption, and even lost teeth. It was a stupid unworkable idea to start with, as I warned patients in my blog.
Now new scammers are on the prowl, promising to fabricate partial dentures using DIY impressions at great cost savings.
You cannot imagine the lengths to which we dentists go to obtain accurate impressions of movable tissue with a tongue and saliva in the way. There is no way a patient can take an accurate impression in front of their bathroom mirror.
Reset smiles advertises partial dentures with “no metal”, yet metal is what makes them strong and keeps a lot of load off the gums. Guaranteed these ratty factory partials will cause gum recession followed by tooth loss.
There is a sucker born every minute. It amazes me how some people believe any advertisement they see. Don’t fall for it. In a short while the lawsuits will start pouring in and ResetSmiles.com will be bankrupt, just like Smile Club Direct. And you will have wasted a bunch of money and have to pay a real dentist anyway.
Although I can understand your initial concern with the risk of offering any online dental services to consumers, there are many factors here that you as a dentist need to consider:
Dentists do not go to great lengths to take the impressions you describe. As a CDT who has worked in denture labs for 20+ years and taught these techniques at the college level, I can count on one hand the number of times I’ve seen an altered cast impression from a GP. Even now with digital impressions many dentists fail to capture proper anatomy for RPD construction and more often than not, delegate this to an assistant anyways.
Implants are now the standard of care and many dentists cannot be bothered with RPDs. For those who do, many lack the proper training or skills needed to do them properly and successfully (see first point). I get it - why would you spend 4-5 or more appointments on a treatment where the insurance allowance may only be $550 per arch? An entire industry has risen to generate qualified implant and all-on-x patient leads for dentists. You don’t see that for partial dentures. Follow the money, I guess.
Many Americans can’t afford tooth replacement and don’t have dental insurance. Implants are out of the question for them, no matter how it’s financed. Many wouldn’t even be approved for financing.
We can deduce that many of the people looking for treatment online probably don’t visit the dentist regularly. Teledentistry can help bridge the gap between not seeing the dentist at all, and getting people to take their oral health seriously. Services like ResetSmile and others can be a stepping stone to get them into a dental office. These patients aren’t being taken away from dental offices, they are creating an opportunity for them that didn’t exist before.
I don’t disagree with your sentiment regarding SDC and online aligner services. There is a fundamental difference between Ortho and removables, and that is that Ortho is an active treatment and restorative is not. A LOT can do wrong if Ortho is not evaluated and monitored correctly for the duration of treatment and after. Flexible partials on the other hand are relatively low risk and treatment ends the day a patient gets their denture instead of beginning a months long process. It’s also worth noting that some of these online services use known and trusted teledentistry providers to review their cases, although there are probably many who do not.
Just my own two cents but there is a massive underserved dental community in need of something like this and as dental professionals we need to think outside the box and offer alternative point of care options to address them.
There is zero chance a patient can take a good impression of his own mouth with silicone putty.
Being a dental tech, you have not seen the damage to the gums and bone that flexible partials without rests do.
Teledentistry is a hoax except for except an orthodontist checking the progress of aligners. Patients cannot x-ray themselves at home. So many times patients incorrectly diagnose themselves and bias what they say over the phone so the doc will concur with them.
Sad to say, making quality removables is becoming a lost art with young dentists. The potential profit from them is not worth all the effort making good ones take. Having a quality removable practice is seen as a very low-prestige market niche.