How Useful Are Byte Aligners?

How Useful Are Byte Aligners?

Aligners are the new trend in adult teeth straightening. The invisible plastic rails are now significantly cheaper – and everything runs digitally. Do-it-yourself orthodontics without doctor contact is also possible, but problematic.

This is what it’s about:

Plastic splints promise a bright smile

They are called “DrSmile”, “SmileDirectClub” or “Byte Aligners”: companies that break new ground when it comes to straightening teeth. Since the patent for the invisible plastic rails expired in the USA , a lot has been happening in the market. The so-called aligners are now available for less than € 2,000 instead of € 5,000 to € 7,000 before. The splints are pushed over the entire row of teeth and should only be taken out for eating, i.e. worn for 20 to 22 hours a day. You switch to the next rail about every two weeks. The companies address a young target group – online-savvy, oriented towards aesthetics and modern methods.

Sometimes patients do everything themselves – a “do-it-yourself orthodontics”

An appointment is made online with the German market leader DrSmile (eight locations, more than 3,000 treatments in 2018). Then the teeth are digitally scanned. After an orthodontic examination, the patients receive all splints at once, including the stabilizing splint (retainer), from a dentist or orthodontist. If the patients send a selfie every week and answer technical questions, there is a guarantee that the treatment will be successful. Other companies don’t even see their customers. You send a set for the self-impression and then the splints – without a dentist. The pioneer of this do-it-yourself orthodontics was the “SmileDirectClub” in the USA. There were several legal disputes there, but the model came to Europe in 2016 and to Germany in 2017.

Is that still medicine?

Official dentistry is outraged. After all, the newcomers saw a very lucrative business model. The German Dental Association argues above all from a legal point of view: According to the Dentistry Act, the “patient-specific planning and manufacture of aligners” is the practice of dentistry and is therefore reserved for dentists “to protect the patient”. The “detection and treatment of tooth, mouth and jaw diseases” is Byte Aligners unsuitable for self-treatment. Commercial providers could therefore “possibly even carry out a punishable healing treatment “- in the case of complications it is physical harm. From a medical point of view, the German Dental Association states that orthodontic movement of teeth sometimes involves strong forces, which is why “continuous monitoring by a dentist” is necessary.

Tooth aligners in themselves are not risky. However, if the condition of the teeth is not medically assessed before and during treatment, tooth decay, inflammation, or problems with crooked teeth may be overlooked. In addition, aligners are usually not suitable for severe bad bites, for temporomandibular joint problems or for bridges and implants.

Straight teeth are in demand, but probably too many are already being treated

The new providers want to expand the market for braces. The German Society for Aligner Orthodontics (DGAO) is assuming growing demand, especially among adults. But experts are already criticizing an oversupply, as probably around half of all children and adolescents are treated with braces. And the Federal Audit Office criticized in 2018 that the benefits of orthodontic treatment had not been adequately researched. This was already criticized in 2001 by the Advisory Council in Health Care and in 2008 by DIMDI, Byte Aligners a subordinate authority of the Federal Ministry of Health.  The Federal Ministry of Health is currently discussing “the need for further research and further recommendations for action with the organizations involved”.

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