Invisalign vs Mail Order Aligners

23rd Feb 2021
Now that clear aligners can easily be bought over the internet, do you really need to see a dentist to get your teeth straightened?  

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It’s the age of convenience and you can buy anything over the internet - even straight teeth. Using impressions taken from the comfort of your own home, companies like WonderSmile and Smile Direct Club create and send custom aligners to your door to straighten your teeth within 6 months on average.
Mail order companies present an alternative to the market leader Invisalign, which pioneered the use of clear aligners to straighten teeth faster and more discreetly, offering treatment led by dentists.
These new companies appear to have the added advantage of cutting out the dentist middle (wo)man. Especially with coronavirus limiting our movements, now might seem like the time for an alternative to dentist led treatments. But how effective is treatment without a dentist? And what else is there to gain from seeing the dentist?

To answer these questions and give you an expert opinion, we’ll break down and compare the treatment processes of Invisalign and mail order aligners. 

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Before Treatment

As we explained in Invisalign Journey from Start to Finish pre-assessment is important to to show precisely where your teeth are with a 3D scan, as well as fully visualise any pre-existing issues or abnormalities to avoid causing adverse effects.

So how does this process compare between Invisalign and Mail order aligners?  

Pre-assessments for Invisalign

The Invisalign process starts with a consultation with a dentist to discuss your goals for treatment and the best way to get you there, Invisalign or otherwise e.g veneers. Then you'll have the following:

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Check up

A check will be recommended if you haven’t had one recently to check that your teeth and gums are healthy

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3D scan or impressions

You’ll need this to show the current position of your teeth. The itero scanner can also instantly show you a simulation of your dream smile.

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Orthopantomogram 

Very importantly, you’ll have an OPG - an x-ray that shows a panorama of all your teeth to highlight any abnormalities like short roots.

 X-rays are fundamental to fully assess the health of your mouth and to provide safe dental care. In this case, your dentist will use this tool to know which teeth to avoid moving (e.g. implants, short roots) and to check for other abnormalities that may need to be treated first to prevent adverse effects later.

Using all the information from your  pre-assessment, Invisalign creates a safe treatment plan called a ClinCheck which shows how your teeth will look at each step of the transformation process, as well as the number of aligners and time needed for this. 

Pre-assessments for Mail Order Aligners

In contrast, with mail order aligners there are no prescribed formal pre-assessments or safety checks done by a dentist. You may fill in an online form to identify whether you’re a candidate by your type of misalignment (overcrowding, wide spacing). Then you’ll have a 3D scan at one of their clinics or take your own impressions at home, and a treatment plan will be shared with you before your aligners are sent. Most strikingly, there are no x-rays which are essential to orthodontic treatment. Without a full assessment, treatment could cause more harm than good, as the risk of problems such as losing or damaging your teeth or gums is higher.


At Loughton Dental Centre we include retainers and home whitening in all our Invisalign packages so you always make a saving

Comparing costs
It’s true that Invisalign is the more expensive option costing between £1,500 - £7,000 - but for this you get an experience that is safe and fully tailored to your needs and goals as you progress through treatment.

At Loughton Dental Centre we include retainers and home whitening in all our Invisalign packages so you always make a saving.
These cost between £2,500 - £3,800 and include features such as extended courses of teeth whitening, enamel contouring and hygiene visits, making you the biggest saving while you get more out of your smile. 


On the other hand, mail order aligners may cost between £1,300 - £1,600,  but for this you only get custom aligners but with no added frills, regular check-ins or adjustments as you go to ensure you stay on track. Notably you could wind up paying more in the end to see a dentist to do corrective procedures if treatment does not go as planned or causes damage.

Generally speaking both options offer finance to spread the cost, but you may find more flexibility in how and when you pay when you are dealing face to face with an Invisalign dentist, compared to a mail order company. 

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During Treatment

To compare the effectiveness of Invisalign and mail order aligners, you’ll need to know a little about how teeth straightening works (see more in Invisalign Journey from Start to Finish).

The thing to remember is that you can move teeth by tipping the visible parts called crowns or by causing bodily movements of the whole tooth including the root. Bodily movement takes more time but also has longer lasting effects. For this to happen space is required for teeth to shift around each other - aligners can do this by moving your teeth outward to reduce crowding (arch expansion). However this is often not enough - your dentist may also need to make adjustments to create space where necessary (see below). 

Interproximal Reduction

Tiny amounts (small fractions a millimetre) of enamel are shaved away between teeth using a special file. This allows just enough space for your teeth to slide past each other

Teeth Extractions

If necessary, your dentist may remove teeth that are not visible when you smile in order to reduce crowding and create space for the aligners to move your teeth. 

Attachments

Small tooth-coloured bumps (barely visible) that are bonded to your teeth for the duration of treatment which act as grips for aligners to help them move your teeth to their desired locations.

So how do teeth straightening methods compare between Invisalign and Mail order aligners? 
Where necessary, Invisalign treatment uses these three methods of space creation and attachments to achieve long lasting bodily movements of teeth. It is not clear if or how bodily movements are consistently achieved with mail order aligners as they don’t use all the space creating techniques.

Another important thing to note is that from time to time treatment doesn't go exactly as expected which is why your teeth movements need to be regularly monitored. With Invisalign you have regular appointments with your dentist every 2-4 weeks to check your progress and make any changes necessary to keep you on track. In contrast with mail order aligners it’s rare that you see a dentist. The latter may seem preferable, but remember that with Invisalign your dentist may spot an issue before you do. Whereas with mail order aligners you need to monitor your teeth yourself, however, by the time you spot something and ask for help, the problem could be harder to fix. Why leave your dental care to chance when you can speak to a dentist face to face who knows your case well? 

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After Treatments


The simple truth is that your teeth can and will move again after treatment, unless you maintain their alignment. To minimise the risk of relapse as much as possible, it’s recommended that you get both removable retainers (usually worn at night) and a fixed retainer that’s bonded to the side of your teeth that faces your tongue (not visible when you smile).  


Vivera retainers from Invisalign are considered the best for preventing relapse

Comparing retainers
Invisalign stresses the importance of retainers, and often treatment is provided only after you sign a consent form promising that you will wear them after treatment - that’s how seriously retainers are taken.
At Loughton Dental Centre we actually go a step further and include retainers in the cost of Invisalign treatment.
Many dentists would argue that Invisalign’s Viveras are the best retainers for preventing relapse. 


They are also very durable and cost effective lasting several years if worn and cared for properly. 

Mail order aligners will usually advertise retainers as an optional extra that you need to pay for. Unless you know how important retainers are, you may decide to forego them to save money. Unfortunately you could later discover that your teeth have relapsed.

Other questions to consider

Are straight teeth all you need to get your dream smile? You may also want to whiten your teeth or reshape certain teeth once they are straightened to get the full effect. If this is true for you, you may find treatment with a dentist beneficial, as they can advise on how to complete the look and include extras like teeth whitening and enamel contouring in the cost of treatment like we do at Loughton Dental Centre. 

The Verdict

When we talk about clear aligners, Invisalign is usually the first treatment that comes to mind. Whilst it may be more expensive, it is dentist led and uses safe and tested methods which are fully tailored to you and carefully monitored throughout treatment.
You may decide to go with a cheaper mail order aligner for convenience but it’s important to be aware that the safety and long term efficacy of treatment is questionable.