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There have been more than 1,800 complaints across the country, according to the Better Business Bureau, from people who used at-home dental alignment service SmileDirectClub, which guarantees straighter teeth at a fraction of what it costs to get braces — under $2,000 — without ever having to step foot in a doctor’s office. But dentists not affiliated with the company report having patients who use the service come in needing to correct and re-straighten teeth as a result.
Phoenix-based Dr. Brian Harris, a cosmetic dentist, said a number of his patients have used SmileDirectClub and are now spending between $800 and up to $5,500 to treat misalignment that was caused by the company’s products.
“There have been bite-related issues where they’ve [patients] finished the case and things appear to be straight, but they have malocclusion,” Harris said, referring to abnormal alignment of the lower and upper teeth. “Teeth get rotated and they touch on one side of the mouth that causes things to be lopsided.”
Harris said since people using Nashville-based SmileDirectClub often don’t go in for an in-person visit with a dentist or orthodontist, problems can develop down the line if they have gum disease or existing cavities they are unaware of.
“If you have gum disease, or periodontal disease or any bone loss or infection in the gums and you move the teeth, that can provoke additional gum disease, loose teeth and cause serious issues if that foundation is not stable. Another major concern and probably the most common is when you bite down, how the teeth hit is extremely important,” Harris said.
SmileDirectClub users can create impressions of their teeth using an at-home kit or get an in-person scan. A licensed dentist orthodontist then creates the aligners and is supposed to check in with patients every 90 days remotely. Then consumers purchase a set of retainers to wear at night after completing treatment. But some patients have reported not being able to get in touch with an assigned dentist, NBC News reported Thursday.
The company's stock was down 16.31 percent on the news Friday.
“When these molds get sent, supposedly there’s a doctor looking at them to make sure they’re correct, but if they never see the patient, they can’t see if there are additional issues like cavities on the teeth so if you have trays made, now your teeth are covered and bathing in saliva that’s going to provoke them to get worse and cause future issues,” Harris said. “You don’t know unless you physically see it in the mouth.”
Users who can show that aligners damaged teeth can request a refund, however, they must sign a nondisclosure agreement that prevents them from bad-mouthing the company in order to get their money back.
“When customers request a refund outside of our published refund policy, we ask that they sign a general release that contains a confidentiality provision, similar to the recommendations set forth by the American Association of Orthodontists and standard business practice,” the company said in a statement.
The at-home dentistry business is booming with products like home teeth-whitening and teeth-straightening kits promising the perfect smile replacing costly in-office visits. Invisalign, a similar company that provides plastic aligners, offers an alternative for adults who don't want to get metal braces, which can cost between $3,000 and $7,000 depending on the condition of a person's teeth. The company raked in $1.7 billion in revenue in 2018, up 29.4 percent year-over-year, shipping 1.2 million cases.
The orthodontist industry was estimated to bring in $12 billion in 2018, according to market analysis by research firm IBISWorld. The industry grew 1.3 percent annually between 2013 and 2018 with the rise in demand for adult braces considering one in five orthodontic patients is an adult, according to a report from Harvard Health Publishing.
Robyn Householder, CEO of the Better Business Bureau in Nashville where SmileDirectClub is based, told FOX Business that the company has done its part to answer customer complaints. “While BBB understands that some customers have not been happy with their experience, the company has answered every complaint filed with BBB, which is required of all Accredited Businesses,” she said.
"Customer focus is our No. 1 priority," said Susan Greenspon Rammelt, chief legal officer and executive vice president of business affairs at SmileDirectClub. "We pride ourselves on enabling care to customers who can't afford the cost of orthodontists. When there are clinical concerns raised by any customer that has used our platform we seek to enable that customer to have their concerns addressed by their treating doctor."
FOX Business' Cortney Moore contributed to this report.