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Do orthodontists recommend smile direct?

With the rising popularity of at-home teeth straightening options like SmileDirectClub, many people wonder if orthodontists actually recommend these direct-to-consumer aligners. The answer is complicated, as orthodontists have varying opinions on DIY aligners. Some support them as an affordable alternative for minor tooth misalignment cases, while others caution against using a remote service without an in-person evaluation. Ultimately, orthodontists look at factors like the severity of each patient’s case, their preferences, and budget when making aligner recommendations.

The Pros and Cons of SmileDirectClub

SmileDirectClub is one of the most well-known at-home teeth aligner companies. Here is a quick overview of some pros and cons to consider:


  • More affordable than traditional braces
  • Convenient home impressions and virtual consultations
  • Discrete aligners that can be removed
  • Average treatment time of 4-6 months


  • No in-person evaluations by orthodontists
  • Not recommended for complex cases
  • You must be diligent about wearing aligners 22 hours/day
  • Harder to monitor progress remotely

Orthodontist Opinions on SmileDirectClub

When looking at orthodontist recommendations for SmileDirectClub aligners specifically, their opinions tend to fall into a few main categories:


Some orthodontists are open to recommending SmileDirectClub, especially for mild alignment cases such as small gaps or crowding. They see it as an affordable and convenient option when traditional braces are not necessary. These providers often recommend SmileDirectClub to teens, college students, and adults on a budget who are embarrassed about wearing braces.


Many orthodontists have mixed feelings about DIY aligners. While they appreciate the lower cost and accessibility, they caution that clear aligner treatment requires close monitoring by a specialist. They are concerned about achieving predictable results without in-person exams, 3D scans, and progress tracking. These orthodontists may recommend SmileDirectClub on a case-by-case basis for simpler needs.


Some orthodontists do not recommend SmileDirectClub at all. They have concerns about the quality of treatment and lack of specialist oversight. These providers believe complex tooth movements should only be done under the care of an orthodontist who can identify issues like bite problems. They encourage patients to save up for traditional braces instead.

Factors Orthodontists Consider for Aligner Recommendations

When advising patients on the best teeth straightening options, orthodontists take many factors into account. Here are some of the key considerations:

  • Severity of Misalignment: For mild crowding or small gaps of 1-2mm, at-home aligners may be sufficient. Moderate or severe misalignment requires in-office solutions.
  • Type of Movement: Simple tipping motions can often be achieved with remote aligners. Rotating or moving teeth vertically requires more precision.
  • Bite Issues: Overbites, underbites and crossbites need in-person adjustment and use of rubber bands.
  • Oral Health: Gum disease, cavities, and other issues should be addressed before starting any orthodontic treatment.
  • Age: Teens and adults have different needs. Younger patients may require more oversight.
  • Compliance: Patients must be committed to wearing aligners properly at home for best results.
  • Budget: The cost of traditional braces ($3,000-$8,000) is higher than DIY aligners ($1,000-$2,000).

Orthodontists balance these patient factors against the benefits and limitations of various teeth straightening products on the market. Most aim to provide customized recommendations based on each individual’s orthodontic needs and lifestyle.

Case Studies: When Do Orthodontists Recommend SmileDirectClub?

Looking at specific patient examples can illustrate when an orthodontist might recommend SmileDirectClub aligners versus traditional braces or Invisalign:

Case 1 – Mild crowding

James is a 19-year old college student with mild crowding of his bottom front teeth. His orthodontist determines 2-3mm alignment is needed. James is on a tight budget and embarrassed about wearing braces. The orthodontist recommends trying SmileDirectClub as an affordable option given his minor crowding. James completes treatment in 5 months with successful subtle straightening.

Case 2 – Gap closure

Sarah is a 27-year old woman with a 3mm gap between her front teeth. She is getting married soon and wants to close the gap for pictures. Her orthodontist says SmileDirectClub could likely fix Sarah’s gap without braces. Sarah chooses SmileDirectClub aligners and her gap fully closes in 4 months, just in time for her wedding.

Case 3 – Complex bite issues

Mark is a 16-year old with an overbite, crossbite and moderate crowding. His orthodontist advises that Mark requires full braces and rubber bands to properly align his bite. The movements are too complex for SmileDirectClub. Mark opts for traditional braces and achieves excellent results after 18 months of in-office treatment.

As you can see, orthodontists make recommendations on a case-by-case basis depending on each patient’s specific needs and goals.

Key Factors That Impact an Orthodontist’s Aligner Recommendation

There are a few main factors that typically influence an orthodontist’s recommendation on DIY aligners versus in-office options:

Factor Favors SmileDirectClub Favors Braces/Invisalign
Misalignment severity Mild Moderate-severe
Tooth movements Minor tipping Rotations, vertical movement
Bite issues None Overbite, crossbite, etc.
Age Adults Teens
Compliance Highly self-motivated Need motivation
Budget Lower Higher

As a general guideline, milder cases with mostly tipped teeth, motivated adults, and lower budgets favor trying remote aligners first. More difficult cases with bite issues, complex movements, teens, and higher budgets lean towards in-office solutions for best results under an orthodontist’s supervision.

Professional Oversight Makes a Difference

One of the biggest differences between SmileDirectClub and traditional orthodontic options is the level of specialist oversight throughout treatment. Braces and Invisalign are monitored in-person at regular orthodontic adjustments, while SmileDirectClub has remote monitoring.

In-office supervision allows orthodontists to:

  • Track progress and make small tweaks every 4-6 weeks
  • Modify treatment plans if necessary
  • Catch any compliance issues early
  • Address any complications immediately

This high level of care is why orthodontists often prefer in-office aligners and braces for more difficult cases. However, for simpler needs, at-home aligners may provide sufficient monitoring from remote orthodontists while costing patients much less.

Which Orthodontists Are Most Likely to Recommend SmileDirectClub?

In general, orthodontists that tend to recommend SmileDirectClub include:

  • Providers focused on affordability and access to care
  • Those with partnerships or affiliations with SmileDirectClub
  • Orthodontists with positive experiences and outcomes using SmileDirectClub for appropriate cases
  • Younger orthodontists open to new remote technologies
  • Orthodontists practicing in areas where patients have lower average incomes

On the other hand, orthodontists less likely to recommend SmileDirectClub may include:

  • Older orthodontists who are more traditional
  • Providers in affluent areas where patients can afford in-office care
  • Those focused on complex cases requiring specialized treatment
  • Orthodontists opposed to remote monitoring of any kind
  • Providers who have only seen SmileDirectClub cause complications

Younger, open-minded orthodontists who balance both perspectives are most likely to look at the full picture and make aligner recommendations on a case-by-case basis.

Key Takeaways for Consumers

The key things for consumers to know are:

  • Get your particular case and needs evaluated in-person by an orthodontist first
  • Ask about all your aligner treatment options, both in-office and direct-to-consumer
  • Follow your orthodontist’s recommendation on what is right for your specific treatment plan
  • Remote aligners can be a good option for milder cases at an affordable price
  • More difficult cases usually require in-office aligner therapy or braces for best results
  • Trust your orthodontist’s judgement and experience for which option is safest and most effective for you

Making the best aligner decision requires an in-person orthodontic evaluation first, rather than relying solely on a remote diagnosis. From there, have an open discussion with your provider about the pros and cons of various aligner choices for YOUR situation, lifestyle and budget.

The Bottom Line

At the end of the day, whether or not orthodontists recommend SmileDirectClub depends on each patient’s unique treatment needs and goals. Mild crowding or small gaps may achieve quality remote aligner results. More complex misalignments and bite issues require in-office care for proper, predictable outcomes. Listen to your orthodontist’s recommendation, ask plenty of questions, review your options, and together decide the teeth straightening route that will work best for you.