Are anchors required to move teeth properly with clear braces? Smile Direct Club doesn't use them.

I am thinking of using Smile Direct Club for clear braces but they don't use "buttons/anchors" like Invisalign does. Are the anchors absolutely necessary? How is Smile Direct Club able to move teeth safely without the anchors? My dentist said Smile Direct Club could make your teeth loose and fall out because they don't use anchors to hold certain teeth in place.

Doctor Answers 4

When you need anchors

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For inpatient invisible aligner treatment, your orthodontist or dentist may prescribe anchors (or buttons or attachments as they're sometimes called) to reduce the duration of treatment or to achieve certain movements on a case-by-case basis. SmileDirectClub doesn't require these. If the prescribing doctor on your case determined you needed them to achieve results, they would refer you for in-office treatment rather than SmileDirectClub's remote model.

Nashville Orthodontist


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Yes and without them the aligners don't usually work properly. One of the major problems originally with clear aligners was that they didn't have the anchors/attachments. Smile direct club will not give a good result and they are really walking a fine line with dental laws on treatment. They don't have attachments and cannot do necessary tooth thinning or IPR. While I cannot assess your case without photos, I would never suggest smile direct club and I would recommend speaking to an orthodontist to see what type of treatment is best for your, whether it be fixed appliances (braces) or clear aligners.

Peter Sutton, DMD
Houston Orthodontist

Attachments are usually needed in any clear aligner treatment for adequate results

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In order for any clear aligner systems to work, they have to "grip" or slightly "snap over" the teeth, like a lid on a tuperware container.  

Depending on the shape or position of the teeth, the aligners may not fit tightly enough to "grab" the tooth to move it. 

The attachments Invisalign uses are actually very small complex geometric shapes placed in exact positions so the aligner both "grabs" the tooth and that the aligner pushes the tooth in the ideal direction.  I would guess that tens of millions of dollars in research and computer modeling has been done by Invisalign to make these attachments as good as they are now.  (I do not work for or promote invisalign, I use it regularly in my office and have watched it steadily improve over the years)

If an aligner system holds some teeth better than others, the ones not held well move in the wrong direction.  (I can actually see this in some of the example cases they show on their web site)  Yes, that means any aligner can actually make some teeth worse!  That is why Orthodontists regularly check patients and carefully monitor case progress.

If you want your teeth to look good, find an experienced invisalign orthodontist and get the treatment done right.  You will not be disappointed.

John McDonald, DMD
Salem Orthodontist

Invisalign vs Smile Direct Club

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Dear forwill,Thank you for posting your questions on RealSelf.  If your orthodontist or dentist suggests that you need anchorage devices (TADs) to correct your bite and straighten your teeth, he is trying to not only give you a great smile but also give you a healthy occlusion to prevent relapse later.Smile Direct Club is a great option for patients that strictly need minor teeth straightening.  If you are concerned with your doctor's decision, I suggest seeking second opinion from an Invisalign treating orthodontist.  From the information provided, it seems that your case is more complicated and requires a more complex treatment plan than what Smile Direct Club can provide.  Also, patients should be careful using Smile Direct Club.  They do not provide close monitoring so your case can spiral out of control if complex.I hope that this helps and good luck.Best,Dr. Jenn

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.