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Writer's pictureMatthew Crist

Dentist Monopoly vs Cheap Braces

An interesting dispute is brewing between those licensed to practice dentistry and SmileDirectClub. SmileDirect is a company that is providing an alternative to the traditional process of getting braces. Instead of a patient who desires to have their teeth realigned going to an orthodontist, the SmileDirect model is that the patient stays at home, takes his own set of impressions of his teeth, and gives those photographs and impressions to SmileDirect.


SmileDirect employs actual licensed dentists to review the impressions and photographs - so the complaint may fail because they are not practicing dentistry without a license. But that doesn't stop the exhausting and expensive process of defending against such a complaint.


The upshot is instead of paying $5,000 or much more for largely cosmetic care by a licensed dentist, the patients would only pay around $1,800 or less.


This type of dispute is arising more and more as the telemedicine model of healthcare is becoming more prevalent. Just as traditional taxicab companies appear to be on the verge of a violent revolt should Uber not be regulated to death, healthcare providers who are losing business because of a shift of paradigm are getting louder.


This dispute about orthodontics brings to mind the college kid who went viral a few years ago for 3-D printing his own invisible aligners.

Amos Dudley

For about $60 in materials, and probably dozens or hundreds of hours of study and work and over $1,000.00 for his 3-D printer, he was able to align his teeth without dental care.


Even if the orthodontists win against SmileDirect, can they stem the tide of homegamers starting up with DIY dentistry? I think not.


3-D printers aside, is this dispute valid? Or should people be free to do with their bodies as they deem fit?


As a medical malpractice lawyer, my first thoughts go to the coming disputes between SmileDirect and their customers who get injured. If they produce a bad aligner and it causes significant harm to the gum or a tooth's realignment causes damage to the root, I don't think they'll be liable under medical malpractice theory. Simple negligence, perhaps, but probably not professional negligence.


This will be an interesting dispute to follow.

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