Orthodontic Aligners: Mail Order vs. Doctor Prescribed


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Dear Dr. Barakat,

What is the difference between the mail order clear aligners and going to an Orthodontist for Invisalign? I work long hours, and the convenience of mail order seems unbeatable. Do I really need an Orthodontist?


Dear Concerned Parent,

It can be tempting to use mail order aligners to straighten your teeth. Mail-order companies emphasize the convenience of no office visits and directly managing your care. They also emphasize the low-cost of “do-it-yourself” when choosing clear aligners.

Direct to consumer aligner companies take digital scans of your teeth but do not use x-rays and other diagnostic tools to see the structure underneath. These companies tout the lack of orthodontic supervision as a positive aspect of treatment but do not explain that those visits allow your Orthodontist to identify when necessary to revise the treatment plan to allow for optimal results. The aligners are not anchored to your teeth with attachments, so your teeth may not be guided into their appropriate positions. Home aligner companies generally do not allow for revision trays, lost or broken trays, or trays that do not fit correctly. In fact, a common “fix” for ill-fitting trays from consumer aligners is to trim the aligners yourself with scissors at home. This solution will not fix the problems; your teeth and gums can be damaged by trimming poorly fitted aligners at home.

It is important to understand all of the factors that come into play when using Orthodontics. While time, cost, and convenience are always considerations for patients, Orthodontists are concerned with the health and structure of a patient’s teeth, gums, and jaws and provide the best outcome. After studying their jaw relationships and function, an Orthodontist plans tooth movement that will work for the patient. Without proper diagnosis and treatment planning, treatment can go off track, causing undue side effects that cost patients a lot of stress, time, and money.

Sometimes clear aligners by themselves are not enough to complete the tooth movement necessary for aligning your bite. An Orthodontist will recognize this immediately and revise your treatment plan. Resin attachments are used by Orthodontists so that complex tooth movement can be achieved without resorting to traditional metal braces.

Face-to-face orthodontic appointments are essential for both the patient and the Orthodontist. Tooth movement disrupts teeth roots. An Orthodontist will use their years of experience, education, and diagnostic tools such as x-rays to ensure that the movement is done safely without causing undue damage to the foundation of your tooth structure. If aligners are not fitting properly, have broken or warped, or are just uncomfortable, an Orthodontist can address the issue during your visit by revising your treatment plan or adjusting your aligner appropriately to ensure proper fit. Your Orthodontist will also take the opportunity to examine your oral care habits during appointments.

Aligners are, in essence, a medical device. Their use and care require a trained, experienced professional Orthodontist who is an expert in their field. Straightening your teeth and aligning your bite is a considerable commitment. Your Orthodontist has taken the time to learn all aspects of the science behind orthodontics. Why trust your smile to anyone else?

Considering the convenience and cost factor for patients, our office has designed a protocol that will minimize the office visits and cost yet keep patients under the supervision of an Orthodontist. For more information, call us to schedule a complimentary consultation.


Dr. Rana Barakat, a board-certified specialist in Orthodontics, has been proudly serving Northern Virginia for more than 20-years! She has built her practice on a personal touch and excellent treatment.

As a parent, she understands wanting the best for your children by giving them beautiful, confident smiles. She makes it a priority to ensure optimal results, but also believes that each patient’s experience during treatment is just as important as the clinical result. As the 2015-16 President of the Virginia Association of Orthodontists, Dr. Barakat’s dedication and expertise reflect why her peers continue to nominate her as a Top Dentist.

Barakat Orthodontics is located at 45745 Nokes Blvd., Ste. 175, Sterling, VA 20166. Connect by visiting them online, or get social with them on FacebookInstagram, and Twitter. Barakat Orthodontics can also be reached at (703) 433-9330.

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