What Went Wrong At SmileDirectClub?

Photo by Jacqueline Kilikita.
“I’m midway through my treatment with SmileDirectClub, and I found out that the company filed for bankruptcy when my boyfriend sent me a screenshot of a tweet,” Kirsty tells Refinery29. “They offer a ‘lifetime guarantee’ and are supposed to support you through the entire process — but now they’re just gone. No email to customers, no reimbursement. I had no idea. I feel abandoned.”
Kirsty is one of two million people worldwide who put their trust in SmileDirectClub, a company that helped people straighten their teeth at home using custom-fitted aligners. The premise was simple: Customers received an “impression kit” through the mail, containing putty and a tooth tray to capture impressions of their teeth. These were mailed back to the company, which would cast them and send them back as clear, plastic aligners. At approximately $1,900, SmileDirectClub was a fraction of the price of Invisalign, a dentist-run, clear aligner service that can cost up to $6,000. 
With costs rising left and right, it’s little wonder that SmileDirectClub piqued the interest of those keen to straighten their teeth cheaply. After all, ads for the business were ubiquitous. Its tagline, “Get a smile you love for up to 60% less than braces”, beamed down from electronic billboards in various cities like London and New York, while commercials flooded television channels. The company was reportedly once valued at approximately $8.9 billion, but despite the glossy advertising, it failed to turn a profit. In 2022, SmileDirectClub reported a loss of $86.4 million, and in September 2023, it filed for Chapter 11 bankruptcy, subsequently closing down its global operations. 

Why did SmileDirectClub go bankrupt?

Chapter 11 bankruptcy involves a reorganization of a debtor’s (in this case, SmileDirectClub's) business affairs, debts and assets in the hope that it will then be able to survive. However, SmileDirectClub reportedly failed to find a partner to keep the company operating. In a statement on SmileDirectClub’s website, the brand wrote that aligner treatment is no longer available, nor is customer care support. Its lifetime guarantee also no longer exists; orders which hadn’t shipped were canceled, and those paying through the brand’s SmilePay finance program are still expected to “make all monthly payments until payment has been made in full. Thousands of customers have since been deserted and are quite literally paying the price for the company’s collapse. 
Initially, Kirsty had a positive experience with SmileDirectClub: “I actually only contacted them on December 4th this year, as I’m three aligners from the end of my treatment, but I’m not sure it’s going as planned,” Kirsty explains. She adds that her calls were always answered quickly and she was connected to a dentist on behalf of the company, who emailed back and told her that she was on track. “Unbeknown to me, they were about to announce bankruptcy,” says Kirsty, who was due to receive her final retainers. She is now unable to order them. 

“When you sign up for a ‘lifetime guarantee,’ you would hope to have some trust in the company and that it won’t just be taken away. It’s been handled terribly.”

Kirsty, A SmileDirectClub Customer
Affordability is why Kirsty settled on SmileDirectClub over Invisalign: “I paid a sum upfront, and then they offered 12-month financing for the rest, which I’m paying currently,” she says. Kirsty now has no guarantee that her retainers will work, but even more frustratingly, she is out of pocket. What has shocked her the most, though, is that SmileDirectClub’s bankruptcy filing occurred several months ago. “It doesn’t tell new customers that,” says Kirsty. “When you sign up for a ‘lifetime guarantee,’ you would hope to have some trust in the company and that it won’t just be taken away. It’s been handled terribly.”

Why do dentists dislike at-home dental aligner services?

The disappointment came as no surprise to dentists and orthodontists, many of whom have tried ardently to caution patients against online dental services like SmileDirectClub, citing specifically their inadequate results and serious teeth complications. “I’ve been warning people about SmileDirectClub for years,” says Joyce Kahng, DDS, a cosmetic dentist in Costa Mesa, California. “I believe most dentists were in alignment about SmileDirectClub. We all saw it as unsafe,” says Dr. Kahng.
According to Myron Guymon, DDS, MS, President of the American Association of Orthodontists (AAO), the online business model was problematic. "What I can tell you is SmileDirectClub patients have not had an x-ray or in-person exam, which are critical to ensuring an accurate diagnosis and safe and effective treatment plan," explains Dr. Guymon. "The AAO emphasizes the importance of an in-person examination and x-rays before starting any orthodontics with a provider to avoid irreparable harm."
Anecdotally, Stephen Dodd, BDS, a UK-based cosmetic dentist at Ringway Dental, says that his team has treated countless patients who had previously used online aligner companies and were unhappy with their teeth. Dr. Dodd says that the “blanket approach” of most at-home aligner services can be detrimental, particularly if the customer is a complex case, for example, they have significant teeth overcrowding or missing teeth. 

“I believe most dentists were in alignment about SmileDirectClub. We all saw it as unsafe.”

Joyce Kahng, DDS, a cosmetic dentist in Costa Mesa, California.
Failures of at-home aligners can include not ending up with straight teeth, but they could be much more catastrophic, says Dr. Kahng, one of which is posterior open bites. “These are cases that end up without any contact on their molars when they bite down; molars are crucial to a stable bite.” This can lead to temporomandibular disorder (TMD), a condition affecting jaw movement. It can also accelerate wear on the front teeth if they take the brunt of chewing forces, says Dr. Kahng. While teeth may appear straighter initially, the occlusion causes significant issues in the long run, including cracked teeth, mobility problems and other conditions where teeth may need to be extracted. Given these problems, she says it is questionable that there were actually dentists overseeing at-home aligner cases. “They were technically approving them,” she says, “but the degree to which they were involved is a blurred line.” She reports that many of her colleagues who chose to speak up about SmileDirectClub were met with cease and desist letters. 

Did SmileDirectClub make people sign NDAs?

Interestingly, there are many positive testimonials for SmileDirectClub. Abbey, a SmileDirectClub customer based in the UK, tells R29 that she was assigned to a dentist but never spoke to them as there was no option to call them directly. “When I did call, I was put through to another dentist entirely,” says Abbey. “I’m not sure if they actually were a dentist, though.” That said, Abbey is happy with the result for the money she spent. “At the time, I couldn't afford the alternative [Invisalign], and my teeth weren't that ‘bad’,” says Abbey. She was pleased with SmileDirectClub’s customer service, and although the company was based in the US, it was easy to get hold of, she says. For this reason, Abbey would have recommended SmileDirectClub to others had it not collapsed.
Similarly, Lizzy, who received treatment through SmileDirectClub’s PR team, tells R29 that she is happy with the results. Still, she thinks that her experience likely differed from many individuals who would have paid in full for the service. “I liked that SmileDirect had a nighttime plan instead of having to wear the aligners 24/7,” says Lizzy. Unfortunately, Lizzy’s decision to go with SmileDirectClub instead of her dentist surgery’s chosen brand, Invisalign, wasn’t received well. “My dentist got super pissed at me,” Lizzy recalls.” Despite her dentist’s reaction, Lizzy says she conducted informal research online before committing to SmileDirectClub. Though she came across a handful of unsavory reviews and bad press, she thought the free treatment would be worth the risk for a straighter smile. Other customers aren’t quite so lucky, though.

“My dentist got super pissed at me.”

Lizzy, A former smiledirectclub customer
In 2020, The New York Times reported that SmileDirectClub had asked customers who were not satisfied with their results and subsequently requested refunds to sign non-disclosure agreements, preventing them from sharing negative reviews. Three years later, in June 2023, The New York Times reported that SmileDirectClub agreed to release customers from these NDAs as part of a settlement. It would allow 17,000 customers to share their complaints. Sure enough, a quick scroll through TikTok serves up dozens of disagreeable reviews. In many videos, former SmileDirectClub users report experiencing pain, discomfort and even chipped teeth.

What should you do if you’re halfway through SmileDirectClub treatment?

Since folding, thousands of SmileDirectClub customers are left to pick up the pieces. Dr. Guymon’s professional advice: "Make an in-person appointment with a local licensed orthodontist." The AAO has a searchable list of experienced orthodontists in every state, US territory and Canadian province. "At the appointment, share all concerns and past treatments," says Dr. Guymon. "Feel confident knowing that an orthodontist has specialized education and experience and has helped patients in similar situations."

"Make an in-person appointment with a local licensed orthodontist."

Myron Guymon, DDS, MS, President of the American Association of Orthodontists (AAO)
In the meantime, Dr, Guymon and Dr. Dodd advise not switching to another online, mail-order dental aligner service. “A concern of mine is that other online brace companies will want to capitalize on [the bankruptcy] news and prey on vulnerable patients,” says Dr. Dodd. “You might be tempted because of cost factors, but I promise that in the long run, this is only going to cost you more.” With this in mind, Dr. Dodd says that people are much better off seeing someone face-to-face for a proper assessment so that the correct treatment plan can be put in place. "If finances are a concern, when booking the appointment, ask about complimentary consultations offered by many AAO orthodontists," offers Dr. Guymon.
Lastly, if you’ve just recently received your SmileDirectClub aligners, Dr. Dodd suggests not using them. As per the brand’s website, you won't be able to contact a company expert if you encounter any problems. 

Can you get your money back from SmileDirectClub?

Dr. Kahng believes that bypassing regular, in-person checkups means that at-home dental aligner “patients” are not patients at all — they are merely paying customers. “Patients are legally protected,” says Dr. Kahng. “Customers are not.” To that end, Kirsty — like thousands of others — has no idea what her rights are. Though SmileDirectClub was based in the US, it operated worldwide, including the UK, Canada, Australia and New Zealand. Therefore, consumer laws and regulations are likely to differ across countries. Lawyer and consumer expert Dean Dunham, who is based in the UK, tells R29 that customers who had not received all they paid for will now be entitled to a refund, but there’s a catch. “Unfortunately, they will join a long queue as a ‘creditor’ and will only receive their money if funds are available to distribute, which is highly unlikely,” he says. 

“Unfortunately, they will join a long queue as a ‘creditor’ and will only receive their money if funds are available to distribute, which is highly unlikely.”

Dean Dunham, Lawyer and consumer expert

What does SmileDirectClub’s collapse mean for other online alignment services, like Candid and Byte?

So what of other online teeth alignment services with similar business models to SmileDirectClub? Dr. Dodd predicts that, eventually, they’ll cease to exist. The news about SmileDirectClub will likely put many people off going down the online route, says Dr. Dodd, who envisions a return to in-clinic treatments, including dentist-approved Invisalign. Dr. Kahng doesn’t personally have an issue with companies trying to innovate in this space. However, she stresses that they must do so with the patient's safety in mind. This would mean a doctor would need to be a more significant part of its business model, says Dr. Kahng. Happily, some companies have started to partner with existing dental offices, like Candid. “What I do hope is that the SmileDirectClub bankruptcy brings awareness to consumers so that they can make better decisions if they choose to move forward with DIY aligner companies,” says Dr. Kahng. She surmises that SmileDirect spent “too much” to acquire their customers through marketing, and thanks to poor reported outcomes and customer service, she believes it was “overextended.” 
Dr. Kahng advises those who still want to straighten their teeth through at-home services to do their due diligence. “As more copycat companies pop up, it’s important to look into each one individually and to understand what you are paying for,” she says. Without a dentist overseeing every step, what you are actually spending money on is simply a bunch of plastic trays, she adds. On the other hand, with professional involvement, you are paying for a result, says Dr. Kahng. Even as a cosmetic dentist with training in Invisalign (a dentist-run company), Dr. Kahng may refer cases to an orthodontist if they are out of her scope. This is the level of transparency that she would expect in a provider or an at-home service.  
Overall, the expert consensus is that, currently, the risks associated with online aligner companies may outweigh the benefits. You only get one set of teeth throughout your adult life, so whatever you do, look after them. You could pay dearly for it otherwise.
This story was originally published on Refinery29UK.

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