At-home aligners: what to know before you order

What 'at-home' aligners are

Aligners are thin, clear plastic trays that fit closely over the teeth. A series of them moves teeth gradually according to a treatment plan. In a 'direct-to-consumer' model, much of the process – impressions or scans, consultations and delivery – happens remotely rather than in a clinic.

The GDC says these services fall within the legal definition of dentistry, so they can only be provided by GDC-registered dental professionals.

GDC: aligners or braces sent directly to your home

What aligners can and can't do

According to the British Orthodontic Society, aligners work best for mild to moderate problems: mild crowding or irregularity, crowding that can be corrected with modest expansion or by slightly reducing tooth width, and mild spacing. Severe crowding, cases needing extractions, complex tooth movements and problems caused by the size or position of the jaws may need other techniques.

Aligners generally need to be worn full-time, day and night, except when eating – and after any aligner treatment you will need retainers to stop teeth drifting back.

British Orthodontic Society: clear aligners

What the regulator expects

The GDC's statement on direct-to-consumer orthodontics rests on three requirements.

• Suitability must be based on a full assessment of your oral health. The GDC says there is currently no effective substitute for a physical, clinical examination.
• There must be direct interaction between you and the dentist – in person or remotely – so you can ask questions and give valid, informed consent.
• You must know the full name of the dental professional responsible for your treatment and be able to contact them directly.

GDC statement on direct-to-consumer orthodontics

Potential benefits

The GDC acknowledges that new ways of providing treatment can bring real benefits, particularly where costs are lower and access is improved. Aligners are also removable for eating and cleaning, and many people find them discreet.

Risks and common complaints

A 2025 GDC blog on clear aligner complaints listed issues raised by patients, including poorly fitting aligners, discomfort, frequent breakages or loss, treatment taking longer than expected, enamel damage, unexpected tooth movements and unclear financial responsibility for replacements. It also noted that adverse outcomes such as gum recession, bone loss and root shortening are sometimes reported after aligner treatment, and that poor baseline assessment makes these harder to investigate.

The GDC's patient guidance adds that there are conditions which can make aligners unsafe, which you might not know you have and which may be missed without an in-person check-up. Impressions taken at home can also be inaccurate, leading to poor-fitting appliances.

GDC blog: lessons from clear aligner complaints

Questions to ask before you sign up

These are based on the GDC's guidance for patients.

• Will a dentist examine me in person? If not, why not – and have X-rays and my medical history been checked?
• Who took my impressions or scans, and were they checked by a dental professional?
• What is the full name of the dentist responsible for my treatment, and can I contact them directly?
• Are they on the GDC register?
• Have alternative treatments been explained, including the risks and likely outcome of each?
• How long will treatment take, and will I need retainers afterwards? Who pays for them?
• What happens – and what does it cost – if an aligner breaks, doesn't fit, or I'm unhappy with the result?
• Am I being pressured to decide quickly?

Check the GDC register

Safer alternatives

You don't have to choose between an expensive clinic and an app. Many dentists and orthodontists offer clear aligners with in-person assessment and monitoring, alongside fixed braces. The British Orthodontic Society recommends seeking an opinion from an orthodontic specialist about your options. Under-18s with a clinical need may be eligible for NHS braces.

NHS: braces

If something goes wrong

The GDC recommends speaking to the treating dentist first. If that does not resolve things, or you think the regulator should know, you can raise a concern with the GDC. If you have pain, swelling or a broken appliance, see a dentist.