Why I think aligners suck
The basically move your teeth out of alignment with the skull and do nothing useful
Lots of people have asked me what I think of aligners.
And I always tell them that they are complete crap.
But let me go into a bit more detail why that is.
And why I think the vast majority of people that do aligners will end up being sorry that they did.
The Rise of Aligners
Clear aligners have exploded in popularity over recent years, transforming from a niche orthodontic tool into a mainstream phenomenon. The global clear aligners market was valued at $3.76 billion in 2024 and is projected to reach $10.17 billion by 2032, a CAGR of 13.4%.
Some forecasts are even more aggressive, with the market potentially reaching $32.35 billion by 2030, growing at a CAGR of 31.3%.
North America dominates the market with a 52% share in 2024, but the rest of the world is quickly catching up. Especially here in SE Asia where I see young folks jumping all over them.
In part because it has gotten quite affordable, especially since financing options are often available.
The numbers are pretty staggering: over 70% of all orthodontic treatments initiated in 2025 involve clear aligners, up from 59% in 2020.
The driving force behind this explosive growth? Cost. Traditional braces and in-office Invisalign treatments can cost $3,000-$7,000, while direct-to-consumer aligners (eg. SmileDirectClub promise similar results for $1,200-$2,400.
For millions of adults who missed orthodontic treatment in their youth, aligners “seem” like an affordable second chance at a perfect smile.
How Do Aligners Work
The basic “science” behind aligners involves applying controlled pressure to teeth through a series of custom-made plastic trays.
Each aligner in the sequence is slightly different, designed to move teeth incrementally toward their target positions. Patients typically wear each set for 1-2 weeks before advancing to the next stage.
They say that the process relies on “bone remodeling”—when pressure is applied to a tooth, the bone on one side breaks down while new bone forms on the other side.
This allows the tooth to move through the jawbone over time. Modern aligner systems use 3D scanning and computer modeling to map out the entire treatment sequence in advance.
The technology sounds sophisticated, but in my view it’s just a bunch of bogus.
I have a feeling what they call ‘bone remodeling’ is actually just the human skull smartly (negatively) compensating for this artificial force on the teeth.
Which to me is evidenced by the fact that this artificial tooth movement is almost always followed by some root resorption as i wrote about here:
The Major Aligner Companies
The aligner market is dominated by a handful of major players, each with their own approach to the fundamental flawed premise of moving teeth.
Invisalign remains the gold standard, manufactured by Align Technology. Align Technology reported $979.3 million in first quarter 2025 revenue, with Clear Aligner revenues of $796.8 million. Invisalign requires supervision by trained dentists and orthodontists.
SmileDirectClub was the pioneer of the direct-to-consumer model before filing for bankruptcy and ceasing operations in 2023. The company's collapse left over 2 million customers stranded mid-treatment. The Better Business Bureau reported over 1,800 complaints about SmileDirectClub, including broken teeth and nerve damage.
Impress has emerged as one of the newer European players, establishing a presence in eight countries across Europe and the United States. After SmileDirectClub's bankruptcy, Impress positioned itself to take on millions of former SmileDirectClub customers.
Other significant players include Byte (with their vibrating HyperByte technology), ClearCorrect (owned by Straumann), and newer entrants like OrthoFX with their NiTime aligners.
The proliferation of these companies is going to, in my view, lead to even faster ‘uglinization” of the human race. Meaning most folks that do it will realize that they are essentially aging and getting more assymetric far faster than they would have.
And eventually all of these companies will be destroyed like SmileDirectClub was… in a pile of lawsuits. As the ugly truth I explain next is revealed.
The Patterns I've Observed
Over the past decade, I've talked to a lot of folks that have done aligners.
Whenever I hear someone has done aligners I want to find out their story.
has their health evolved/declined since doing it?
what did they look like before the aligners?
did they wear their retainers?
etc.
And generally what I’ve seen is what I expected. After aligner treatment, people lose the "edges" to their skull. Their faces appear to "melt" as Mike Mew likes to describe it.
Not just their skull but also their body often worsens.
And some folks have clearly had new health issues they didn’t have before.
Why is this? Let’s answer that question next.
How the bite works
Remember that my rule is that if you haven’t done orthodontics then “the teeth are always where the skull wants them.”
Meaning that even if they are crooked and not very pretty to look at… there is a functional reason why they look like that. And that reason is that they are supporting the skull.
A natural bite will naturally support the jaw positions of retrusion and protrusion as I explained here.
Supporting those positions is key to keeping the skull ‘inflated’.
Ruin or artifically change those positions, as aligners do, and the skull deflates. And when it deflates a number of things happen:
cranial bones get deranged and the face typically gets more assymetric
the skull compresses on the brain… increasing the likelihood of neurological and cognitive impairment
the curve of spee that i talked about in the past flattens
the skeleton compensates (ie. twists)
Don’t believe me? Start following the patterns yourself.
I’m not just talking based on my observations… i’m talking from experience of having screwed up my bite numerous times the past decade and then fixing it.
Final Thoughts
I’ll end by telling one of my favorite aligner stories…. it is a colleague I had in late 2019.
He was a healthy, pretty fit guy. Ran his own company that was doing very well.
He felt on top of the world.
We were in a meeting and he took off his aligners in the middle of speaking to me…. as apparently they were uncomfortable.
When I saw them I instinctually told him about my dental/health story as I often do. And warned that I think aligners have very bad skeletal consequences.
He faked some interest and kind of laughed.
I heard later from a mutual friend that he thought i was a lunatic.
Fast forward to 2025.
This guy’s neck has completely disappeared. His body has completely changed for the worse. He looks like a completely different person.
And his luck has changed. He is very much no longer on top of the world.
For example his company is a small shadow of what it once was and I heard they nearly went bankrupt several times.
He has learned what it is to struggle.
Now i use him as one of my favorite examples when people ask me what I think about aligners.
Is it the nicest thing to do? No.. but he wasn’t the nicest of people. And so i honestly don’t care.
When people like him mock me about this shit… I usually end up having the last laugh. Hahahahahaha
My daughters did expanders to open their pallet. Both of them no longer mouth breath, have dark circles or morning congestion and headaches. They finishes up with aligners to correct any misalignment but keeping the wider pallet. My youngest also mouth breathed and has dark circles so she is expanding while also wearing a toothpillow at night with it. I haven't seen any negative health affects. One of my daughters had a very narrow pallet and a Sever tounge tie with myo functional exercises she has improved her tounge function and her facial structure is so much better now. Less health issues.
I'm new to this topic so excuse my ignorance but what are the differences between how aligners and mouthguards work?