I'm sharing this anonymously for personal and legal privacy reasons. I believe patients deserve full transparency before starting treatment. I think prospective patients should be aware of some unique aspects of this practice: 1. In-house clear aligners: Dr. Riolo uses custom clear aligners fabricated in-house using a 3D printer from a company called Formlabs. According to Formlabs' own website, Dr. Riolo is featured as the first dentist to adopt their system, which claims to reduce production costs by up to 90% compared to commercial brands like Invisalign. These aligners are made from different materials and follow different manufacturing processes. Unlike Invisalign, which is FDA-cleared and supported by extensive clinical research, I am not aware of any independent testing, published studies, or regulatory review of the aligners used in this office. Without such oversight, it's difficult to assess their safety, durability, or long-term effectiveness. I personally know of patients who experienced complications during treatment with these in-house aligners, though I cannot speak to the clinical causes of those outcomes. Dr. Riolo had minimal involvement in managing or resolving those complications, based on what I observed. *From his reply on Google, Dr. Riolo mentioned that the materials used in his in-house aligners are FDA-approved. That may be true -- but it's important to note that for Invisalign, it's not just about materials. Invisalign is a Class II medical device that was FDA-cleared via the 510(k) process, meaning the entire system -- including the aligners, the digital treatment software and algorithm, and the manufacturing process -- has undergone regulatory review. To my knowledge, there's no equivalent FDA clearance available for this in-house system. I believe this is an important distinction for patients considering treatment. If such documentation does exist, I welcome Dr. Riolo to share it publicly. 2. Delegation of orthodontic care to minimally trained staff: After the initial consultation, Dr. Riolo is rarely involved in ongoing care. Nearly all adjustments and hands-on procedures are performed by staff who may have little or no formal training. Based on my experience, some of them appeared to be in training and lacked basic proficiency -- taking up to two hours for what should be routine wire adjustments. While Washington State permits on-the-job training for dental assistants, this setup can leave patients in the hands of individuals without adequate experience or supervision. In my opinion, this compromises the quality and safety of care. If you're considering treatment here, I strongly recommend seeking multiple opinions -- especially when it comes to irreversible dental work. Marketing may emphasize affordability or convenience, but it's critical to understand both *who* will be providing your care and *what* treatment system will be used. In-house solutions like custom-printed clear aligners may not offer the same level of clinical validation or regulatory oversight as established options like Invisalign, and hands-on care may be delegated to minimally trained staff. While Dr. Riolo may hold prestigious titles -- including affiliations with institutions like UW -- those credentials offer limited value if he is not personally involved in your treatment. These are important factors to weigh when making a long-term decision about your dental health. read more