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November

2023

The Whole Tooth: The Highs and Lows of Clear Aligner Therapy

By Dr. Robert Kelly, D.M.D.

The Whole Tooth: The Highs and Lows of Clear Aligner Therapy

Since Invisalign transformed the dental landscape with widespread aligner therapy for orthodontics, there have been many other companies duplicating its product in the dental industry.

Aligner therapy is the use of clear plastic trays that are changed out in a systematic order to move and straighten teeth just like traditional braces do. In some situations, traditional braces are still better, leading to more predictable, quicker and better results. There are some more challenging teeth movements that aligners may struggle to accomplish properly.

However, for many cases, aligner therapy can be a great alternative. One obvious advantage is that they are clear and so more invisible in your smile. Another advantage is that you can take them out to eat and clean your teeth, so it is usually not as difficult to keep your teeth and gums healthy, versus having braces.
There has been an explosion of other companies that have utilized aligners for orthodontics. Some of these companies have good reputations – I have heard and seen good things about them. They are from tried and true dental manufacturing companies that produce a good product. Some companies have not been as good. I have seen some patients who have tried the mail order aligner companies and have not found this to be a good experience for them. While there may be patients who have had good experiences with this, all of the cases that have shown up in my office mid-treatment or at the end of treatment have not been happy patients.

One of the biggest competitors to Invisalign in the past decade has been Smile Direct Club. According to Bloomberg News, the company sells low-cost teeth straightening and grew very quickly after starting up in 2014. Ultimately this led to Smile Direct Club going public in 2019, raising $1.35 billion. When the company first went public it was valued at $9 billion! It got listed on the NASDAQ stock exchange and the founders became billionaires! The future was bright. Four years later, it is a very different story. The company has $5 million on hand and has filed for Chapter 11 bankruptcy. If they do not find a buyer before November 23, they will have to liquidate and close. There are about 1800 employees in Smile Direct Club.

I am not an economics expert, so I am sure there are many factors that led to this debacle. It does highlight how quickly the world of business moves sometimes. There are so many industries that have rapid rises and falls. The cryptocurrency company FTX recently, and the medical device company Theranos many years ago, come to mind. Who knew the dental field would have its share of epic highs and lows too! No one ever said capitalism was boring!

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