Orthodon­ists aren’t smil­ing about teeth-straight­en­ing star­tups

There’s more to treat­ing a smile than just mov­ing vis­i­ble por­tions of the teeth

The Borneo Post - Nature and health - - Front Page - By Janine Wolf

IT’S EAS­IER than ever to get straighter teeth. Or­tho­don­tists think that’s a big prob­lem. Where me­tal braces in­stalled in a doc­tor’s of­fice were once the only way to cor­rect mis­aligned teeth, a new method that uses re­mov­able clear align­ers can elim­i­nate a visit to an or­tho­don­tist and save pa­tients thou­sands of dol­lars. That’s what led De­niece Hud­son, who al­ways dreamed of hav­ing straighter teeth, to a startup called SmileDirec­tClub. Hud­son, a 24-year-old Ge­or­gia South­ern Univer­sity grad­u­ate, vis­ited one of the com­pany’s re­tail out­lets in an At­lanta strip mall in Fe­bru­ary to have her teeth scanned. That ex­pe­ri­ence would turn out to be her only in-per­son in­ter­ac­tion with a med­i­cal pro­fes­sional dur­ing a nine-month jour­ney through the grow­ing field of tele-or­thodon­tics. From the scans, SmileDirec­tClub used 3D print­ers to cre­ate 24 trays of trans­par­ent plas­tic braces, which were de­liv­ered by mail with in­struc­tions on when to switch trays. Den­tists mon­i­tored her progress by look­ing at self­ies she sent over the in­ter­net. The only thing she ever learned about the physi­cians treat­ing her was their last names. “I trusted the com­pany enough to not ac­tu­ally give me some­one who didn’t know what they were do­ing,” Hud­son said. The pro­gramme cost US$2,170, com­pared with the US$5,000 to US$8,000 for a tra­di­tional or­tho­don­tist us­ing the in­dus­try-lead­ing In­visalign sys­tem cre­ated by Align Tech­nol­ogy Inc. With one month to go in her pro­gramme, Hud­son says she’s sat­is­fied with the re­sults. “I used to be so ner­vous, but now I’m al­ways smil­ing,” she said. Hud­son may be grin­ning, but a grow­ing num­ber of or­tho­don­tists aren’t. In­stead, they’re warn­ing con­sumers about the pos­si­ble dan­gers of un­der­go­ing a com­plex med­i­cal pro­ce­dure with­out the in-per­son su­per­vi­sion of a den­tal pro­fes­sional. The main orthodon­ists’ trade as­so­ci­a­tion has filed com­plaints against SmileDirec­tClub with 36 state den­tal boards and at­tor­neys gen­eral, al­leg­ing reg­u­la­tory and statu­tory vi­o­la­tions. “I don’t think the di­ag­no­sis can hap­pen with three clicks,” said Hera Kim-Ber­man, a clin­i­cal as­sis­tant pro­fes­sor at the Univer­sity of Michi­gan’s depart­ment of or­thodon­tics and pae­di­atric den­tistry and the pro­gram di­rec­tor of or­thodon­tic grad­u­ate train­ing. “These com­pa­nies treat them as con­sumers, as clients, and that’s re­ally the ma­jor dif­fer­ence.” About 300 mil­lion peo­ple world­wide with teeth mis­align­ment could ben­e­fit from straight­en­ing yet are un­likely to seek treat­ment through a tra­di­tional doc­tor’s of­fice, ac­cord­ing to a Fe­bru­ary se­cu­ri­ties fil­ing by Align. The global or­thodon­tics mar­ket, which in­cludes tra­di­tional braces, is pro­jected to in­crease to US$2.6 bil­lion by 2023, from US$1.5 bil­lion in 2016, ac­cord­ing to Al­lied Mar­ket Re­search. SmileDirec­tClub, which is closely held, is the most prom­i­nent of a grow­ing batch of star­tups seek­ing to cap­ture that mar­ket. Since launch­ing in 2014, the com­pany says it has treated more than 250,000 pa­tients with cus­tom-made align­ers. It de­clined to dis­close sales fig­ures. Two key fac­tors are driv­ing growth of the tele-or­thodon­tics busi­ness. More so­phis­ti­cated 3D print­ing now al­lows com­pa­nies to use dig­i­tal scan­ning to cre­ate cus­tom-made clear plas­tic align­ers and re­tain­ers, which are re­plac­ing the un­com­fort­able me­tal braces used by or­tho­don­tists for decades. And last Oc­to­ber, In­visalign lost its ex­clu­siv­ity on 40 patents that kept it as the lead­ing clear-aligner brand, open­ing the door for new­com­ers like SmileDirec­tClub. “There’s more to treat­ing a smile than just mov­ing vis­i­ble por­tions of the teeth” “A lot of our cus­tomers at one point had braces, they for­got to wear their re­tain­ers, their teeth shifted a lit­tle bit,” said SmileDirec­tClub co-founder Alex Fenkell. “And be­fore SmileDirec­tClub, they were look­ing at US$5,000 to ad­dress some­thing that they’ve al­ready in­vested in; it just wasn’t mak­ing sense to them.” – Wash­ing­ton Post.

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