Author: Konstantin Pipunurov
Direct to Consumer (“DTС”) aligner vendors is a relatively new trend in the orthodontic market. Relying on massive investment in online and offline marketing, such companies offer teeth straightening services to consumers directly, bypassing dental professionals altogether. The premise behind this concept is quite simple: treatment planning and ongoing supervision of aligner treatments can be done virtually and remotely so it is not imperative for the patient to use the services provided in the dental office. In the absence of any direct dental supervision, thousands of dollars can be saved by avoiding the dentist's fees. Smile Direct Club, the leading DTC company in the US charges less than $2,000 for full treatment. That’s significantly lower than the $5,000 charged by a specialist orthodontist for aligners treatment.
Given the simplicity of this concept and the considerable savings offered, no wonder that DTC aligners are experiencing rapid growth. However, despite the hype and massive marketing campaigns DTC aligners also feature some real and substantial drawbacks, when compared with traditional aligner therapy:
This method can only be used for simple aesthetic corrections, mostly addressing anterior-only alignment. More severe orthodontic indications, as well as bite corrections, are excluded by definition.
Dental impressions have to be taken by the patient. For this purpose, usually, a dental impression kit is mailed to the customer along with detailed instructions. Since dental impression taking requires special training, no wonder then that the quality of home-made impressions is a major issue for the DTC vendors. Many times, customers have to repeat this process a few times, until the quality of the impressions is sufficient.
Modern aligner therapy relies extensively on attachments, small composite bubbles that are placed on the teeth at the onset of the treatment, serving as much needed anchorage points . DTC aligners cannot use attachments as they can only be placed in a dental office. As a result, multiple aligner vectors, such as rotations or extrusions are not present in DTC aligners, which in turn limits the quality of the correction provided and/or unnecessarily prolongs treatment duration as a result.
No interproximal reduction (IPR). Crowding is a common orthodontic indication and a key complaint for patients seeking aligner treatment. To create some space allowing the teeth to align, dentists grind some tooth surface using special diamond strips. With DTC aligners, this procedure can not be carried out as there are no dentists involved in the process.
Lack of dental supervision. In the absence of periodical visits to the dental office, it is quite difficult to supervise the course of the treatment. Some DTC companies offer remote, virtual monitoring but there are no established protocols for this method. Not seeing a dentist during the treatment leaves patients with the need to decide on treatment progress, a task that non-dentists will find impossible to perform.
Yet, despite the above limitations, the DTC approach appears to be gaining momentum. Smile Direct Club has reported treating more than 0.5 million people to date. The company is also planning to raise additional $1.2 Billion by floating its shares, which in turn would provide even more back wind to its already-aggressive marketing efforts.
While traditional aligner vendors such as Invisalign and Clear Correct watch this market segment closely, the sector that is most threatened by the emergence of the DTC concept are dental GP’s who are currently providing aligner treatments to their customers. Today, aligners are provided by both specialist orthodontists and dental GP’s. It is a common belief that orthodontists treat all types of aligner cases, whereas the GP’s, in the absence of orthodontic expertise, tend to focus on minor to moderate malocclusion indications. Those cases are similar to what the DTC is focusing on. In that sense, the emergence of DTC aligners poses a major competition to aligner cases currently sold by dental GP’s.
The answer to the question above is quite simple - make aligner treatment more affordable to their customers. This cannot happen if they continue to use the services of traditional aligner vendors since lab fees from these companies are an obstacle to any major fee reduction. A new method of providing aligners must be adopted.
Luckily, with the in-office approach developed by eXceed, dentists can now reduce the price of aligners' lab fees significantly, Helping them to offer aligners to their customers at the same price of the DTC companies or at a slight premium. However, compared with the DTC concept, patients are treated in the clinic, with IPR, attachments, dental supervision and above all, a chance for a better orthodontic outcome. With eXceed, production costs for an average 40-aligner case are around $450. This compares very favorably with lab fees provided by First Gen. aligner vendors which are around $1500 for a comparable case.