I keep hearing people talk about offering clear aligner therapy, using third party financing and how much they love the mouth vibrators that allegedly make the trays work better and faster. People are really excited about this combination but I’m not sure anyone has stopped to do the math. Let’s take a look.


$5000 case fee

-$745 (14.9 % third party financing fee)

-$1500 (clear aligner fee)

-$800 (mouth vibrator average cost to doctor)

-$115 (@5% local/state use tax on aligners and vibrator)

= $1840 (collectable fees)


But wait, you disagree? You are super duper elite and only pay 1000 bucks for your aligners and get a deal on mouth vibrators and only pay 500 bucks each? Awesome let’s add that 800 bucks back.


= $2640 in collectable fees per case


I don’t know about you but I would much rather offer regular old braces (@200 bucks per case in expenses) for $2999.99 instead of the aligner scenario! Which do you think will bring in more new patients – $5000 for aligners or $2999 for braces? If you said aligners, please take a moment to slap yourself for me.


Do the math.

I didn’t even add in the cost for the PVS material or, worse yet, the $25,000.00 scanner that you have or want or have ordered but have to wait until next year to get because everyone and her brother have ordered one too….

8 thoughts on “Don’t Be Dumb – Do The Math



    Thanks for thinking beyond the thrill!

  2. Dad, you nailed it as usual.
    Having the cool tech is becoming the latest game of “keeping up with the joneses” for orthodontists. We gotta be smarter.

  3. To be clear, I’m not suggesting that anyone SHOULD charge 2999 a case, only demonstrating that you’d be BETTER OFF, get more new patients in the door and make more money to do that as opposed to doing aligners, third party financing and mouth vibrators.

  4. Totally agree with the above, given that the doctor is operating under capacity. At full bore, aligner treatment can open up chair time and increase overall profitability. Of course, the math becomes a little more complex. Thanks Ben!

  5. Brian thanks so much for raising this point. I am sure many more people were thinking it!
    I hear what you’re saying and I know lots of people talk about that being a reality but I have to tell you that I did a significant number of aligners and went full bore for some time but didn’t see the resulting profitability. I don’t claim to be a genius or an awesome orthodontist but I’m an awesome implementer and I went all in. I do know a few gals and guys who do very well with aligners but they are practically gods among men – Jason Tam and Anil Idiculla to name a couple – and I don’t see us mortal orthodontists being able to approach what they do. If you can then good for you! If you want to learn how they do it, come to TheMKSforum.com and hear them in person. I also have personal knowledge of several big time aligner guys who struggle with their monthly aligner habit bill, who are on “credit hold” with the vendor or who have significant balances carried because they speak for the vendor. This is the state of most of us mortals who try to play the aligner game “full bore” I’m sorry to say.
    I do agree with you that if you are truly at capacity then things like “increased capacity, reduced chair time and less doctor time” do come into play. The problem is that almost zero doctors are at true capacity and even if they are it is far less expensive to visit a practice that does more and learn how to increase capacity than it is to buy technology and pay monthly for using it.
    Another problem is that vendors (and thus orthodontists) talk about things like “profit per visit” because it makes the product look better. However looking at orthodontics like an accountant rather than like an economist is dumb unless you are truly at capacity because you have fixed and variable expenses to contend with.
    I know what I’m saying flies in the face of what most orthodontists believe and I know that most orthodontists believe that “you have to offer aligner therapy because patients demand it” but remember that there is a reason profit margins are shrinking and we are loosing ground and getting out competed as a profession. We know about moving teeth but are very vulnerable to professional salesmen with well designed pitches and products that appeal to our vanity. We shouldn’t abdicate our authority or responsibly and allow patients to dictate what we use to treat them. If you told your mechanic what parts and tools to use to fix your car, could you hold him or her responsible for a bad result? Do you think they would “take the case” if you tried to make them do it based on an Autozone ad you saw? I think not – mechanics are smarter than we orthodontists from what I’ve seen.

  6. Great article… Also with cash flows, how many people collect the down payment that covers that huge up front costs of aligner treatment with vibrator with tax and how many people are knocking down the front door to pay $2000 up front in costs…

  7. Great point. I feel that this is the biggest deterrent to doing more aligners in my office. I am super small and cannot take the big hit of a lab bill if a patient decides to change their mind after I have already ordered the manufacture of their of aligners. So I have no choice but to ask for the larger down payment upfront. And like you said, few patients these days can afford that.

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