Or at least we tried very hard to tell you.

Read this press release about the arbitration results between Align and SDC if you haven’t yet. 

DTC aligners are a thing. Teledentistry is a thing. The orthodontic space is changing and the mighty are not assured of their positions. The old standards and delivery models have their place and probably always will to some degree, but they are woefully behind. It’s fun to watch orthodontists defend the status quo in general and Align specifically, while hoping aloud that the co-branded doctor/Align stores won’t have to close. We aren’t sure why they care so much (other than those doctors who “own” stores with Align of course). Align may indeed see this as a “pivot” and part of a bigger strategy as some suggest now that the ruling has come down, but we doubt it because the leadership at Align thinks too much like orthodontists and therefore will never compete with the new DTC aligner companies in the long run (or even the short run).

The Innovator’s Dilemma was never more applicable than today.

Consumers of orthodontic treatment have dominion over their bodies, a right to choose who and how they are treated, a right to access information (including price) and they are starting to figure that out despite what orthodontists think should happen. Orthodontics is a non-invasive, elective and largely reversible aesthetic procedure – we are much more aesthetician than medical doctor and the sooner we own up to this the better our lives will be.

Licensed dentists have the right to practice within the law no matter how you think the law should read or what the prohibitions should be. Scanning (aka taking a series of photos of the mouth) is not practicing dentistry and it is not “taking impressions for a working model” no matter how much you wish it was. The attempts to change the laws to include scanning in order to protect the dental cartel will generally fail in the short term and all fail in the long. Look at the attempts medicine made to protect their cartel decades ago and how that worked out if you don’t believe us. It will only get worse (for traditional orthodontists) while getting better for patients and those on the right side of access to care unless the orthodontic profession is truly able to understand what is going on, change mindset, and get on the right side of access to care. It’s improbable but very possible. Maybe it will happen when all of the AAO’s futile attempts to block DTC aligners at the state board level fail (and they will) and orthodontists will wake up and smell the new reality?

Marc and Ben

16 thoughts on “We Told You So

  1. Ben and Marc,
    Y’all keep telling “traditional orthodontists” to wake up, smell the coffee and accept that people want places like SDC and Invisalign stores and take home Ortho, etc. They know people want that! They get it! Y’all keep saying the same thing over and over and over again. It doesn’t mean they have to accept that this is what’s best for the uneducated consumer. People want diet pills to lose weight too. It doesn’t mean that’s a good idea for everyone
    …(or anyone). I got scanned at SDC last week. It was such a joke. I won’t get into it on here. Specialists should continue to fight for their profession and for their patients. We know that a lot of this is crap treatment. So why lay down and accept that this is way it’s always gonna be?

    1. Preach brother and then send this link to all the orthodontists you sell brackets to and the ones you hope to sell brackets and aligners to. As a 3m salesman I would take the same, protectionist, illogical, unethical position. But as an orthodontist I’d say 1) your assessment of orthodontic treatment is no better than the people you call ignorant because you’re not an orthodontist or even a dentist, 2) people want beer and that’s not good for them either so are you suggesting that we should prohibit them from partaking? 3) let’s have this conversation again in 5 years 4) I do braces for my patients almost exclusively (I’ve done 4 aligner cases out of @ 600 cases in our startup practice) and I encourage doctors to do braces not aligners, 5) pointing out some DTC aligner cases where someone is unhappy or the result wasn’t perfect is fine as long as you also consider the thousands of unhappy people and imperfect cases that orthodontists produce annually.
      You don’t have to agree with the weatherman but you’ll get rained on all the same. But then again you may be right and we may be wrong. I’ve been wrong many many times before and if I am then I’ll change as I have many many times. The question is who is more credible? A bracket salesman or an experienced orthodontist who has practiced on both sides of the fence.
      Thanks for commenting.

  2. There is room for everyone. As a retired orthodontist (40 yrs) and now marketing consultant, I think the biggest fallacy is that all prospective new patients want the same thing. Some want the lowest price, some want the most convenient, and some want the most ideal treatment provided by an experienced trained specialist that practices in their community. The problem for “traditional” ortho practices is that to a new patient everyone looks the same. That needs to change. There is room for everyone.

    1. Holy smokes! I actually totally agree with your assessment, Leon. It’s not a common occurrence (not that you care or that we should always agree) but I have to give you huge props on your explanation of the situation. Well done sir. I will be paying more attention to what you say in the future.

  3. True. I am a bracket salesman. And I sell clear tray aligners too. My main point is that I think most private practice orthodontists are more and more aware of what the market is demanding everyday. And at the end of the day, people want speed and aesthetics at a fair price. Some have and will get that with treatment not supervised or planned out by a specialist or even a general dentist. But most wont. The historic business analogies when trying to make points about where the specialty is headed or how we get here don’t always equate. Like I’ve said before, you always get us thinking and the profession needs that. I still think, however, that many of these new business models have foundations laiden with duping the consumer. And I think the average consumer may be smarter than you think they are. But dang I need to get off my phone and go sell some stuff 😉😂.

    1. Once again you are making the assumptions that orthodontist clients make but without the technical knowledge to do so. Invisalign did no attachment aligners for years before they decided globs of glue were aesthetic and orthodontists freaking love Align (just because it’s been around so long). HSO is offering “attachment less” aligners and the HSO groupies are eating that up. Doctors are doing doctor less consults, scanning on non-patient days, giving the entire box of aligners to patients (and have been for years) but this is just fine. The AAO guidelines say the records needed are up to the doctor and the British society of orthodontists says that radiographs are not needed for simple cases and that is ok. I see unhappy and effed up patients treated by orthodontists – and many of them board certified orthodontists – but that is ok? You are not only off base you are dead wrong when you assert that people shouldn’t be able to choose. Orthodontists treat less than 1 percent of the american population. That is not serving the public good any way you slice it. Worse still is their refusal to change now that the demand is clear.

  4. I said people shouldn’t be able to choose? No I didn’t say that. I’m saying that when the public sees an ad for DIY ortho or their GP says they can straighten their teeth or a company that only sells aligners says every malaclussion can be treated with aligners, the patient isn’t getting all the info. And you can make other analogies about other businesses or products like beer (I love beer) but it isn’t always a good way to anologize to the specialty of orthodontics. Doctor less consults, attachment less aligners (every company who makes aligners has these), non doc scanning days are all great. Those aren’t the same as DIY ortho companies. Totally different.

    1. Dude you crack me up. DTC is not DIY no matter how many times you say it. It is treatment rendered and overseen by a licensed dentist in the state where the patient is. That is a fact. Your opinion on the technical issues of orthodontic treatment don’t hold any water because you are a salesman not a dentist. Your assessment of what and what does not happen in DTC treatment and in traditional orthodontic treatment is not accurate and total speculation because you have never practiced either. I have. I’m done wasting time with you. Go ahead and post all the comments you want here but I don’t know how else to explain it – perhaps you can’t understand what I’m saying due to your lack of a formal dental education? We obviously disagree but again, what status, education, degrees, experience do you have that gives you any credibility outside of convincing people to buy expensive brackets from you? The only reason orthodontists/dentists may agree with you is because you are parroting the popular party line. We can revisit this conversation in 5 years and we will see who is right – possibly neither of us. But I won’t spend any more time arguing treatment, theory, philosophy or ethics with someone who is clearly trying to take us on to look good for clients and potential clients who buy into the AAO’s groupthink in order to sell product. Have a great week.

  5. I’ve never pretended to be nothing more than a salesman. You know way more than me about moving teeth. Nobody would argue that. None of what I’ve said on this forum is me pretending to be an orthodontist or knowing anymore about treatment, etc.

  6. “You make assumptions”, “You crack me up”, “I’ve done it every way and failed yet I still think I’m a superstar”, “Traditional Orthodontists are in trouble if they dont…..”, “I knew it” (even though you’ve claimed to know the future plenty of times in the 5 short years I’ve been in the ortho world)…..I haven’t read this trash in a while, but its good to see things haven’t changed. You guys really do make me laugh….Here’s your gentle reminder that you’re still irrelevant despite attempts to convince yourself and others otherwise!!

  7. As the owner/operator of the only co-branded Invisalign Experience Center that is open to the public already, I believe that my knowledge of the situation may be somewhat more intimate than most. (Except for Ben’s pipeline into SDC)
    While I believe that fixed appliance orthodontics is a proven and reliable way of doing orthodontics (I taught at the graduate level for 29 years) I prefer doing Invisalign to doing fixed appliances. After roughly 40 years as an orthodontist I get to choose who and how I treat people, just like decades of patients have chosen to be treated or not treated by me. I offer a choice for those that want their teeth straighter and functioning better but who have not been treated because they don’t want “braces”. And for the record, 3000+ cases using Invisalign and a duly earned reputation as a very good orthodontist I believe qualifies me to comment.
    I have been told why Align and SDC got together initially (by people in a position to know) and personally never cared one way or another. Now that they are going thru their divorce, I could care even less. Corporations are in this for their own reasons and I do what I do for my own reasons.
    I can’t imagine how SDC can take issue with my practice. I own it 100%. I paid for it 100%. And run it with nothing directed by Align. I charge the same fees as in my other two traditional locations. My contracts are the same and the payment plans are similar (we are experimenting with approaches similar to what OCA did years ago in the new location). My fees are my choice. Patients are free to choose where they are treated just like they choose where to eat.
    I am experimenting with a different location design and access to care hours. We have a licensed dentist in attendance every hour that we are open and take the same records that we do in the other two offices (including CBCT).
    I’m not thrilled about SDC in general – not the model for healthcare that I would choose – but I understand. I do wish that radiographs were part of their diagnostic records and that they were more transparent about the role of a licensed provider in designing treatment. Given the number of patients being treated and the estimates of the number of “doctors” involved, those “guys” must be working 24/7.
    Not going to waste any time in saying that you get what you pay for and all that. The market forces that are changing the delivery of everything will sort this out. I will adapt and continue to do my best to provide quality care, and support the specialty that I am proud to be a part of.

    1. Just as an update – Ben was right – I got my Cease and Desist Threatening letter from SDC yesterday.

      I am the sole owner and operator of 3 orthodontic practice locations (two of which were opened before SDC existed) with no contractual ties or business arrangement with Align beyond the license to use their trade mark and provide Invisalign as I have for 19 years.

      I am supposed to stop the following practices/procedures in all three of my office locations (even the one that has been in operation for 19 years):

      “Informing and educating consumers regarding teeth straightening; obtaining pertinent medical and dental history necessary for the doctor’s (my) decision; scanning and photographing consumer’s teeth to enable a doctor (me) to render services to the consumer; simulating correction that may be obtained to help the consumer decide if clear aligners serve the consumer’s objectives; preparing a draft treatment plan for consumers who have visited the store (private practice – mine);” etc.

      I am sure that none of you would attempt to violate SDC rules and regulations for the dental / orthodontic profession by doing any such things!

  8. You had me in the comments until you discredited a guy because he wasn’t “a dentist”. His opinion is valid, and he makes good points, even if you see right through them. Address him on his ideas, not his credentials. On the DIY vs DTC topic: I’ve read the post, and I agree with your main points, but let’s clarify what you describe as “treatment rendered and overseen by a licensed dentist”. I am a dentist, and know dentists who oversee these cases. They clicked accept, and collect $50. They even print the name of the dentist on the bag… but can the patient contact them? Have patients in SDC contacted you? I looked up the Texas Dentist, Dr Gary Chapman, and his license leads to a PO Box in El Paso. Do you think he practices there? In my eyes, it is supervised neglect, and may follow the letter of the law (I’m no lawyer), but not the intent. That said, I agree that the patient deserves this option.

    Leon Klempner hit it out of the park with his comment.

    1. I explained why I disagree with Ryan on the facts multiple times but the fact that he is a bracket salesman and not a dentist is pertinent when it comes to credibility of opposing views. He was my 3M rep when I lived in AR, I know him well and he’s definitely trying to curry favor with customers/potential customers by parroting the aao party line. I’ll stand behind what I said. As to supervised neglect I see that daily here in Orlando from traditional orthodontists – treating patients involves responsibilities no matter what the delivery mode and the dental practice act defines those responsibilities. They apply equally to all delivery modes. If a dentist neglects these responsibilities that’s on them not the delivery system. I absolutely dealt with sdc customers who had questions, comments or concerns when I was an ELP. Regularly. If someone wants to just click approve and get paid they can do that with Align cases in and office just as easily as they do it with any aligner system and any delivery system but they are all on the hook for the outcome reguardless of delivery system. Thanks for commenting.

      1. No problem, and I am so impressed in your responses. Your point of view challenges the status quo in a good way. People are reading. Continue to ignore the Chris Feldman’s of the world. If you want a good read, check out Aligner Nation on facebook. I posted an open letter to Align and the Dentists that use their products.

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