December 11, 2017

Invisalign let us know what is going on!

Last week I wrote a very popular post about Invisalign, their advertising and the opening of an Invisalign store in San Francisco. Since then Jamie Morley who is the General Manager for Invisalign, UK and Ireland, has responded to me. He has provided clarification on some of the points that I raised. I thought that this was interesting and I have posted his well set out comments in this post.  This is great two way interaction and it is good that Invisalign have responded.

Invisalign response

I would also like to take the opportunity to comment on your recent blog post.  We realize you and your readers have some questions regarding some of our recent marketing activities, and I’d like to address some of those concerns and clear up a few misconceptions that we saw in your blog post.

Align is committed to helping expand the market for orthodontic treatment and connect more potential patients with Invisalign practices – that is at the heart of everything we do. We invest millions of dollars each year in technology innovation to advance the practice of orthodontics, and to build a brand that creates positive awareness of orthodontic treatment and connects potential patients with Invisalign practices.

The Invisalign pilot store

The Invisalign store pilot programme that we launched in November is an extension of our long-standing direct-to-consumer marketing programmes that connect potential patients directly to doctors for Invisalign treatment. This model relies on the doctor – and the doctor’s office – for treatment. We believe the Invisalign store pilot will encourage more people to straighten their teeth by engaging consumers who might not otherwise seek orthodontic treatment. The store concept leverages what is familiar to consumers about retail shopping. They can stop in, browse, learn, make a purchase decision – or not make one and just leave better informed.

The store allows consumers to learn about clear aligner treatment in a comfortable retail environment and uses a digital scan and simulation to help them see how they might look after Invisalign treatment. The simulation is not a ClinCheck treatment plan. Store employees are not treatment planning. They are discussing options, leveraging the power of visualisation, and helping interested consumers get started with an Invisalign doctor of their choice. Our in-store message to consumers is clear: we believe doctors play a critical role in your treatment from start to finish.

The advertisement

Similarly, the social media post featuring the image of dental tools that you referenced in your blog was intended to educate and inform consumers on the evolution of orthodontic treatment, in particular, how Invisalign represents the modern approach to straightening teeth with clear aligners.  Many consumers, especially adults for whom the post was intended, don’t realize that treatment options today have advanced significantly from what they might think, or from what they remember from their childhood. We recognize and regret the poor execution of this message in the social media post. Our intent was not to offend orthodontists or portray orthodontists as outdated – what would this serve? Align’s consumer marketing is designed to always, ultimately connect interested consumers with Invisalign practices, and we want and need consumers to think positively of orthodontists and teeth straightening.

There are millions and millions of people around the world who want or could benefit from straighter teeth. Reaching all of those people, helping them understand treatment options, and getting them started in treatment will require new approaches, new models. We’re committed to doing that in partnership with orthodontists.

Points in the blog post

Finally, there were several specific points in your blog post that I would like to clarify:

“Invisalign bought a large shareholding in SmileDirectClub (SDC)…”

Align Technology is a third-party supplier of non-Invisalign aligners to SDC and has a 19% equity investment in SDC.

“Invisalign is exploring a similar model. …(to SDC) with the opening of an Invisalign store…”

The Invisalign store pilot is a different model from SmileDirectClub. First and foremost, consumers who explore Invisalign at the Invisalign store must see an Invisalign doctor in their practice to start treatment. The objective of the Invisalign store pilot is to reach more consumers, educate them about how they could look with a better smile, and connect them with an Invisalign practice of their choice if they decide to pursue orthodontic treatment.  We are engaging with consumers in a new way, but our goal remains the same: get more patients started in treatment with an Invisalign doctor.

“The staff, who may not be dentally qualified, discuss treatment and scan their teeth…”

The Invisalign store retail staff is trained to conduct intraoral scans and to educate and inform consumers about their options for obtaining a better smile with Invisalign.  They explain the process for selecting an Invisalign doctor of their choice who will make all decisions regarding treatment and who will conduct a physical examination to confirm the consumer is a good candidate for treatment before that treatment starts .

“The technician then builds a ClinCheck and discusses this with the patient.”

The Invisalign store does not show consumers a “ClinCheck treatment plan.”  If the consumer gets a complimentary intra-oral scan, then they will see an Invisalign simulation so they can visualize what their smile might look like after Invisalign clear aligner treatment.

“The patient selects a local dentist/orthodontist to monitor the treatment.”

The doctor the consumer selects does more than monitor treatment. The Invisalign doctor selected by the consumer will create a ClinCheck treatment plan for that consumer and send it to them for review. Invisalign treatment will not start until the consumer has reviewed and approved the treatment plan prepared by their doctor and their doctor has conducted a physical examination of the consumer and confirmed they are a good candidate for treatment.

“The patient then attends the dentist/orthodontist to have their aligners fitted and treatment monitored.”

Per above, the doctor does more than monitor treatment. The consumer must visit the doctor’s office and have a physical examination by the doctor before they can receive clear aligners and Invisalign treatment can begin.

“I think there are several issues. These are concerned with whether a dentist examines the patient in the Invisalign store.”

Align does not practice dentistry and is not treating patients in the Invisalign store. Consumers who subsequently elect to become patients see a doctor in the doctor’s office. A consumer from the Invisalign store cannot receive clear aligners and Invisalign treatment cannot not start until the consumer has reviewed and approved the treatment plan prepared by their doctor and their doctor has conducted a physical examination of the consumer and confirmed they are a good candidate for treatment.



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Have your say!

  1. So it has boiled down to this. The rebuttal does not mention anywhere the importance of scientific research or evidence gathering in formulating treatment options for patients. Or the relative effectiveness or suitability of aligners compared to braces for patients who come to Orthodontists for advice. Instead, the letter focuses on issues of marketing, retail leverage, etc and to put it bluntly, selling treatment to patients who might otherwise be best left untreated. I think Orthodontists deserve this state of affairs and have only ourselves to blame that for the last 100 years, we have too often embraced a culture of guru orthodontics and neglected the importance of scientific methods. When everyone can straighten teeth, why should new patients look up to Orthodontists as experts? I worry about the present and future, and often think about the opening lines by Pink Floyd “So, so you think you can tell, heaven from hell…”

    • Beautifully and concisely put – you have encapsulated everything I believe. We are great at pointing fingers and complaining, but not at actually doing something (research etc) – yes all of us – and not at acknowledging our own serious complicity in the entire gradual destruction of the profession. We are pretty much a bunch of boiling frogs as a profession and are getting what we deserve for abandoning science and truth for money and marketing. I think research and evidence is not just a tool – it is the ONLY tool we have to credibly restore ourselves. I only hope it is not too late

  2. Both parties (Kevin and Invisalign) should not cross the legal and the ethical boundaries. Since Invisalign apologized, all are almost back at the initial position.

  3. Kevin, maybe your rep can add a few more specifics. First. Is the purchase for treatment actually made at the invisalign store? Your rep uses the phrase, “make a purchase decision”. This is an uncommon phrase which I believe was carefully chosen for its ambiguity. Does money change hands at the store? The the payment for the lab bill? The orthodontist fee? Both? Does funds flow from the store to the provider? Second. If a purchase is made at the store where are the aligners ultimately shipped? To the orthodontist or to the patient directly?
    Oh! I’m sorry. I assumed “orthodontist “! How silly of me. Maybe I should have said “ Invisalign doctor”? But that degree doesn’t exist! Maybe he should have said dentist.

  4. One might notice the overwhelming use of the term ‘consumer’ (it is mentioned 21 times) instead of the term ‘patient’ (which is mentioned 3 times only) in this short response from a company representative. I think the ClinCheck treatment plan is the same as ‘Invisalign simulation’. In hindsight, institutions offering graduate orthodontic courses, orthodontic societies and, of course, leading orthodontists (who deliver Invisalign certification courses) around the world should have looked for solid evidences before promoting and advocating ‘Invisalign System’ as an alternative to traditional fixed appliance, orthodontists should be ready now to serve the ‘Invisalign Stores’.

  5. “Align’s consumer marketing is designed to always, ultimately connect interested consumers with Invisalign practices, and we want and need consumers to think positively of orthodontists and teeth straightening” How? By circulating offensive ads that disparage orthodontics? These thinly-veiled interloping attempts certainly don’t benefit the Practitioner-Patient relationship. The best treatment modality for patients can only be determined by orthodontic professionals and not some aligner company. If this type of advertising persists, Align runs the risk of destroying any credibility they might have once have had. Several practitioners are so distraught that they have either stopped aligner therapy, or are now endorsing other companies.

  6. if you are going to scan a person’s teeth and discuss treatment options, you are practicing dentistry. Period

  7. Invisalign take the teeth straightening out of the immensely important context, which is HEALTHCARE.
    Aligned and straight teeth is not, in itself, healthy teeth, healthy bit, healthy gums or healthy joints.
    As they are not providing the necessary mentoring around the use of their product, the cases selection and continuing education through continuing mentoring, then their product is set to fail for a certain amount of treatments, meaning patients health is at risk! In my opinion, that makes Invisalign a bad choice and and questionable product.
    They write that they use millions of dollars on developing the product, but obviously nothing on the most important, education.
    Please do better. With all that money, I know they can.

    • I think that this is unfair criticism because Invisalign (in the USA and Canada) has an Online Academy that provides education on almost any type of case including combined treatment with restorative and implant dentistry. The discussion is thorough starting with diagnosis, treatment planning, and then many cases illustrating the particular problem that is being discussed e.g. deep dental bite, posterior cross bite etc. This is available to any doctor that has an Invisalign account and avail themselves of this service. As far as support for the clinician, I had a chance to visit their global support center in Costa Rica and was very impressed with their operation. I was told that they have 80 clinicians on staff providing expertise on almost any orthodontic problem that is presented. I met with the doctor and the technicians that normally work on the cases that I send in and can communicate with them anytime I want. Also the company provides live seminars and webinars on a regular basis for the interested doctor. This sounds pretty good to me.

      Lastly, I am not a shill for the company for I neither own any stock in the company nor do I work for the company in any capacity, and I do recognize that Align Technologies can do things that are very annoying but I do think that they do a number of very good things.

  8. Pharmaceutical companies marketing directly to the public at least state that you should ask your doctor if this is right for you. Align’s response and behavior demonstrates their objective. This is not good for patients or the profession.

  9. I have a concern here and I would appreciate any inputs on this. Are all our concerns about invisalign unbiased or is there any chance that our concerns may b partly arising from the fear that what we do might be partly outdated by the technology?

  10. I think the word ‘consumer’ sums up the issue here. Im concerned about the precedent Invisalign sets in terms of other forms of treatment that could become detached from healthcare models, as Rikke V Jacobsen alludes to. What is next? Consider the way it affects how society thinks of treatment: Is it a good thing for treatment to be readily available on the high street? or does it encourage a society who are comfortable to rely on treatment rather than prevention? Tony Weir makes some very pertinent points however. Should any practitioner be comfortable selling not- so-quick fixes to a problem we don’t know the causes of.

  11. I can’t imagine why anyone would visit a store without a trained dentist to get Invisalign? During my appointment at my Katy dental office there was quite a bit involved with imaging and planning. I would stick to a trusted dentist for sure!

  12. I absolutely loved my Invisalign treatment in Burlington, MA! I was so worried I was going to have metal mouth when I decided to visit an Arlington orthodontist, luckily they told me I was a candidate for clear braces in Arlington. My entire treatment took only 13 months, was barely painful at all and none of my coworkers even knew I was undergoing orthodontic treatment until they noticed how much better my smile looked. I would recommend Invisalign to anyone interested in a more perfect smile, it was SO WORTH IT!

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