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The Surge in Teeth Straightening

The business of achieving a perfect smile is booming in the age of Zoom.

The Zoom effect is real. When consumers stare back at themselves for hours on end, it’s easy to find something to focus in on. Teeth being one of them. More specifically, their alignment.

That is driving a boom in the teeth-straightening market — from direct-to-consumer at-home make-your-own-mold iterations to new versions of lingual braces, and innovative ways to accelerate Invisalign treatment.

“We have seen a boom in all cosmetic dentistry, especially teeth straightening,” said cosmetic dentist Dr. Brian Kantor of Lowenberg, Lituchy & Kantor. “This is for a few reasons, everyone is on Zoom looking at their teeth and people are upset that they have crooked or dark teeth.”

The numbers bear out the anecdotal evidence: the World Health Organization reports malocclusion, or crooked teeth, is the third most prevalent dental disease after cavities and periodontal disease globally. According to Fortune Business Insights, U.S. Clear Aligners market size is said to reach $4.55 billion by 2028.

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Search data also reflects the booming trend. “We’re seeing more searches for teeth aligners than neck lift and anti-aging facial combined,” said Sarah Barnes, Trendalytics content marketing manager.

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Invisalign parent company Align Technology pioneered the invisible orthodontics market 24 years ago and new evolutions of that technology are covered by hundreds of patents today. In April, Align Technology reported its first-quarter clear aligner revenue was $753.3 million, up 7 percent sequentially and an increase of 56.4 percent year-over-year.

Grand View Research reported the teenage segment dominated the clear aligners market and held the largest revenue share of 73 percent in 2020. Teenagers prefer avoiding discomfort caused by metal braces and want something aesthetically appealing.

The growth of clear teeth aligners is also giving rise to a slew of new treatments in dental offices. New York City-based cosmetic dentist and founder of Les Belles NYC, Sharon Huang, has created a procedure called Propel to speed up Invisalign treatment time. “The aligner is the same,” Huang said. “We go in and create micro-perforations in the gums similar to microneedling to increase cellular activity so that the bone cells turn over faster.” Instead of wearing each Invisalign tray for 14 days, the patient wears each for about four. Propel, $16,00, which is not associated with Align Technology, is a one-time treatment.

“According to research, we’re able to increase teeth movement by 72 percent,” added Huang, who added her Invisalign cases are finished between one and a half to six months. The cosmetic dentist can also speed up the treatment further using high frequency, which increases teeth movement by 66 percent.

Huang also created a program called the Smile Preview to physically show her patients what their teeth will look like post-treatment. The Smile Preview, $300 to 3,000, is for those seeking veneers and looking for straighter and/or bigger teeth. “I utilize AI technology to incorporate each patient’s unique facial features to ensure the teeth fit their smile and face,” she said. “It’s a pain-free procedure, requires no anesthesia, and is 100 percent reversible.”

Another company innovating in the category is Spark, $3,500 to $8,000 for aligners, which primarily works with orthodontists. The company’s proprietary material is said to grip the teeth so that a patient won’t have as many refinements. “We recently introduced a new material called TrueGen XR, which is extra rigid,” said Sheila Tan, vice president of global marketing and clinical education at Ormco. “The minor movements at the end of treatment are hard to achieve and this takes care of those minute details.”

But certain brands don’t require a visit to a dentist or orthodontist. Candid, an at-home clear aligners company, was created as a more accessible model. “I was charging fees that most can’t afford,” said Dr. Lynn Hurst, cofounder and chief clinical officer. “It became an exclusive club of people who would come to my practice.”

Accessibility has become an important pillar of this new teeth aligners market with other direct-to-consumer players like Byte, which was acquired this year by Dentsply Sirona Inc. for $1 billion, SmileDirectClub and Alignerco, among others.

Candid aligners are $79 a month or $2,400. Candid clients can either order a kit to create their impressions at-home or visit one of 35 Candid studios, the brand’s retail locations owned by orthodontists, who will monitor treatment remotely after the initial appointment. The company also has an app where patients can do a virtual office consultation. Candid’s average treatment plan takes about seven months.

Most dentists aren’t a fan of at-home solutions that forgo a dental expert. “We do a lot of corrections,” Huang said. “The biggest issue is there’s no dentist to call. No one is supervising it. My certified dental assistants, when they start, it takes them about a week or two to get a really good Invisalign mold to capture all the details.”

Kantor agrees. “It’s great that these d-to-c aligners are cheaper and can reach more people, but when patients are doing this on their own without a dentist overseeing it, there are a lot of problems that can occur,” he said. “If you aren’t a good candidate to have teeth moving, for instance, if you have a lot of bone loss, decay or implants, there is a chance you won’t get them perfectly straight.”

Clear aligners aren’t the only invisible solution for straightening teeth. InBrace, $5,000 to $7,000, is a treatment that uses a personalized Smartwire worn on the inside of the mouth, for example. “The Smartwire is made out of space-age, memory wire,” said John Pham, chief executive officer and cofounder. “There are no monthly tightenings and you don’t have to switch out trays.”

And more are on the horizon. “Invisalign used to be the only company able to correct crowded teeth, but now there are so many advancements such as opening up the bite, closing bites, fixing class two or class three, it’s almost taking the place of braces,” Kantor said. “The future is endless.”