Traditional orthodontics remain popular, but the sale of invisible braces boomed during pandemic, and a 'high-stakes war' is on

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As invisible braces offered by Invisalign and direct-to-consumer companies like SmileDirectClub become more popular, the firms are in a "high-stakes war" with traditional orthodontists over how best to straighten your teeth, Nathan Bomey reports for Axios.

The new products are taking traditional orthodontists' profits, pitting them "against new upstarts against state dental boards, with millions of dollars in marketing and legal bills piling up along the way," Bomey reports.

Invisalign and consumer-direct companies like SmileDirectClub offer clear-plastic aligners that progressively straighten your teeth. The aligners can also be removed as needed. 

The difference between these two companies is that Invisalign involves in-person oversight from a dentist or orthodontist while consumer-direct companies allow users to obtain their teeth aligners through an online process that largely does not require office visits. Bomey reports, "Invisalign costs about $5,000 to $6,000 per case," while "SmileDirectClub typically costs a few thousand less." 

The American Association of Orthodontists has discouraged the use of direct-to-consumer orthodontics and has issued a consumer alert on its website that cautions: "Orthodontic treatment involves the movement of biological material, which could lead to potentially irreversible and expensive damage such as tooth and gum loss, changed bites and other issues if not done correctly." 

Bomey reports that while sales boomed during the pandemic for Invisalign and SmiledirectClub, they have since "trailed off over the past year, bruising manufacturers' stock prices."  

And after years of legal battles and aggressive marketing, SmileDirectClub is in "particularly rough financial shape,"  Bomey reports. And in an effort to increase opportunities for grown, SmileDirectClub has attacked state dental boards, which it views as protecting the orthodontics industry, he wriets. 

All that said, Jefferies analyst Brandon Couillard, who tracks the teeth alignment industry, told Axios that traditional braces are still used in about eight in 10 cases, including in most children -- leaving lots of room for the aligner industry to grow.