StraightSmile Solutions®

Orthodontic Emergencies

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Clear Correct Treatment Plan

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Wisdom Teeth and Braces

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Underbites and Class III Bites

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What it’s like to get an Invisalign / iTero scan

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What Age Should You Stop Thumbsucking?

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Orthodontist Turned Mystery Shopper for a Day: My Invisalign Store® Experience

Click here to watch the video.

Note: The opinions presented below are that of the author, and have not been verified by Align Technology®. Multiple attempts were made to both contact the Align® Corporate team by email, but as of the date of this publication, Align® failed to return the inquiries.

As an orthodontic consultant and the CEO of StraightSmile Solutions®, I am frequently asked to forecast Align Technology’s® next strategic move. Take a moment to peruse the hundreds of dentist forums on Facebook® and you’ll see the full spectrum of emotions the dentists embody towards this corporation: admiration, disgust, rage, and fear. Don’t get me wrong, I have tremendous respect for Align Technology’s® clinical products. Over the span of the past two decades, they have single-handedly changed the face of an entire profession.

Contrary to their other ventures which were quite ostentatiously celebrated on social media, in Q4 2017 Align® demurely launched its first brick and mortar “Invisalign Store®”. This shop is located on some of the most expensive real estate between the Cow Hollow and Marina districts of San Francisco. It is nestled nondescriptly between bourgeois shops like an organic baby food store, a Starbucks Reserve® (look that up if you aren’t familiar!) and various concierge medical practices and holistic wellness centers.

As a Bay Area native and a citizen concerned about corporate cannibalization, I openly welcomed the request from a client to visit the store to learn more. Evidently, I wasn’t the only orthodontist who was concerned. As I was walking into my appointment, the manager was very professionally escorting an enraged orthodontist from New York outside to answer his questions more privately. The treatment coordinator apologized for the disruption and proceeded with the appointment.

Initially, setting up the appointment online was simple, but it was not without issues. In my opinion, the site was rushed and not thoroughly vetted and de-bugged. My appointment was canceled and rescheduled due to a change in hours. When I arrived, I was asked to log in to the site. There were some technical malfunctions in the process as well, and it took about 15 minutes and several managers to resolve it. In contrast to the smooth and seamless scanning experience at a competitive DTC aligner company, this process was not yet idealized. I was also given an online medical history, which was pretty standard.

The décor was high-end, which matched the clientele they are courting. It looked more like a luxurious living room with recliners instead of dental chairs. Unlike the DTC scan center nearby, no swag was distributed. It was a no-nonsense records appointment My scanner was a licensed RDA who scans as a 2nd job. She was clearly experienced. I tried timing the scan in my head, but I think she completed it in less than 3 minutes for both arches. She was swift and comfortable with the intra-oral photos as well. She followed OSHA regulations perfectly.

After the scanning session, I was sent to the treatment coordinator who was supposed to show me my outcome simulation. Unfortunately, due to the bugs in the system, they weren’t able to access mine. They told me that they would call me and let me know if I was a candidate for “Invisalign Deluxe”® or “Invisalign Signature”®. You are assigned the Deluxe® treatment if the outcome simulator designates you as 14 aligners or less. The beauty of this is that there’s a flat rate cost on this at $2499. You are given a list of 8-10 doctors in your area who are “recommended” and participate in this program. I was assured that at this moment, all the doctors are certified, orthodontists. If your case is staged on the simulation at over 14 aligners, you are still referred, but the doctor sets the price. Essentially this is now a Full® or Teen® case. I was told the average in the Bay Area was $5000-$8000. Because of the technical difficulties, they were unable to show me my selection, but I was told I’d be emailed it later. At this time, only doctors in the greater Bay Area are participating but they would be expanding to other geographic areas in the future. Once I selected my doctor, they would set-up the appointment.

The doctor would finish the Clincheck® and meet with you to complete the financial arrangements but I was guaranteed that if my case was less than 14 aligners that all the doctors they recommended would charge me $2499. This is the cash price. I imagine it’s not applicable if insurance is involved. I am not sure if this includes retainers or not. I was encouraged to “yelp” or research my providers and find the best one for me. Given that the 2018 doctor lab fee for Invisalign Lite® is $1199 and there are no volume discounts with these cases, this is a very slim profit margin for these participating doctors. They did not tell me what the fee for retainers would be and if the doctor could set their own fee. How does Align Technology® select the doctors who are allowed to opt-in to this program? My e-mails to Invisalign® corporate were not answered.

Ultimately, this so-called “beta”® store for Align Technology® is one more step in the direction of corporate cannibalization and will likely push many doctors towards 3D printing their own aligners. Trying to compete with the $2499 fixed price for a mild-to-moderate case will be near-impossible with such a high lab fee. By 3D printing your own aligners, your overhead can be as low as only $100 per case once you’ve purchased the initial equipment, which ranges from $30000-$50000. Depending on your volume, you can be in the black in just a month or two. You can also scan and deliver your aligners in just a few hours as opposed to waiting 2-6 weeks for shipping. If you are planning to do volume, this is the right direction to go. If you are hesitant about purchasing the equipment outright or staging your own treatment plans, connect with me and the StraightSmile Solutions® Team, as there are many hybrid options. If you have questions, visit my other blogs at or connect with our team for a 20-minute complimentary consultation and a review of your orthodontic overhead and process flow. You can schedule an appointment at In light of the unfortunate status of the 3-Shape/ Trios® users, StraightSmile Solutions® is also offering 60 days of upgraded services to all 3-Shape® doctors who sign up for services within the next month who are looking for alternative aligner companies. This offer is valued at $999 per doctor and is for a single doctor- solo practice. Contact our team for group-practice and DSO discounts.

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Should You Dump Your 3Shape Trios®?

No! 3Shape Trios Scanner is arguably the best scanner on the market today.

If you’ve been too busy with your shopping to keep up on current events in the dental industry, 3Shape® integration was abruptly “terminated” by Align Technology® this week, leaving thousands of dentists in a significant pickle. Without the ability to scan their new and existing patients for additional aligners or retention, dentists are forced to revert back to archaic technology and take PVS impressions to capture this data. As a result, my inbox has been flooded this today by dentists wondering if they should accept the Align Technology® offer of an iTero Element to replace their Trios Scanner for 15K.

I would like to encourage all the involved dentists to take a step back an explore your options first. StraightSmile Solutions® is offering every dentist a complimentary 1:1 consultation to discuss your alternatives. Visit our website at to schedule. Because of the time-sensitive urgency of this matter, we have extended our hours over this holiday season and are available every day for complimentary consultations. Please also feel free to visit our blog page to learn more about alternative aligner options in the US and abroad, as well as 3D printing and treatment-planning support.

The StraightSmile Solutions® Team wishes ever dentist and team a happy holiday and a fantastic new year.

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‘Twas the Night Before Align® Terminated 3Shape®

‘Twas the week before Christmas when all through the town,

not a dentist was working no-one was around…

The aligners were worn by the patients with care,

with hopes that a debond would soon be near.

When out in the mailbox arose such a clatter,

I sprang from my golf game to see what’s the matter,

I tore open the envelope and read through the letter,

Such terrible news, would it get any better?

It’s not only us but it’s all ’round the globe,

Dentists can’t believe the news they’ve been told.

That $20,000 you just spent on your scanner,

In 30 days time can’t be used in that manner.

The news as it hit me gave such a fright,

As my patients awaited we turned out our lights,

Our 3Shape® Scanner we could no longer use,

for Align® just brought us the Christmas Blues.

StraightSmile Solutions is the future of orthodontic coaching. We are the first online portal to provide a doctor-to-doctor consulting service that will allow dentists and their teams to access the knowledge and expertise of an industry expert, in order to enhance information sharing and efficiency in problem-solving. Visit StraightSmile Solutions to schedule today.

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October 2017 is a special month in the aligner world; this is the date of the first batch of Invisalign® patent expirations. What does this ultimately mean? Nobody knows for sure, but it should mean lower lab prices as competition confidently emerges.
Straumann® took a huge step in the right direction with its acquisition of Clear Correct® several months ago, and now Straumann® has also acquired a 35% share of the 3D printing company, Rapid Shape. If you would like to hear more about 3D aligner printing, you can click here.
Try a Google® search on clear aligners, and you’ll be surprised by the outcome: dozens of companies all excited to get a valuable piece of the aligner pie with lab fees of $500–$1,000. Try comparing this to the average Invisalign Full® or Invisalign Teen® lab fee of $1,800! With StraightSmile Solutions monthly unlimited coaching fees as low as $499, you can afford your own orthodontic coach by just completing one aligner case a month! Given that every new patient, recall patient, or hygiene patient is a potential orthodontic opportunity from age two to age ninety-nine, it should be easy to start dozens of cases a day. Imagine your potential and profits! If you aren’t sure about the options in the early/interceptive orthodontic arena, do take a look at my previous blog post here.
Which cases are appropriate for in-house aligners or generic aligners, and which cases are better for branded aligners? The answer comes down to both volume and biomechanics. As the original dental director of SmileDirectClub® and now founder of StraightSmile Solutions®, I’ve seen a lot of aligner treatment plans and amazing outcomes come my way. You’re fooling yourself if you think that Invisalign® technology or even attachments are required for an ideal outcome in all cases. It’s not. The vast majority of cases can be treated either without attachments or with more simplistic attachments that are available with the in-house/non-branded aligners. You don’t need G5 or G6 technology for the average case.
The key to success is case selection. I would recommend treating only mild to moderate, adult dentition, Class I malocclusion cases with the in-house or generic aligner option. I would also recommend learning some straight wire biomechanics. These can be taught by an orthodontic coach or at one of the many weekend orthodontic courses, like Six Month Smiles®. Want to hear more about their course? You can click here.
If you need guidance on case selection, I always recommend that general and pediatric dentists have an orthodontic coach help guide them through the case selection and assist with some of the obstacles they may encounter through the duration of the treatment. StraightSmile Solutions® is the first online portal to provide a customized orthodontic coaching solution for every practice. Visit to get started.

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