Straight Talk On Invisible Braces
Nov. 30, 2000 -- Forget the gunmetal-gray strapping -- it's not
the only way to get straight teeth. That's essentially the marketing pitch
behind a new type of orthodontic device that promises a straight smile while
being easy on the eyes.
The Invisalign process uses a series of clear, plastic molds to
gradually move the teeth. They're kept in place 24-hours a day -- except for
when brushing, flossing, and eating -- and changed out every two to three weeks
as the teeth straighten. The shape of the molds -- and hence the final position
of the straightened teeth -- is determined by creating a three-dimensional
"movie" of each patient's mouth. It simulates, from beginning to end,
the stages the teeth will go through as they're adjusted.
The manufacturer of the system, Align Technology, Incorporated,
of Sunnyvale, Calif., says the molds offer a more efficient way of
straightening teeth, because at different stages in the process, only the teeth
that need to be moved are moved. Still, that saves no time. The company
says the Invasilign process works at about the same rate as conventional braces
-- and can cost 20-50% more.
And there's something else: Children can't use them. The
company says its computer imaging technology doesn't work for growing
So where's the market? Right here: "Twenty or 30 years ago
we weren't treating too many adults," says Michael Rennert, DDS, an
orthodontist in Montreal and president of the American Association of
Orthodontists. Today, "I would say the average orthodontist in an urban
practice probably has 20-30% of the practice in adults." That's compared to
about 5% in the past, he says. Rennert adds the new adult market has money and
is concerned with both how the mouth looks and works. But not all of them can
use the Invisalign system. "It is certainly something that has a place in
every orthodontist's armamentarium ... for select, minor adult cases."
Which does not necessarily mean the other adult cases have to
stuff tire chains into their mouths. Rennert says today's conventional braces
are smaller and less conspicuous -- and even work better than the old clunkers.
"The wire is still there, but the [newer] appliances are much more
comfortable," he says. "The traditional metal brace can be replaced by
clear braces and braces from behind."
But hold on. Robert L. Boyd, DDS, chairman of the department of
orthodontics at the University of the Pacific in San Francisco, says that even
with more complicated cases, he has seen good results with Invisalign.
"There's no doubt it will take its place as one of the methods to
straighten your teeth," he says. "On simple cases, it worked quite
well. With moderate to moderate-difficult cases -- those needing the equivalent
of one year of treatment with braces -- it worked very well. And that
represents 40-50% of the market." Boyd, who conducted studies of
Invisalign, says that in three short years, about half the orthodontists in the
U.S. have learned to use the system -- and patient demand is high.