Reasons why I don't do Invisalign

Reasons why I don't do Invisalign

Ugh, I've been dragging my feet on this blog entry.

PLEASE know that these are my personal opinions, and my decision is not a moral one or based on some treatment superiority complex.  In fact, it could change at any time and one year from now who knows  I could end up being an elite provider of some sort! So if you do IA know that I absolutely respect your decision and am a little envious that you've made it work for you.

PLEASE also know that I move teeth every day with plastic. We re-set our retainers for very limited movements like ortho relapse, and my goal is to have a scanner and 3D printer in the house hopefully by the end of this year to allow us to dial in more precise movements.


Evil Empire

Nope, this isn't one of my reasons. Yes, Invisalign is happy to get their product to as many GP's as possible, and yes they market directly to consumers (which can make us feel helpless at times), but those things don't really bother me that much.

Bottom Line: Invisalign is a business that is in business to make a profit (like us). They have a product to offer, and we can decide if it is in our best interest and our patients' to use it or not. Our arms are twisted at times, but it's still our decision.


BIG FACTOR in my decision. I couldn't tell you at this point if Invisalign is $500 a case or $1200 but it's certainly much more than I pay for brackets, wires, adhesive, etc. I've finally got my supply costs down significantly, and it's going to take a magic wand AND a miracle to get me to start paying those huge supply bills again. And even if you increase your fee the extra amount, by the time you spread the treatment payments out and are competitive with your down payment requirements it never really seems to cover the added cost, does it?

It's not (as) efficient

I don't think plastic can move teeth as effectively as braces can do in a shorter amount of time.  Don't get me wrong I've seen excellent cases posted by great clinicians on Orthotown and elsewhere and I really feel the results are very good; even better than I expected. However, I'm not sure too many could argue that the results wouldn't be better with fixed appliances in a shorter time period.

So actually I do feel Invisalign can be EFFECTIVE when the cases are chosen carefully. But I still feel it is not as EFFICIENT as fixed appliances.

I'm a perfectionist, and The patient demographic is the exact group that is probably not the best fit for Invisalign

Ok, hang in there with me on this one. I am NOT a perfectionist with my treatment results. Yes, I try my best to get "perfect" results and I think I do a pretty good job but I don't kick myself if I can't get it perfect. I don't spend several extra months in braces trying to get the perfect result.

 But what I am a perfectionist in is patient satisfaction. I'll go the extra mile for patients doing re-treats for no cost, multiple retainers with re-sets, to try to help a dissatisfied patient (this drives my staff crazy and they often feel I should "cut the cord" but hey I gotta be me).

So here's my reasoning on this. My pickiest patients are adults. That's not to say  I don't enjoy treating them.  I absolutely feel it makes me a better Orthodontist when adults test my skills. But I know when we get to the finish line if the patient is not extremely satisfied I'm going to be pushing to put some appliances on to try to get things as perfect as possible.  And of course, I won't be charging them, especially if I already up-charged for Invisalign.


Some adult patients can very picky. And this group can overlap somewhat with those desiring IA.

They have paid a premium to avoid braces. And so have I!

Treatment time, in general, is longer than fixed appliances, often with modified treatment goals.

The last thing at the end of the treatment I want to do is try to persuade patients to let me put appliances on them to get the result we both desire.

So my conversation with a typical adult (often female) Invisalign seeking patient goes something like this:

"Yes I've done some Invisalign, but with clear braces, I'm able to have full control over your teeth so I can really  BROADEN your smile, and straighten them as perfectly as possible in a much shorter time, for a lower fee."

This conversation usually leads to a start in fixed appliances, although I'm sure I've lost my share of patients to more experienced IA users. I've also potentially lost patients who never came in for an exam in the first place because "You don't do Invisalign." I know the latter is true because I've done re-treats on several of these patients in my community.



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