A Chicago dental practice has filed a proposed class action lawsuit against Align Technology, Inc. in which it alleges the Invisalign maker has leveraged its dominance in both the aligner and hand-held digital dental scanner markets as a means to suppress competition.
According to the 30-page suit out of Delaware federal court, Align Technology’s anti-competitive conduct has allowed it to not only artificially boost and/or maintain its market share and power, but to artificially inflate prices in both markets. The defendant’s alleged conduct, the lawsuit says, essentially amounts to a de facto bundling of its aligners and intraoral scanners that offers no corresponding discount to purchasers.
Align’s Technology’s Invisalign-brand aligners are by far the dominant product in the overall aligner market, the case begins. The defendant reportedly pulls in “well over a billion dollars per year” selling Invisalign, according to the suit.
The plaintiff charges that the defendant knew from the outset that dental practitioners’ use of digital scanners would make them more likely to use its aligners in that “once a dental practice purchases a digital scanner, that practice would be more likely to order more aligners as a way to pay for the scanner.”
“The bottom line,” the complaint reads, “was that more iTero Scanners meant more Invisalign orders.”
Since at least March 15, 2015, the defendant, the case claims, had been able to charge high prices and keep its profit margins in the black for Invisalign due to protection from “a thicket of hundreds of patents” Align Technology has supposedly wielded aggressively to “protect its aligner monopoly.” As the lawsuit tells it, however, once some of Align Technology’s key patents expired in 2017, the company was forced to turn its attention to the outside influence of competitors while keeping one eye on the lofty expectations of its investors. To juggle its predicament, the defendant “responded with the anticompetitive scheme” over which the lawsuit was filed, the plaintiff argues.
Moreover, the defendant’s possession of Invisalign-related patents, along with “other high barriers to entry” in the above-described markets, allegedly served as an effective deterrent for competitors looking to enter the market.
“Instead of reacting to the advent of competition by improving its product or lowering its prices, Defendant worked to suppress that potential competition by using its dominance in the Aligner market to impair competition in the Scanner market, and then in turn using its dominance in the Scanner market to impair competition in the Aligner market,” the case reads.
With regard to the particulars of the defendant’s alleged competition-quashing scheme, the lawsuit says it came down to Align Technology’s production of both Invisalign and the tool with which dentists determine whether the treatment is right for a patient:
All this amounts to a de facto “closed system” that essentially makes it impractical for dental practitioners to order Invisalign aligners from other manufacturers, the case says. The defendant’s iTero scanner, according to the suit, does not accept scans in an industry-standard format nor from other scanners. The plaintiff stresses that this makes it more time-consuming and expensive for proposed class members to go outside of the framework set in place by Align Technology.
As of September 2018, Align Technology has “an over 80% share in the market for aligners in the United States and an over 80% share in the market for scanners in the United States,” the lawsuit says. With this much muscle, the defendant, the plaintiff alleges, has been able to leverage its position to inflate prices for its iTero dental scanners and Invisalign treatments.
When the final school bell rings and two months of unstructured free time stretch out before your kids, back-to-school season may feel like a lifetime away. But in reality, it’s just a few weeks, meaning now is the time to schedule all those late-summer doctors appointments. And if your child is one of the millions of kidsin North America who will likely seek orthodontic help this year (according to the American Association of Orthodontists), you can add the orthodontist to that list.
With more than 6 million patients, parents and teens are increasingly choosing Invisalign treatment for everything from simple to complex cases. The clear aligners not only have the confidence-boosting benefit of being less noticeable, but because they are removable, they make it easier for teens to enjoy every type of food and care for teeth. They also are more convenient for teens who play instruments and safer for those who play sports. In fact, with Invisalign treatment, there are no emergency visits due to broken wires of brackets. If you want to learn more about Invisalign treatment, click here.
This summer SheKnows has partnered with the Invisalign brand to give parents a chance to win free Invisalign treatment for their child. Enter below for your chance to win.
SHARE: FacebookTwitterLinkedinPinterestGoogle+tumblr Dr. Jim Raman. Photos obtained from Irmo Smiles website and Facebook. It was announced that a local orthodontist at Irmo Smiles, Jim Raman, has passed away. Irmo Smiles sent out a letter notifying patients of the doctor’s death, describing it as “a tragic loss.” It was mentioned that all appointments of Raman’s wife Misti, who is also a…
James Pelletier, an orthodontist, created a hydroponic vegetable garden in his Dracut back yard to grow a better crop of tomatoes in a smaller space. Watch video at lowellsun.com. SUN photos /Julia Malakie)
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DRACUT — James Pelletier says he’d cry if he ever came home to find his tomato plants wilted.
“The biggest fear every hydroponic gardener has is a power failure,” he says.
The Dracut orthodontist circles around his labor of love on a recent Friday to make sure the solar-powered garden in his backyard is running seamlessly. The Big Boy tomatoes that grow in bato buckets are not yet ripe. All are bright green, some plumper than others.
As the sun bears down on Pelletier and the tight rows of tomato plants, he shares that he has trained them to thrive on one vine. “Because one vine doesn’t allow them to grow bushy and get wet, and get diseases,” he explains, reaching out to pull a velvety sucker from one plant.
Above, the crop; at right, a jar of sauce made from his tomatoes.
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“You only want one grow point, and that’s how you have one vine.”
After years of trouble with growing tomatoes and subsequently running out of space in his yard for more tries, Pelletier, 57, wanted to find a way to grow the vegetables every year without having to move it to a new spot. He wanted something easier than conventional gardening. Pelletier read books on hydroponic gardening — a method of growing plants without soil — and made several attempts at the garden before building his current one two years ago. Three solar panels supply energy to batteries that run two special pumps and an aerator that, in turn, feed the tomato plants. Instead of soil, Pelletier uses coconut fiber and perlite.
He regularly pours different liquid nutrients into a reservoir built into the ground, which are then pumped into each tomato plant. Once the buckets the plants are in reach a certain level, the fluid drains back into the reservoir. The cycle repeats four times a day.
“I’m a scientist in my heart. I just get a lot of satisfaction out of doing it,” Pelletier says. “I am creating something from nothing and tweaking it this way and that way over the years to get it to do exactly what I want it to do.
It’s like a big, huge science experiment and, when it goes good like this, it feels great.”
The garden’s greatest threat according to Pelletier is blight, a plant disease that actually hasn’t affected his garden. There’s also a pesky chipmunk who sneaks into the garden to steal tomatoes. On this recent Friday, the chipmunk made an appearance, having stolen a small, green one.
After the science comes the fruit of Pelletier’s labor. Once the tomatoes have ripened, he and his wife, Karen, pluck them and prepare them for canning, sometimes with the help of their daughter, Mollie Andrews, 30. On the weekends they sit on their deck to can the tomatoes in Mason jars before storing them away.
The irrigation system for James Pelletier’s hydroponic vegetable garden in his Dracut backyard is powered by these solar panels. The garden also includes a bed of asparagus, center. SUN photos /Julia Malakie
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Karen makes sauce from the tomatoes, and dishes that also incorporate the other vegetables growing in their backyard such as zucchini. Pelletier says he also gives out canned tomatoes to relatives and neighbors across the street.
“I love it. He works very hard on it,” Karen, 58, says. “It takes a lot of time, but he enjoys gardening so we get a lot of beautiful vegetables from it.”
Follow Amaris Castillo on Twitter @AmarisCastillo
Batteries on the top shelf of this cabinet store power produced by Pelletier’s solar panels.
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ABC 33/40 in Birmingham, Alabama offers news, sports, and weather reporting for the surrounding communities including Tuscaloosa, Anniston, Cullman, Gadsden, Talladega, Sylacauga, Carbon Hill, Jasper, Hoover, Bessemer, Vestavia Hills, Alabaster, Trussville and Homewood.
As Robert Cavanaugh walked through the Old Town Banquet Hall in Valparaiso last month, the former Valparaiso High School and Valparaiso University basketball player was struck by the amount of meaningful relationships he’d made with people in the room over the years.
Cavanaugh was one of 10 individuals inducted into the Valparaiso High School Hall of Fame on Jan. 20, and while he had two tables of supporters, Cavanaugh spent plenty of time floating around the room.
Joe Otis was holding court on one side of the room, telling old basketball stories. Mike Jones and Scott Anselm traded stories while forming a unique bond with Cavanaugh with the three having played for both the Vikings and the Crusaders. Former coach Bob Punter told a tale or two before introducing Cavanaugh to the audience.
The honor of getting inducted into the Hall meant a lot to Cavanaugh, an orthodontist with Cavanaugh & Nondorf Orthodontics, but the people is what he’ll remember.
“(Getting inducted) was kind of humbling,” Cavanaugh said. “The best part of it was going to the event and seeing all these people that were such a big part of my life. The evening itself was really neat because of getting to spend time with so many different people.”
Cavanaugh knows a lot of people simply because he is as ingrained in the Valparaiso community as one can be. He and his wife, Heather, have five children that have come up through the Valparaiso school system, the same system that produced Cavanaugh before he graduated in 1990.
Cavanaugh spent his first three seasons at VHS playing basketball under Skip Collins. The 1988-89 team won a sectional championship before falling in the regional. Collins gave way to Punter and Cavanaugh for his first taste of a different coaching philosophy.
“Skip was very regimented, very organized and very detailed,” Cavanaugh said. “Punter let us go a little bit more. We scored a lot more points going up and down the floor, but we gave up a little bit more, too.”
The 1989-90 Vikings also won a sectional title and Cavanaugh learned a life lesson in watching Collins, and then Punter, that he has taken with him to his orthodontics practice.
“You can see there’s ways to look at different approaches,” Cavanaugh said. “Now as a business owner, being in charge of 10 to 12 staff members, you can see that they’re all different. The coach has to decide what everyone is good at. Watching (Collins and Punter), there’s not only one way to do something, there’s positives and negatives.”
Cavanaugh set the IHSAA record for consecutive free throws at 72 his senior year and he made 102 out of 104 attempts from the charity stripe. Despite scoring 18.5 points per game and leading the Vikings in assists, Cavanaugh wasn’t highly recruited out of high school and it wasn’t until he had a stroke of good fortune that he found his landing spot.
“(Second-year Valparaiso University coach) Homer Drew called me and told me that he really liked me, but also wanted to tell me that he wasn’t going to recruit me because they didn’t need a guard,” Cavanaugh said. “The season ends and two of their guards leave. Homer called me and immediately offered me a scholarship. I was lucky how the opportunity came about.”
Cavanaugh started all four years for the Crusaders and has made a profound impact on the Valparaiso record book. He finished his career with the highest 3-point percentage at the time and now ranks No. 6 in program history. Cavanaugh is joined in the top 10 by Bryce Drew, Casey Schmidt and Mike Jones, all Valparaiso High graduates. Cavanaugh also ranks among the program’s best in assists and free throw percentage.
More important than individual statistics was the ascent of the team when Cavanaugh played for the Crusaders. Valparaiso won five games in each of his first two seasons before breaking through for 12 wins in 1992-93. The following year the Crusaders won 20 games, a mark they’d hit in eight of the next nine seasons.
“We were starting to see the hard work paying off,” Cavanaugh said. “It was about setting goals higher, having persistence. Those first couple years when you’re not winning, it’s hard. People are hanging their heads, but once you start winning, it changes your whole feeling.”
While basketball was a passions for Cavanaugh, so was dentistry. His father, Tom, worked in the field for 40 years and Rob gotten bitten by the bug at an early age. After graduating from Valparaiso, Cavanaugh completed his dental studies at the Indiana University of Dentistry in 1998 and then graduated from NOVA Southeastern University in Fort Lauderdale with orthodontic specialty education in 2001. Cavanaugh became board certified by the American Board of Orthodontics in 2005.
“During some of those summers (when I was younger), I worked for my dad in his office,” Cavanaugh said. “I started making some appliances. My grandfather was a general dentist and I had the opportunity to visit some of the other dentists in town.”
Dentistry is certainly a family business as far as Cavanaugh is concerned. His partner, Matt Nondorf, is the same way as his father, sister and wife also work in the field. Just as dentistry brings Cavanaugh and his family together, so does flying. Tom was a longtime flight instructor and Rob’s brother Brad owns Air One, an aerial photography business.
“During my sophomore year at VU I got my pilots license,” Cavanaugh said. “My dad was a flight instructor and was honored by the FAA with the Wright Brothers Award for 50 years of no accidents. Hanging out at the airport with all the guys, it’s something I’ve always had an interest in.”
Cavanaugh has built a successful business career, but the itch to compete is still there. He cures it with weekly basketball games and by coaching his children. While basketball has always come natural to him, Cavanaugh is finding a new love with following his children in cross country. While dentistry and sports don’t quite go hand in hand, Cavanaugh has found a balance between the two that is rooted in more life lessons he learned back at Valparaiso High.
“The big thing going into dental school was to remember time management and being able to multitask,” Cavanaugh said. “Learning how to deal with failures, how to make mistakes and to be persistent.”
Invisalign aligners are an effective alternative to metal braces. Most patients are able to get the same results with these clear aligners that they would achieve with brackets and wires. Invisalign aligners are clear, unobtrusive, and easily removable. If you’re considering Invisalign for your treatment, here are some quick answers to common questions about what it’s like to live with Invisalign.
What Should I Do About My Sports Guard?
Invisalign aligners help straighten your teeth, but they do not protect them. Don’t make the mistake of thinking your aligners can double as a sports guard. If you play contact sports, it’s best to remove your Invisalign aligners before playing and protect your teeth with a sports guard designed for just this purpose. This will protect your teeth while you’re on the field or the court and keep your aligners safe from damage as well.
Does Invisalign Effect What I Eat and Drink?
No, Invisalign won’t have any impact on what you eat and drink. This is one of the most compelling reasons to choose Invisalign over other treatment options. While popcorn, taffy, and other tricky treats can get stuck in the brackets and wires of braces, you won’t have any such problem with Invisalign. You can remove your aligners at any time. Just pop them out at mealtime and brush your teeth carefully before putting the aligners back in.
Can I Still Play an Instrument With Invisalign?
Since Invisalign is a removable option, you can take your aligners out if they make it difficult to play an instrument. If you play a woodwind or brass instrument, you’ll likely find it’s easiest to remove your aligners when you’re playing. This is fine as long as you remember to keep them in for 20 to 22 hours a day.
Will I Still Be Able to Kiss?
Though it can seem like a touchy topic, there’s no need to worry about kissing while you’re using Invisalign. The aligners are barely noticeable in your mouth, so there’s a good chance your partner won’t notice a thing. If you’re with someone who asks about your aligners, you can explain that it’s much easier and more comfortable to kiss with aligners than with braces, and plenty of people have braved kissing in braces!
Aligners are smooth and fitted close to the tooth. They won’t dislodge while you’re kissing. Though you may feel nervous your first few kisses, you’ll soon forget all about these unobtrusive aligners. Although it may be tempting to take your aligners out, try to do so only on special occasions. You need to keep them in for as many hours as possible each day to get the right results.
Will Invisalign Change How I Talk?
During your first few days with Invisalign, you may notice a slight change in your speech. Your tongue needs a little time to get used to this new device in your mouth. While you may have a slight lisp at first, this typically goes away. You should be speaking normally again in a short time.
How Can I Keep My Aligners Clean?
There are two steps to keeping your Invisalign aligners clean. First, you need to keep your mouth clean. Brush and floss your teeth after every snack and meal. If you skip brushing, you’ll get food, plaque, and bacteria in your tray. Since aligners sit so close to your teeth, they can trap these hazards right next to the tooth and gum line where they can cause ample damage. Keep your teeth clean to prevent this.
The second thing you need to do is clean the aligner itself while it’s out. There are several methods for doing this. You can soak your aligner trays in clear mouthwash, a 50-50 solution of water and hydrogen peroxide, Polident denture cleaner, or a 50-50 blend of vinegar and water. Invisalign also sells a cleaning kit designed just for your aligners. Whichever method you choose, make sure you’re using it daily to prevent discoloration of the aligner tray.
Do Invisalign Aligners Smell?
No, your Invisalign aligners should not smell if you’re taking care of them properly. If your aligners have an odour, this means you’re not cleaning your teeth or your trays as thoroughly as you should. Step up your cleaning routine to help eliminate the smell.
Will Invisalign Give Me Bad Breath?
Properly cared for, your Invisalign aligners won’t do anything harmful to your breath. As mentioned previously, if there’s any unpleasant odour coming from the tray, you may want to re-examine your oral hygiene routine. Since you should be brushing your teeth several times a day with Invisalign, you should actually enjoy much fresher breath than you might if you were brushing just twice daily.
Invisalign is a comfortable alternative to traditional braces, and as you can see, living with Invisalign is easier than you might think!
Often Imitated. Never Simulated. Exclusive to the iTero® Element™ Scanner, the Invisalign® Outcome Simulator gives you a fun and engaging way to communicate the potential benefits of Invisalign treatment while increasing case acceptance. Simulated outcomes make it easy to show the benefits possible with Invisalign and may motivate greater patient acceptance. 3D Progress Tracking At…
A lot of people feel that, once they are adults or older teens, the time to improve their smiles with braces has gone by. But, thanks to advanced cosmetic dentistry, Invisalign allows many people to discreetly straighten their teeth without calling attention to the work.
Not convinced? Invisalign dentists straightened the smiles of all these celebrities while they were in the public eye:
1. Khloe Kardashian’s Invisalign Treatment
As a reality star, Khloe Kardashian is rarely far from the public view, which makes her self-improvement projects all the more noticeable. She’s slimmed down significantly during her years in the spotlight, shedding over 30 pounds with the help of a personal trainer. She decided to straighten her smile, as well, and had her braces put on last year at the age of 28.
2. Justin Bieber’s Invisalign Treatment
This Baby singer was still a teenager when he opted for clear Invisalign braces. In a Youtube video, he praised the braces’ unobtrusive look. The unobtrusive nature of the braces meant that they could really only be seen when he took them out to show them off.
3. Katherine Heigl’s Invisalign Treatment
Actress Katherine Heigl began wearing Invisalign in 2007 in preparation for her wedding. With these discreet braces, she could keep attention on her instead of on the corrections to her teeth. These days, the former Grey’s Anatomy star is all smiles as she prepares for the premiere of her upcoming TV series State of Affairs.
4. Tom Cruise’s Invisalign Treatment
Hollywood hunk Tom Cruise has always been famous for his smile. But, when the star began bringing his kids to the orthodontist in 2002, he discovered that his front teeth were not as straight as they could be. He chose a combination of Invisalign and ceramic brackets to keep his smile metal-free while straightening his teeth.
5. Gisele Bundchen’s Invisalign Treatment
Not even supermodels are born perfect! Gisele Bunchen told interviewers that she started wearing Invisalign because one of her teeth was moving and made her smile look less than perfect in pictures. She wore the braces only at night, taking advantage of the Invisalign system’s flexibility.
6. Zac Efron’s Invisalign Treatment
As this actor made the jump from teen heart throb in High School Musical to grown-up stunner in fare like The Neighbors, he decided that it was time for the slight gap between his front teeth to transition to a solid white smile, as well.
7. Eva Longoria’s Invisalign Treatment
This steamy star began wearing Invisalign at age 36 to straighten her bottom teeth. No longer spooked by a crooked smile, the star is working on a new horror TV series based on Latin American folk tales.
8. Serena Williams’ Invisalign Treatment
This powerful tennis player made sure that her smile was as strong as her serve by wearing Invisalign braces as a teenager. Years later, she has a straight and stunning smile, and continues to stack up the Grand Slam wins.
Are you ready to take on your insecurities and improve your smile? Talk to a local dentist about Invisalign in Mansfield. There are a number of highly qualified Mansfield MA dentists who can talk to you about whether these invisible braces are right for you.
At the Rapid 2019 3D printing conference, the company said they will use 49 HP Jet Fusion 3D printing systems around the clock to make more than 50,000 unique mouth molds per day. This means they have the capacity to make as many as 20 million individualized 3D-printed mouth molds in the next 12 months.
The goal is to revolutionize the way millions of people achieve a straighter smile.
“SmileDirectClub is digitally transforming the traditional orthodontics industry, making it more personal, affordable, and convenient for millions of consumers to achieve a smile they’ll love,” said Alex Fenkell, cofounder of SmileDirectClub, in a statement. “HP’s breakthrough 3D printing and data intelligence platform makes this level of disruption possible for us, pushing productivity, quality, and manufacturing predictability to unprecedented levels, all with economics that allow us to pass on savings to the consumers seeking treatment using our teledentistry platform.”
The orthodontics industry is 120 years old. SmileDirectClub cofounders Fenkell and Jordan Katzman first met at summer camp as teens with metal braces. They decided later that innovations in technology and telehealth could democratize access to safe, affordable, and convenient orthodontic care.
They started the company in 2014 using a digital network of state-licensed dentists and orthodontists who prescribe teeth straightening treatment plans and manage all aspects of clinical care — from diagnosis to the completion of treatment — using the company’s proprietary teledentistry platform. To date, they have served half a million customers in the U.S., Canada, and Puerto Rico, with plans to expand to Australia and the United Kingdom in 2019.
An estimated 80% of Americans could benefit from orthodontic care, yet only 1% receive it each year, with cost being the biggest prohibitive issue. In the U.S., 60% of counties do not have access to an orthodontist. By leveraging the benefits of teledentistry coupled with HP’s 3D printing technology, SmileDirectClub is bridging these gaps, offering people a chance to build confidence through a straighter, brighter smile at a cost that is up to 60% less than traditional options.
SmileDirectClub and its manufacturing partners rely on HP Jet Fusion 3D printing solutions to produce the mouth molds for each patient’s aligners and retainers, creating an average of more than 50,000 personalized mouth molds each day.
“SmileDirectClub and HP are reinventing the future of orthodontics, pushing the boundaries of customized 3D mass production and democratizing access to affordable, high-quality teeth straightening for millions of people,” said Christoph Schell, president of 3D Printing and Digital Manufacturing at HP, in a statement. “Through this collaboration, HP is helping SmileDirectClub accelerate its growth, enabling a new era of personalized consumer experiences only made possible by industrial 3D printing and digital manufacturing.”
HP and SmileDirectClub also announced a new recycling program, through which excess 3D material and already processed plastic mouth molds are recycled by HP and turned into pellets for traditional injection molding, leading to more sustainable production.
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Wilmington orthodontist John Nista has developed a new process called “Simply Fast Smiles” that combines new industry concepts and emerging technology. The doctor said through clear, plastic trays, he can straighten some people’s teeth in six months. And the bill is typically about $3,000, half the normal cost of most sets of braces.
“If you say you’re going to the orthodontist because you need braces, the first thing that goes to your mind is that it’s going to be expensive, it’s going to take time and it’s going to be painful,” he said.
“My piece of the puzzle doesn’t have to do that.”
Nista uses a 3-D scanner and printer, as well as advanced software, to create about 25 plastic moving aligners. He prints all of the plastic trays at the same time for the patients, resulting in fewer check-up appointments. The patients wear a new aligner every week, which incrementally straightens their teeth.
While this program can be for anyone with adult teeth, most of his patients have been adults who have had previous dental work.
Nista, who has been an orthodontist for 28 years, said the industry has changed and adapted its practices every couple of decades. But it wasn’t until Invisalign was created in the late 1990s that there has been such a major technological breakthrough in orthodontics, he said.
Invisalign showed orthodontists that clear, plastic aligners can efficiently move people’s teeth while avoiding the severe pain and unattractive look of braces. Forbes reported in April that Invisalign hit its 4 millionth patient last September. In 2016, the company’s sales reached $1 billion for the first time.
In recent years, it has led to the creation of a handful of other clear aligner competitor companies.
The startup SmileDirectClub has received national attention in recent months for its business model of saying it will straighten people’s teeth — without in-person doctor consults and X-rays.
People can get fit for aligners by going to a SmileDirectClub store or ordering a mail-in kit. The aligners are then sent in the mail and cost $1,850. There aren’t any locations based in Delaware.
The American Association of Orthodontists has filed complaints with dental boards and attorney generals in 36 states against the company, saying its service can lead to medical risks.
While Nista is also wary of the company, since there’s no direct contact with a doctor, he said it does signify the changing times of the industry. People don’t want to pay a fortune and invest a lot of time to get straight teeth.
“There is a big wave of this coming,” he said.
The first step of Nista’s “Simply Fast Smiles” is the free online consultation — which is done via selfie.
To see if a patient qualifies, Nista asks people to complete the “Smile Test” by submitting four photos that show different angles of a person’s mouth through his website. The images will be sent directly to Nista’s email. He’ll then determine the amount of work he or she needs and email the patient directly.
The idea to use telemedicine for orthodontics came to him when he watched his niece, a dermatologist, do a consult on her phone while on the beach during a family vacation. There’s no reason he couldn’t do the same thing, Nista recalled thinking.
“Everyone knows how to take a selfie,” he said.
Nista said it only takes orthodontists a couple minutes (at most) to decide if the aligners can properly straighten a person’s teeth in a short period of time. Looking at images via email saves time for both him and potential patients, he said.
Telemedicine applications have become increasingly popular because doctors can treat patients in the comfort of their own homes reducing costs including travel time. The Medical Society of Delaware and Nemours/Alfred I. DuPont Hospital for Children have encouraged their doctors to use this technology in the past year.
In addition to orthodontic X-rays and photographs, Nista uses software that takes a digital scan of a patient’s mouth. The computer program then shows what it will take for the teeth to get into a “goal position.”
It also creates the design of the 25 plastic aligners which are then 3D printed at the same time. Whitening gel is also included in the individual aligners.
For most patients, the aligners are changed about once a week. Additional aligners can be printed over the course of the six months if necessary, Nista said.
Unlike other patients, Keogh has about 40 aligners due to the amount of work she needs on her teeth. She said the whole process was a lot easier than what she imagined, especially with the payments.
She was still quoted a total of about $3,000. That’s about $800 less than what her mother paid for aligners at another practice. Since Keogh paid for it upfront, she said she doesn’t need to worry about for copays or charges for follow-up appointments.
Now at the halfway point, Keogh said she’s seen progress in her bottom teeth. It’s already boosted her confidence, she said.
“I can’t wait till they’re all the way straight,” Keogh said.
Contact Meredith Newman at (302) 324-2386 or at email@example.com. Follow her on Twitter at @merenewman.
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icsnaps/ShutterstockYour smile is one of the first things somebody notices about you, and seeing an orthodontist practically ensures you’ll always have straight, pearly whites. At least, that’s the idea. But as with any other doctor, your orthodontist has some things they wish you knew, but probably won’t ever tell you. (By the way, you’ll definitely want to follow these 10 golden rules for white, healthy teeth.)
Someone else might’ve used your braces before you
VP Photo Studio/ShutterstockBefore you get grossed out, this isn’t always the case—and if it is, it’s not actually as skeevy as you might think. According to foxnews.com, some orthodontists professionally sterilize and remanufacture used braces through companies like Ortho-Cycle, which saves up to 50 percent on costs. This process “is based upon the dissolution of polymerized acrylates at temperatures at which simultaneous sterilization occurs,” according to orthocycle.com.
We know when you haven’t been wearing your Invisalign
Andrey_Popov/ShutterstockDespite how persistent you are when you tell your orthodontist you’ve been actively wearing your Invisalign, they’ll know the truth right away. “We know if you haven’t been wearing your Invisalign because of a cool feature [on the aligners] (not just because of your answer to our question or the way your teeth look),” says Dr. Matthew LoPresti, DDS, a cosmetic dentist in Stamford, CT. “There are little blue marks towards the back of your aligners that should wear away as you wear the Invisalign. If the blue mark looks untouched, we know you haven’t been wearing the aligners.” (Here are some things your dentists NEEDS you to start doing differently.)
Your treatment will probably take longer than what we initially tell you
Rocketclips, Inc./ShutterstockYour orthodontist might tell you your treatment will only take a year and a half to two years, but that’s a rough estimate. A lot of treatments take much longer than expected. “Delays in the process may occur like a misdiagnosis of your case, patient’s neglect, or unanticipated movement of the teeth,” says Danica Lacson, a representative for Hawaii Family Dental.
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Our fees might be negotiable
sumire8/ShutterstockLet’s be honest, a trip to the orthodontist is anything but cheap. “The good news, though, is that orthodontists offer a variety of payment plans. Many allow patients to pay through monthly installments with no interest, and with some orthodontists, you can negotiate the fee itself,” according to foxnews.com. “Some orthodontists will give a discount, usually 5 to 10 percent, if you pay the total in cash or with a credit card at the beginning of treatment.” (You won’t believe these shocking diseases that dentists find first.)
You have to wear retainers after you complete your treatment—forever
Olga Miltsova/ShutterstockIf you think you’re done with orthodontics after you finish your treatment—think again. “A retainer holds your teeth in place. After you complete Invisalign or any orthodontics, it is necessary to hold those teeth in place,” says Dr. LoPresti. “There are different options which include a removable clear retainer that is worn at night or a permanent fixed retainer that gets bonded to the back of your teeth.”
We know when you’re lying about wearing your retainer
ponsulak/ShutterstockNot only do you have to wear a retainer after you complete your treatment, but your orthodontist will definitely know if you’ve really been keeping up with it. “Patients that complete their advised treatment and achieve their desired result but then fail to wear their retainers, generally have teeth that drift apart,” says Dr. Timothy Chase, co-founder of SmilesNY. “This can cause a relapse such as crowding, spacing or flaring of the teeth.” (Whatever you do, never, ever ignore these symptoms of a cavity.)
We know when you eat or drink with your Invisalign in
karelnoppe/ShutterstockIt might seem harmless to eat or drink with your aligners in, but you won’t be fooling your orthodontist. “When patients eat or drink liquids (other than water) come in to see me, their Invisalign trays are often slimy, dirty, and stained,” says Dr. Chase. “Not only does this result in a cosmetically undesirable appearance to the aligners but it also damages them and can lead to decay.”
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Braces aren’t just a cosmetic treatment
salajean/ShutterstockIt might seem like people go to the orthodontist just to straighten out their teeth, but there are tons of other reasons, too. While some people can go through life with crooked teeth and be just fine, others actually require fixture in order to chew and speak properly. “While we do want everyone to have a perfect smile, the reality is not everyone requires orthodontics,” says Seth Newman, DDS, a board-certified orthodontic specialist. (You’ll never catch your dentist eating these 15 foods—and you shouldn’t be snacking on them, either.)
We know you don’t floss or brush as much as you say you do
Andrey_Popov/ShutterstockRemember all those times you lied to your dentist or orthodontist when they asked if you’ve been flossing? Yeah… they knew you weren’t. “Those who do not brush and floss properly generally have a higher incidence of plaque calculus, gingivitis, and tooth decay,” says Dr. Chase. “A single day of forgetting to floss is damaging but a week or a month of poor hygiene will result in swelling of the gums, bleeding and a foul odor.” (This is the easiest way to get rid of bad breath, according to a dentist.)
Even if you don’t think your child needs orthodontics, get them checked out anyway
pattara puttiwong/ ShutterstockEven if your child doesn’t show any signs of needing to see an orthodontist, you should really bring them in for a check-up no later than age seven. “If we see a patient early, we can remove baby teeth and the canine has a good possibility of coming in properly,” according to Dr. Jackie Miller, an orthodontist in Washington, MO, and member of the American Association of Orthodontists. “An early visit to the orthodontist can prevent and help detect future problems.” (Here are some dental etiquette rules everyone should follow.)
If you smoke, your treatment might take longer
Quinn Martin/ShutterstockIn case you needed more of a reason to not smoke, it might actually cause you to need to make more trips to your orthodontist’s office. “Smokers give away their habit because of the excessive plaque that builds up on their teeth,” according to Dr. Chase. “This can have a big impact orthodontic appliances used to straighten teeth and result in a longer treatment period.”
You don’t have to wait for your dentist to refer your child to an orthodontist.
Parents are often the first to recognize that something is not quite right about their child’s teeth or their jaws. A parent may notice that the front teeth don’t come together when the back teeth are closed, or that the upper teeth are sitting inside of the lower teeth. They may assume that their dentist is aware of the anomaly, and that the dentist will make a referral to an orthodontist when the time is right. A referral might not happen if the dentist isn’t evaluating the bite.
AAO orthodontists don’t require a referral from a dentist to make an appointment with them.
Dentists and orthodontists may have different perspectives.
Dentists are looking at the overall health of the teeth and mouth. He/she could be looking at how well the patient brushes and flosses, or if there are cavities. While dentists look at the upper and lower teeth, they may not study how the upper and lower teeth make contact.
Orthodontists are looking at the bite, meaning the way teeth come together. This is orthodontists’ specialty. Orthodontists take the upper and lower jaws into account. Even if teeth appear to be straight, mismatched jaws can be part of a bad bite.
A healthy bite is the goal of orthodontic treatment.
A healthy bite denotes good function – biting, chewing and speaking. It also means teeth and jaws are in proportion to the rest of the face.
The AAO recommends children get their first check-up with an AAO orthodontist no later than age 7.
Kids have a mix of baby and permanent teeth around age 7. AAO orthodontists are uniquely trained to evaluate children’s growth as well as the exchange of baby teeth for permanent teeth. Orthodontists are expertly qualified to determine whether a problem exists, or if one is developing.
AAO orthodontists often offer initial exams at no (or low) cost, and at no obligation.
When you choose an AAO orthodontist for orthodontic treatment, you can be assured that you have selected a highly skilled specialist. Orthodontists are experts in orthodontics and dentofacial orthopedics – properly aligned teeth and jaws – and possesses the skills and experience to give you your best smile. Locate AAO orthodontists through Find an Orthodontist at aaoinfo.org.
I don’t try to make bad choices. Really, I don’t. In fact, I don’t think most people set out to do make them either. I think we all end up in a place we hoped not to be and in retrospect say, well, that was probably a bad idea.
Such was my life this past week when I found myself sitting in an orthodontist’s office being handed an estimate for approximately $8,000 (for Invisalign, I don’t want more braces, of which $3,500 would be covered by my insurance), that would essentially correct (or finish) the job I assumed was completed when I paid $4,000 to get my teefus fixed back in 2012. As sad as it is that if I have to pay all over again, how we got to this point is so much dumber than you can possibly imagine.
It all started in 2007 when I told my then-dentist I wanted braces. In order to do so, I was going to have to get my wisdom teeth removed, so I had all four of my wisdom teeth removed at the same time. Can we talk about that for a minute? Yes, let’s. If you’ve had your wisdom teeth removed, you know they can do general (put you out) or local (numb your mouth) anesthesia. Because all of my wisdom teeth were erupted, they opted for local anesthesia. This is where I learned about how my body responds to numbing agents and pain killers. Basically, it doesn’t. My mouth was numb for a solid 10 minutes before I started to feel the orthodontist literally breaking my teeth in half with some pliers.
Nigga. I cried so hard. It hurt so much, but I made it through thinking that I’d get some pain killers and be high off my gourd for the next week. First, they prescribed me Vicodin. It didn’t work. Then Percocet. Which also didn’t work. Literally, my body didn’t respond to pain killers AT ALL. I pretty much had to wait out the pain in the fetal position on my couch at home for a week and some change. After that experience, I put braces out of my mind, because short of checkups, I didn’t want anything unnecessary done to my teeth.
But then (and we’re about to get to the shenanigans now), while riding around in my car in 2011, I heard a commercial for braces and I said to myself, “P, you should get braces.” There was some number to call, so I called it. And it led me to a dentist’s office in Maryland. Well, I live in Washington, D.C., so that made sense. I scheduled an appointment and showed up for my consultation. And no lie when I tell you I was so dumbfounded at this office: the dentist was a black man but his entire office looked like a Pitbull video shoot. I was in an office full of some of the most beautiful women I’d ever seen. And they all worked there. As far as medical office spaces go, it might as well have been heaven.
I even remember calling a few of the homies to be like, “If you need a dentist, THIS IS WHERE YOU NEED TO BE!” I got my consultation and was told the braces would run me $4,000, and I’d walk away with pristine pearly whites. And all of the work would be handled in-house. And I should just come to them for regular dental services. Cool. SIGN ME UP.
That’s where it started going downhill. For one, while I thought the office was unreal, it was easily the most inappropriate office I’d ever been in. The dental assistants were a little too friendly and familiar. I’m not saying it was a happy endings spot or anything, I’m just saying the folks who worked there were super comfortable in ways that I’m not sure are…appropriate. Well, I got my braces and paid the cost to be the boss. Once that was done, and because my insurance changed, that office was no longer an option. Which made me sad, but I also figured that one complaint might take that office off the map anyway, so perhaps it was just time to move on.
I had permanent retainers on the back of my teeth and recently, the retainers on the back of my top row snapped. Because I could feel my teeth almost immediately start to shift, I found an orthodontist and scheduled an appointment the same way I found any new doctors: I checked the list of folks who would accept my insurance and looked for the black folks.
I went in for an appointment, and in the nicest possible way (and without professionally shitting on her fellow unnamed dentist), the orthodontist was like, “Yeah, your teeth ain’t supposed to do what they’re doing, ever, but since I wasn’t there in the first place, I’m not sure if this is accidental or intentional.” You can imagine how hard I clutched my pearls since I JUST got my braces off in 2012. I asked if she was saying the other dentist fucked up my teeth but made it look like the job was done and she would neither confirm nor deny this. I told her that’s what I get for staying at an office because everybody looks like J.Lo.
In order to address and correct the issue, the estimate came back a cool $8,000 strong. I’d feel dumb not getting them fixed since that was a decision I made in the first place and my teeth would just start crip walking again. Mildly, but a crip walk is a crip walk. But I can’t help but thinking I got got by a dentist’s office that didn’t feel right and stuck me for $4,000 out of pocket. And my teeth aren’t terrible, but the new ortho noticed some things that she had various curiosities about.
And it all takes me back to the fact that I seriously picked an office for braces based on a radio ad.
The moral of the story: Don’t pick dentist offices based on radio ads.
Whether you call the process “braces,” “orthodontics,” or simply straightening your teeth, these 7 facts about orthodontics – the very first recognized specialty within the dental profession – may surprise you.
1. The word “orthodontics” is of Greek origin.
“Ortho” means straight or correct. “Dont” (not to be confused with “don’t”) means tooth. Put it all together and “orthodontics” means straight teeth.
2. People have had crooked teeth for eons.
Crooked teeth have been around since the time of Neanderthal man. Archeologists have found Egyptian mummies with crude metal bands wrapped around teeth. Hippocrates wrote about “irregularities” of the teeth around 400 BCE* – he meant misaligned teeth and jaws.
About 2,100 years later, a French dentist named Pierre Fauchard wrote about an orthodontic appliance in his 1728 landmark book on dentistry, The Surgeon Dentist: A Treatise on the Teeth. He described the bandeau, a piece of horseshoe-shaped precious metal which was literally tied to teeth to align them.*
3. Orthodontics became the first dental specialty in 1900.
Edward H. Angle founded the specialty. He was the first orthodontist: the first member of the dental profession to limit his practice to orthodontics only – moving teeth and aligning jaws. Angle established what is now the American Association of Orthodontists, which admits only orthodontists as members.
4. Gold was the metal of choice for braces circa 1900.
Gold is malleable, so it was easy to shape it into an orthodontic appliance. Because gold is malleable, it stretches easily. Consequently, patients had to see their orthodontist frequently for adjustments that kept treatment on track.
5. Teeth move in response to pressure over time.
Some pressure is beneficial, however, some is harmful. Actions like thumb-sucking or swallowing in an abnormal way generate damaging pressure. Teeth can be pushed out of place; bone can be distorted.
Orthodontists use appliances like braces or aligners to apply a constant, gentle pressure on teeth to guide them into their ideal positions.
6. Teeth can move because bone breaks down and rebuilds.
Cells called “osteoclasts” break down bone. “Osteoblast” cells rebuild bone. The process is called “bone remodeling.” A balanced diet helps support bone remodeling. Feed your bones!
7. Orthodontic treatment is a professional service.
It’s not a commodity or a product. The type of “appliance” used to move teeth is nothing more than a tool in the hands of the expert. Each tool has its uses, but not every tool is right for every job. A saw and a paring knife both cut, but you wouldn’t use a saw to slice an apple. (We hope not, anyway!)
A Partnership for Success
Orthodontic treatment is a partnership between the patient and the orthodontist. While the orthodontist provides the expertise, treatment plan and appliances to straighten teeth and align jaws, it’s the patient who’s the key to success.
The patient commits to following the orthodontist’s instructions on brushing and flossing, watching what they eat and drink, and wearing rubber bands (if prescribed). Most importantly, the patient commits to keeping scheduled appointments with the orthodontist. Teeth and jaws can move in the right directions and on schedule when the patient takes an active part in their treatment.
AAO orthodontists are ready to partner with you to align your teeth and jaws for a healthy and beautiful smile.
When you choose an AAO orthodontist for orthodontic treatment, you can be assured that you have selected a highly skilled specialist. Orthodontists are experts in orthodontics and dentofacial orthopedics – properly aligning teeth and jaws – and possess the skills and experience to give you your best smile. Locate AAO orthodontists through Find an Orthodontist at aaoinfo.org.
BLUEFIELD, Va. — Dr. Dean Evans, who has served the Bluefield, Va. community for 37 years by providing orthodontic treatment to both children and adults, is now in the transitional process of passing his practice on to Dr. Tyler Crowe, a former patient.
Evans, who’s father was a dentist, grew up in Welch before moving to Princeton in 6th grade.
After deciding on orthodontics as a profession he went on to attend Concord College and West Virginia University where he then attended the School of Dentistry and completed his orthodontic residency program. Directly out of his residency, he and his wife spent three years in Alaska with the Air Force. Afterward, he returned to the Bluefield area where he began practicing orthodontics.
“It’s the most fun practice of dentistry,” Evans said. “Orthodontics is just fun. I love the work, I love the kids, I love the adults.”
Crowe said he was Evans’ patient roughly 15 years ago and that Evans is who ultimately inspired him to become an orthodontist.
“After coming here and getting my braces off and just the whole experience I just wanted to be able to provide that experience to other kids,” Crowe said. “The years that you have braces are very impressionable years. Just that impression that you can have. I know what it did for me and how I felt personally about myself through orthodontic treatment, so I wanted to be able to have an impact on other kids in that way.”
According to both Crowe and Evans, they proceeded to stay in touch through the years as Crowe applied to dental school and orthodontics residency where he too graduated from West Virginia University.
As Crowe neared the end of his residency they began discussing his future and what opportunities were ahead locally.
“To be quite frank, I’m not ready to stop practicing. In my mind I was always focused on another five to 10 more years, and then Dr. Crowe came by and he asked if I would be interested in selling the practice,” Evans said. “So I started thinking about it, and say in five years, I want to practice five or 10 more years, and I put out my for sale sign, I may not get anybody half the quality or half the character that Dr. Crowe is.”
According to Evans the final deciding point came when Crowe advised him that he would keep the full staff – which he says is a rare move by new doctors.
In April, Evans disclosed the exciting news with his patients where he shared that his job is more of a calling he never took lightly and he believes Crowe will ensure optimal orthodontic care to all patients.
The outpouring of love to Evans by his patients thus included their welcoming of Crowe in May as the two began working together in anticipation for Evans’ retirement. According to Evans, this is to secure Crowe is comfortable with the diagnosis and treatment plans and that the patients are likewise comfortable with Crowe. Evans plans to stay a minimum of 60 days or longer based on the comfort level by all parties involved.
“It was important to both of us that this be smooth and the patients feel comfortable with me. So as we plotted it out, we wanted to make sure they had the opportunity to see both of us at the same time. That way it wouldn’t feel so abrupt to anyone,” Crowe said.
Evans has put optimal trust in Crowe.
“He’s very focused. He’s very detailed for perfection, and as a perfectionist, he’s a perfectionist like I am, it drives you crazy to try to get perfection. It’s just so hard to do that, but he’s very much like that,’’ Evans said of Crowe. “He has a good eye for detail. He’s very very gentle. He’s got good hands. He’s got good patient communication skills.”
Crowe says the transition thus far has been relatively easy as he considers his relationship with Evans to be a friendship unlike the experience of many business transitions. Crowe has also received a positive response from the patients and families.
“I do want to reiterate just the importance that Dr. Evans has had on this community. I remember, this is the guy who had Dr. Dean’s Dodgers, a t-ball team, and shaved his head when one of his patients was going through chemo. So those are really big shoes to fill, and he has just been such a pivotal person in so many lives, so many young people’s lives here. So, moving forward, I’ll miss him every bit as much as the community will miss him,” Crowe said. “He’s still going to be a vital part of this community, just in a different way.”
Just as Crowe and the patients will miss Evans, Evans will likewise miss the people and the impact they’ve had on him while he’s helped their smiles.
“I’m going to miss them. I’ve had so much fun with all my patients and parents and families. And the thing about this area, the people make this area. There’s no greater people anywhere in the world than right here in this area. They’re good people. They’re strong people. They’re honest. And it’s just a real joy to be able to have that as patients and families, and that’s the thing that’s probably impacted me the most, is just the people,” Evans said.
Murray Klauber, an orthodontist from Buffalo, N.Y., reinvented himself as the owner of a Florida tennis resort where Nick Bollettieri taught tennis and Al Gore practiced for debates, before a dispute sent the business into a death spiral.
If someone tells you that your child should have all of his/her permanent teeth before visiting the orthodontist for the first time, that “someone” is incorrect . In fact, putting off a first visit to the orthodontist until all of a child’s permanent teeth are in could do more harm than good. Here’s why:
There’s a lot more going on than meets the eye.
A child’s mouth is a busy place. Think about a 6-year-old. Everything is growing, including the bones in the jaw and face. At around age 6, the first permanent molars appear. An exchange of teeth begins as baby teeth fall out and are replaced by larger-sized permanent teeth. And it all happens in a predictable, particular order. Unless it doesn’t.
The gums hide about two-thirds of each tooth, as well as all the bone that hold teeth in place. The gums can mask conditions that interfere with the emergence of teeth.
Parents can watch for clues. Early or late loss of baby teeth can signal a problem. So can trouble with chewing or biting, speech difficulties and mouth-breathing. If these indicators are not addressed until a child has all of his/her permanent teeth and growth is essentially complete, correcting the problem may be more difficult than it might have been had treatment occurred earlier.
Orthodontic treatment is about creating a healthy bite – the beautiful smile is a bonus.
The goal of orthodontic treatment is to make sure the bite is right – that upper and lower teeth fit together like interlocking gears. The timing of your child’s treatment is critical and is based on his/her individual needs.
Some children can wait until they have all or most of their permanent teeth. Other children’s orthodontic problems may be better treated while some baby teeth are present. These children require growth guidance of bones in the upper and lower jaws, so there’s enough room for permanent teeth. Their treatment can be timed to predictable stages of dental development and physical growth. Once teeth and jaws are in alignment, a beautiful smile is the bonus result of treatment.
Dentists and orthodontists look at the mouth differently.
Dentists assess and promote overall oral health. They look for cavities and gum disease. They advise patients on diet and home hygiene care. And they monitor patients for diseases that appear in or affect the mouth. Dentists take “bite wing” x-rays to isolate a particular section of teeth as part of their diagnosis and treatment planning process. Orthodontic evaluations may be a lower priority for dentists.
Orthodontists are laser-focused on each patient’s bite. Orthodontists use “panoramic” x-rays to visualize all of the teeth above and below the gums, and the jaws, all at once. The bite is orthodontists’ area of specialization.
If your dentist has not referred your child to an orthodontist, you need not wait for a referral. Orthodontists do not require a referral for your child to be seen.
Here’s what the experts say: remember age 7.
The American Association of Orthodontists (AAO) recommends that children have their first visit with an orthodontist no later than age 7. If a problem is detected and treatment is advised, you are giving the orthodontist the opportunity to provide your child with the most appropriate treatment at the most appropriate time.
To answer the question that headlines this blog, there’s no need to wait until your child has lost all his/her baby teeth before you consult an orthodontist. It’s fine to talk to an orthodontist as soon as you suspect a problem in your child, even if your child is younger than 7. Many orthodontists offer a free or low-cost initial consultation. And adults – there’s no time like the present to talk to an orthodontist about getting the smile you’ve always wanted. Locate AAO orthodontists through Find an Orthodontist.