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 teeth.

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."

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