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Why the invisible orthodontics market is booming

Invisible orthodontics has both transformed an existing market and created an entirely new one. Dr Joy Antony, Founder and MD of Dr Joy Dental Clinic in Dubai, examines the factors behind the industry’s success, and those charting its future.

Just 20 years ago, straightening and aligning teeth required unsightly metal braces. But with the welcome introduction of invisible or ‘clear’ aligners the market has completely changed and is now one of the dental industry’s biggest growth segments.

Transparent, customised trays worn over the teeth, invisible aligners apply pressure over time, moving teeth into a desired position. Made from clear medical grade plastic resins, they are individually designed to fit each patient and offer clear advantages.

First, they are almost invisible, which is far more aesthetically appealing than traditional metal braces. This isn’t simply a vanity issue, as wearing metal braces for up to two years is a considerable undertaking and commitment, and many patients struggle with feelings of self-consciousness and reduced confidence.

Second, the clear aligners are comparatively comfortable and convenient. Unlike conventional braces there are no brackets and wires involved, and wearers can easily remove and replace the tray (most aligners need to be in place for around 20–22 hours per day). This also means that patients can eat anything they desire, which isn’t the case with regular braces.

Designed for everyday life

Clear aligners have only a minimum impact on lifestyle. Children, for example, like them because they can still do things like play contact sports while wearing them.

In addition, aligners usually deliver results faster than traditional braces for mild to moderate malocclusions (the misalignment of the upper and lower teeth).

Every patient is different, but an average treatment programme can be as short as six to 18 months, compared to 12–24 months for traditional braces.

This is largely because with traditional braces it’s difficult to predict the movement of every individual tooth. But, with the digital design software used in aligner treatments, you can do just that – and design an aligner to deliver precise, predicted results.

The pandemic also accelerated demand and desire for healthcare solutions that offer shorter recovery times and require fewer in-person consultations. Invisible orthodontics is absolutely in line with this shift, and this could well become yet another factor influencing growth moving forward.

No signs of slowing

Invisible orthodontics has experienced exponential growth in the last two decades. By 2020, the global market for clear aligners had reached $2.41 billion, according to Fortune Business Insights.

As in other sectors, the phenomenal pace of growth slowed slightly in 2020, registering 4.4 per cent. The market is predicted to exceed $10 billion by 2028, however, with growth spiking to 19.7 per cent during this period.

We’ve witnessed the boom firsthand in the UAE. Our clinics were among the first to adopt invisible aligners in the region, acquiring the certification for Invisalign. Since then, the ratio of metal versus invisible aligners has completely flipped.

Around 80 to 85 per cent of orthodontic patients were historically fitted with metal braces, and just 15 per cent opting for invisible aligners. But, today, that share has grown to almost 60 per cent.

Aesthetics fuelling demand

Numerous factors are driving this growth, starting with the patient benefits and preferences discussed earlier.

In the UAE, these are also reinforced by a strong health and beauty market. According to a 2021 Market Data Forecast report, the Middle East & Africa dental consumables market, which includes prosthetics, was valued at $1.45 billion in 2021 and is expected to hit $1.62 billion by 2026, growing at a CAGR of 2.21 per cent.

It is also a leading global market for health tourism, where people fly in specifically for any number of world-class treatments. And with Dubai’s reputation as a safe and highly attractive visitor destination, which was further bolstered by exemplary handling of the Covid-19 crisis, I fully anticipate continued future growth.

Mature patients opting for treatment

The idea of proactively opting for treatment is certainly a key driver in the success of invisible solutions. The combination of convenience, comfort, speed and appearance is a major factor in encouraging people to opt for treatment, particularly those who were put off by the prospect of conventional metal braces in the past.

This is particularly true of adults. Orthodontics used to be perceived as predominantly for children and teens, and for corrective or preventative cases. Increasing numbers of adults, however, are now opting for both corrective and cosmetic treatment using invisible aligners.

It’s not just about ‘the perfect smile’ for adults and teenagers, even if this is a significant contributor to the success of the industry. Innovations in invisible orthodontics are now enabling us to offer preventative and interceptive treatments to younger patients using clear aligners.

Ongoing technological advancement

Another factor driving growth is technological development. Having been involved since the early days of invisible orthodontics, I can see how the technology has come on in leaps and bounds.

Today, only complex malocclusions cannot be addressed with clear aligners, and still require braces. In the not-too-distant future, however, I imagine this too will change, with an invisible orthodontic treatment possible for almost every patient.

Indeed, the concept of teeth alignment is being transformed. Using AI and resulting gathered data, companies are now learning how to base treatments on highly accurate predictions of how teeth will move and react. Similarly, the aligners themselves are becoming more flexible and accurate.

Moving forward, this pace of change is likely to continue. The sector is also becoming increasingly competitive, which, in turn, is leading to increased R&D, investment and innovation by key industry players.

A good example is US-based Align Technology, the name behind the world-leading Invisalign brand, which currently accounts for 80 to 85 per cent of global market share, according to Fortune Business Insights. In April 2020, Align acquired global dental software leader EXOCAD, and throughout the pandemic was busy developing its digital platforms to cater for the rising demand in online consultation and diagnosis.

Untapped global potential

When it comes to assessing future opportunity, it’s clear that there is still a significant untapped market to explore.

Data released by Fortune Business Insights in 2020 estimated that around 60 to 75 per cent of the world’s population has misaligned teeth, so demand is there.

It’s important to remember, however, that this is not necessarily an immediately convertible market. Many people – especially those in developing countries – may not be aware of the effects of this condition, or see it as worthy of treatment, or be able to afford treatment.

Currently, global penetration remains low with only 10 per cent of those who seek treatment currently being prescribed clear aligners.

Price is obviously also a factor. Invisible aligners cost more than traditional braces. In markets like the US and UAE, insurance plays a major part in ameliorating the cost implication, but this is not always the case elsewhere.

Rising competition is helping bring costs down, however, and this could help drive adoption in other markets.

Another possibility is the growth of self-treatment or ‘do it yourself’ orthodontics, where patients bypass a dentist to directly order aligners from a provider. This comes with a number of risks that I believe limit its use and potential.

Critically, you always need a proper diagnosis to get the right treatment. You need to check whether your teeth are healthy before you start moving them. Patients with gum disease, for example, can see additional problems arise due to tooth movement, and potentially lose more bone over time.

Likewise, if you are just moving teeth without checking other factors such as bite, then this could create fresh problems. The consequences might not emerge for several years but, ultimately, result in a patient needing more serious treatment down the line.

Invisible solutions have, without doubt, transformed orthodontics for patients and practitioners. As technology continues to inform opportunity, I believe that the sector’s long-term potential lies not only in opening up treatment to a greater number of people in the Middle East, but in making it available to a broader global patient demographic – irrespective of income, location and other constraints.


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