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Align and SmileDirectClub Idea Proposal (ALGN, SDC)

Align and SmileDirectClub Idea Proposal (ALGN, SDC)

How will COVID-19 affect demand for clear aligners?

Report Available: April 23, 2020


Blueshift’s initial research found dentists and orthodontists seeing their industry slow to a crawl as it adjusts to the coronavirus. Two-thirds of all dental practices in the U.S. are temporarily closed and patient volume has declined significantly. New patient starts for SDC and ALGN are likely to decline dramatically as elective medical procedures have been discouraged during the pandemic. Still, teledentistry, which had been growing pre-coronavirus, has the potential to build momentum and provide a lifeline for SDC and ALGN through the end of the pandemic and possibly beyond.



  1. Survey results from 137 dentists conducted last week revealed that 67% have now closed their dental offices and expect them to be closed for another four to five weeks. There were some geographic differences:
    • West Coast closures – 84%
    • New England closures – 78%
    • South Atlantic and Mountain region closures – 40%

This has led to patient volume declines and less spending. Patient visits dropped 63.6% and several offices reported an 80% to 100% decline, according to the survey.

  1. Teledentistry has not been strongly supported by dental associations in the past. But the increasing number of consumers using DIY clear aligner platforms and the recent coronavirus pandemic are expected to bring about significant change. The American Association of Dental Boards (AADB) and the General Dental Council in the U.K. are now looking to provide regulatory guidance for the use of teledentistry. As healthcare workers and patients become more comfortable with telehealth, it is possible this will apply to dentistry and the clear aligner space as well, and may last far beyond the end of the COVID-19 pandemic.
  1. SDC was founded as a direct-to-consumer clear aligner provider using teledentistry to communicate with its patients and dental professionals. The majority of its sales come through its online traffic, though it started wholesaling products to dental and orthodontic practices this year. SDC’s DIY business model could help generate new patient starts during the coronavirus pandemic and keep current customers engaged during stay-at-home orders. It has also offered its HIPAA-compliant teledentistry platform to any practice free of charge to maintain contact with its patients. SDC is referring its online patients to local dentists who agree to use its teledentistry program. But the company has also had to furlough many of its employees as it has extended its store closures.
  1. ALGN said some of its doctors are using video and patient-submitted photos to monitor their patients’ Invisalign treatment progress. ALGN’s model does not include an online DIY option. All new patients must be seen by one of its participating dentists, hampering new patient starts for the foreseeable future. In an interview with Blueshift, one dental practice using ALGN said they are trying to copy SDC right now by making customers’ Invisalign trays available without contact, while some of his colleagues are using video tools like Zoom to interact with patients.
  1. Blueshift’s Feb. 12 report on SDC was positive, indicating that its decision to sell its clear aligners directly to dentists and orthodontists would drive growth and improve its poor reputation. Our Oct 3, 2019, report on ALGN cautioned that sales of its Invisalign aligners were at risk in the mild and moderate teeth straightening market segment because of intense competition for low-cost DIY competitors including SDC.


How has COVID-19 impacted overall demand for clear aligners? How do new patient starts for Q1 2020 compare to Q1 2019? What are dentists’ expectations for appointment booking for Q2? Will patients previously scheduled to start clear alignment treatment postpone or cancel? How resilient will clear aligner treatments be compared to other elective dental procedures? Do decreased office visits and office closures put Invisalign’s share of business at risk? Is SmileDirectClub’s teledentistry and online DIY platform a competitive advantage? To answer these and other questions, Blueshift will gather data and issue a market research report from independent sources in the following areas: Dentists, Orthodontists, and the Dental supply chain.  



Companies: Align Technology Inc. (ALGN), 3M Company (MMM), Danaher Corporation’s (DHR), Dentsply Sirona Inc. (XRAY), SmileDirectClub Inc. (SDC), Straumann Holdings AG (STMN.SW)



Research Begins: April 6, 2020



To see other ideas Blueshift Research is currently working on, please click here.



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