45 Data Points on Teeth Straightening, Direct-to-Consumer Orthodontics, and Clear Aligner Therapy Solutions [Backed by Research]

Whether you’re entertaining the idea of getting braces again or would prefer a second opinion on corrective orthodontics via clear dental aligners, the right data is necessary in your decision-making process. 

Where should you start? NutrishMe analyzed 45 research points about: 

• Teeth Straightening and DTC Clear Aligner Demographics
• What the Clear Aligner Industry Looks Like In 2022
• Leading Discoveries Between Clear Aligners and Fixed Appliances
• Why the Invisalign Market Continues to Stay on Top
• What’s Next for Clear Aligner Therapy (CAT) Solutions

The information was vetted and sourced from lab studies, journals, and reports that were released within the past 8 years. 

Let’s dive in. 

Teeth Straightening and DTC Clear Aligner Demographics

• Caucasian female millennials represent the largest buyers of direct-to-consumer (at-home) clear aligners, like those offered by SmileDirectClub. (Journal of the American Dental Association)
• 3 in 4 orthodontic patients are younger than 18 years old. (BMC Oral Health)
• Nearly half (48%) of Americans (aged 18-24) have untagged a picture of themselves on Facebook because they were insecure about the appearance of their smile. American Association of Orthodontists

• Worldwide, across both mixed and permanent dentitions, Angle Class I malocclusion displays a higher prevalence than Class II malocclusion. (Dental Press Journal of Orthodontics)
• Generally speaking, a clinical exam and X-rays of the mouth are all that’s needed to evaluate a patient’s periodontal state. (Case Reports in Dentistry)
• Several reports convey that women are more likely than men to consult with an orthodontist for treatment, but men have a higher probability of full compliance with their plans, when compared to their female counterparts. (L' Orthodontie Francaise; Progress in Orthodontics)
• While 87.5% of respondents were satisfied using a direct-to-consumer (at-home) orthodontic provider, 6.6% met with their dentist after experiencing aligner-related side effects. (The Journal of the American Dental Association)
• General orthodontists say approximately 10% of cases at their practices require orthodontic surgical solutions – i.e. jaw surgery. (European Journal of Orthodontics)
• A standard, unbiased orthodontist would also deploy an orthodontic extraction – i.e. tooth removal in roughly 25% of cases. (European Journal of Orthodontics)
• When asked to reevaluate their quality of life (post-orthodontic treatment), a sample of adults between the ages of 20-30 provided a rating that was 50% higher than their initial (pre-orthodontic treatment) responses. (Journal of Pharmacy and Bioallied Sciences)

2022 Clear Aligner Industry Statistics

• There’s a significant reduction in the number of emergency appointments needed with clear aligners vs. fixed appliances. (International Journal of Dental and Medical Speciality)
• Invisalign “Teen” Packages show promise for candidates as early as 12 years old. Licensed orthodontists and dentists may see a large opportunity to implement this multi-phase plan, with an elevated option to request supplemental aligners throughout the entire course of treatment. (International Journal of Environmental Research and Public Health)
• In a 30 patient assessment of non-extraction Invisalign cases, movement of the maxillary second molar between targeted and actual positioning was the only inconsistent, valid observation worth noting. (The Angle Orthodontist)
• At this time, the list of contents being used to manufacture clear orthodontic aligners are the only approved properties for the CAT market. (Materials)
• 73% of clear aligner patients gathered insights about CA (clear aligners) with the help of their social network and social media advertising – not from a doctor, professional group or office marketing. (Progress in Orthodontics)
• Although it’s crucial for websites to convey a deep understanding of clear aligner treatment for prospective patients, a readability assessment proves that information quality remains poor to average across the board. (Journal of Orofacial Orthopedics)
• Clear aligners are viscoelastic, meaning their contents are between viscous and elastic properties. Therefore, changes can deviate before any movement in the mouth takes place (due to climate and environmental stressors). (Frontiers in Materials)
• What sets different clear aligner companies apart is their overall breadth of application, assembly, aligner density, their utilization of bonded resin attachments, treatment sequence, and the duration of wear per each set of aligners. (Journal of Clinical Medicine)
• One study examined the color stability of clear aligners following 12-hour immersions. Its findings suggest that coffee led to noticeably stained Invisalign trays, against other dark beverages — such as red wine and black tea. (International Journal of Oral Science)
• An experimental test on clear orthodontic mechanics makes a conclusive argument that the gripping force of aligners is strongest on the labial side of the central incisors and weakest on the lingual side of the first molar. (Dental Materials Journal)

Leading Discoveries Between Clear Aligners and Fixed Appliances 

• Clear aligners showed a lower rate of effectiveness than braces in creating adequate occlusal contacts, controlling teeth torque, as well as opening transverse width/retention. (BMC Oral Health)
• According to a 2019 peer-reviewed journal, there’s a longer span between orthodontic visits for patients using aligner therapy, than those relying on fixed appliance (metal braces) treatments (10–12 week intervals vs. 4–6 week intervals, respectively). (Turkish Journal of Orthodontics)
• Both Invisalign and fixed appliances can modify the positioning of intercanines, interpremolars, and intermolars when crowding is present. Incisors enter a state where they’re vulnerable to extend and retract when crowding is > 6 mm. (The Korean Journal of Orthodontics)
• Discomfort following the first and second monthly adjustment stages was consistently lower for clear aligner patients than fixed appliance patients. (The Angle Orthodontist)
• A retrospective study showcased how clear aligner treatment for mild malocclusions had a more favorable outcome in tooth alignment, occlusal relations, and overjet – when stacked against results from fixed appliances. (The Angle Orthodontist)
• When comparing areas of plaque index and gingival index among clear aligner and fixed appliance treatment cases, clear aligners had a better impact on a patient’s periodontal health. (The Journal of the American Dental Association)
• Unlike fixed appliances, limitations of CAT include the extrusion of anterior teeth, rotations of rounded teeth, as well as anterior buccolingual inclination improvement. (Australian Dental Journal)
• Orthodontists assert that with CAT, they have the ability to to focus on teeth that have structural anomalies and difficult-to-bond surfaces. This may not always be the case with the capabilities of fixed appliances. (International Journal of Dental and Medical Specialty)
• Fixed appliance treatments aren’t dissolving entirely. In fact, orthodontists may recommend them on a case-by-case basis. 2017 survey results highlighted that general dentists had higher confidence in being able to treat deep bite, severe crowding, and Class II malocclusions with clear aligners than orthodontists. (The Angle Orthodontist)
• While clear aligners and braces showed effectiveness in the treatment of malocclusion, clear aligners posed more of an advantage in the segmented movement of teeth and could predict outcomes during a shortened treatment plan. (BMC Oral Health)

Why the Invisalign Market Continues to Stay on Top

• In 2018, it was recorded that 5 million patients have turned to Invisalign clear aligners. (Vision Research Reports)
• Over 1 million teenagers have used Invisalign, at an estimated total of 87k cases. (Vision Research Reports)
• During 2020, the number of Invisalign adult and teen patients jumped 36.7% and 38.7%, respectively. Moreover, Invisalign cases for teens or younger patients reached its peak in the midst of the coronavirus pandemic. (Grand View Research Inc.)
• 2020 evidence indicates that Invisalign patients tend to experience less pain in their initial days of treatment, when compared to those on a fixed appliance course. (Progress in Orthodontics)
• After a one-week period, Invisalign patients began noticing minimal discomfort on a more regular basis. (The Angle Orthodontist)
• The percentage of Invisalign patients requiring pain medication goes up by 11% on day one, and then tapers off for the duration of their first week with aligners. (The Angle Orthodontist)
• When tested in a quantitative analysis, Invisalign outbeat three other clear aligner technology systems for containing the lowest amount of leached chemicals. (Dentistry Journal)
• In a 2019 observational study, better chewing ability was cited as a significant improvement for Invisalign candidates. (Medical Principles and Practice)
• In 2015, Invisalign maintained a record of 45,580 active doctors. Fast-forward to Q3 ‘21, and there was an almost 90% increase with 85,500 active Invisalign doctors. (Australian Dental Journal; Align Technology)

• Invisalign aligners can straighten teeth in a predictable time frame, yet practitioners should know that when power ridges and attachments are applied for extensive tooth movement, a ~50% loss in torque is highly probable. (BMC Oral Health) 

What’s Next for Clear Aligner Therapy (CAT) Solutions

• Considering the last 2 decades, financial trends show a substantial increase of 8.4 billion dollars allocated to orthodontic expenditures. (BMC Oral Health)
• Align Technology, Inc., Envista Holding Corporation, Institut Straumann AG, Dentsply Sirona, 3M Corporation, Henry Schein, Inc., and TP Orthodontics, Inc. are currently the biggest key players in the clear aligner market. (Global Market Insights Inc.) 
• 69% of orthodontic/general dentist patients who haven’t yet tried clear aligners, intend to start CAT in the future. (Progress in Orthodontics)

Source: Progress in Orthodontics

• Because direct 3D printing can manipulate the thickness of clear aligner trays, CAT allows for a more measured control of tooth placement Materials)                       
• Research about clear aligner orthodontics is on the rise and the scientific community has an interest to keep adding to the pool of new CAT studies and papers. (American Journal of Orthodontics and Dentofacial Orthopedics)

Global Market Insights Inc. estimates that the value for clear aligners and clear aligner therapy (CAT) will reach 29.4 billion dollars by 2028. That’s a lot of smile corrections! 

I know… this is a lot of information to digest. I’m interested to hear which nuggets you were most surprised to see. 

Share them in the comments below.