Two years ago, the American startup SmileDirectClub entered the US market with a very lucrative offer. Plastic aligners for straightening teeth are half the price of braces from an orthodontist. Plus a bonus: patients don’t need to go to the dentist at all.
The concept was so successful that the company immediately had a dozen small competitors. But SmileDirect still has a big problem, Bloomberg found out . Patients complain of damaged teeth, and the American Association of Orthodontists demands that the state take control of the dangerous practice. In Russia, this business is only gaining momentum. “Secret of the Firm” found a similar Russian startup and found out what was happening to it.
Dentists from business
Six years ago, the founders of the SmileDirect startup, Alex Fenkell and Jordan Katzman, were making money by replacing their old driver’s licenses. For days, future startups hung out in the office of Jordan’s father, venture capitalist David Katzman, and listened to what serious businessmen were talking about. This is how they learned about one of Katzman Sr.’s most lucrative investments – contact lens manufacturer 1-800 Contacts Inc.
Future startups realized that they needed to invest in a business in the field of medicine. The choice fell on transparent plastic braces Invisalign, which was developed by Align Technology Inc. in the 90s. The advantage of the development was obvious: patients could put on and take off the aligners themselves. But only a licensed dentist could prescribe treatment. Then the idea appeared to work remotely – by mail.
The startups created a test site, attracted 500 clients, and in May 2014 they officially registered SmileDirect. After a while, the company’s services were advertised literally everywhere: in American social networks, on street signs and in public transport. By 2017, 342 SmileShops had opened in the USA and Canada, including 94 points in the CVS pharmacy chain.
A billion on my teeth
SmileDirect’s motto was simple: orthodontics is not as difficult as dentists say. It worked almost flawlessly: in the first half of 2019 alone, the startup sold 232,000 sets of aligners – almost the same as in the whole of 2018.
The scheme works like this: the patient goes to the store where they take a picture of his teeth, or he buys a set and takes an impression of the teeth and gums himself. The results are sent to a licensed dentist in the state where the patient lives. Sometimes a company asks for a copy of a medical record or an X-ray. In addition, the patient must confirm in writing that they have recently been examined by a dentist and that their oral cavity is in good condition.
Then the dentist prescribes the treatment remotely, and SmileDirect manufactures a set of individual aligners for several months. The patient takes pictures of the teeth from time to time and sends them to the dentist. He keeps track of all the changes.
A basic set of aligners costs $ 1,895 (122,863 rubles) – about 60% cheaper than braces.
SmileDirect does not work directly with licensed dentists, but rather acts as a platform through which they can offer their services.
The SmileDirect user agreement states that the company’s services are not the same as a visit to the dentist. “Since I have not been examined in a dental clinic, I take responsibility for the fact that the condition of the teeth may deteriorate,” the document says.
Four orthodontists interviewed by Bloomberg say it is dangerous to prescribe aligners without a detailed examination. A person may develop diseases of the gums, teeth and jaw joints. In addition, they note, it is much more difficult to diagnose a disease from a photograph than live.
Dr. Jeffrey Sulitzer, head physician at SmileDirect, says that the company’s work is practically no different from the medical practice of ordinary dentists. Patients do an excellent job of photographing, and medical records and x-rays only create additional difficulties. According to him, “Moving teeth is a simple, safe process. It is selective and non-invasive. “
However, the more popular SmileDirect becomes, the more patients complain of damaged teeth. The website of the Bureau of Impeccable Business has already accumulated about 1050 complaints.
And what about Russia?
When the startup SmileDirect conquered the American and Canadian markets, Russian businessmen copied the concept to implement it in Russia.
The business seemed profitable. At the same time, the partners copied the idea of aligners by mail and opened a website that offered to align teeth without leaving home. The profit was divided in half, but the agreements were oral. The service was adapted to Russian conditions. You do not need to go to the store for a picture or take an impression yourself. The dental technician came directly to your home or office and did everything for free. The treatment plan also did not require any costs – you only had to pay for the aligners. The order amount seemed quite hefty: 5,500 rubles a month or 99,000 rubles for a year and a half.
The businessmen promised that a licensed orthodontist would be assigned to the client for the entire course of treatment. He will monitor the treatment process every two months. A special application will remind the patient of changing aligners. Instead of going to the dentist, you can send photos of the dentition, and the doctor will look at the dynamics of teeth movement.
What about the USA?
Most patients complain that as a result of treatment, their teeth have become loose and broken, or their bite has deteriorated. Some require SmileDirect to pay damages. But the money can be returned on one condition: you need to sign a confidentiality agreement in which you undertake not to discuss your experience, and to withdraw all complaints from government agencies.