How DTC Invisible Aligner Brands Build Trust to Challenge the Orthodontic Status Quo

SmileDirectClub and Candid Co. have grown, even as the dental establishment questions their safety

SmileDirectClub and other DTC brands are typically much cheaper than Invisalign. Courtesy of SmileDirectClub
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Jordan Katzman and Alex Fenkell met at summer camp when both were 13 years old, bonding immediately, in part over their shared mouths of metal. As their friendship continued into adulthood, they keenly remembered the awkwardness of their orthodontia experience.

“It was just truly a pain point in our youth,” Fenkell said. “We figured there had to be a better way to approach it.”

The better way turned out to be SmileDirectClub (SDC), which Fenkell and Katzman co-founded in 2014. The company is one of a number of direct-to-consumer brands cropping up in recent years that provide invisible aligners (commonly referred to as “Invisalign,” the company that pioneered the use of clear aligners in the 1990s) at a fraction of the cost typically paid at an orthodontist’s office. The entire process, in fact, can be done without an in-person visit: an at-home kit creates a mold, and then aligners are sent by mail.

For April Fools' Day, SDC promoted a number of gag products, including flavored aligners and aligners for dogs.
Courtesy of SmileDirectClub

As SDC’s premise grows in popularity, similar companies like Byte, Candid Co., Smilelove and SnapCorrect have popped up, with a particular boom since 2017, after Invisalign’s patent on clear aligners ran out. Considering the typical expense associated with orthodontia (Invisalign can run up to $8,000, but a DTC treatment usually costs about $2,000), the lure of these direct-to-consumer brands is obvious. So obvious that it begs the question: Is it too good to be true?

Some orthodontists seem to think so, claiming these providers are only suited for minor concerns. Dr. Joseph Hung, an New York-based orthodontist, called the emergence of these businesses “appalling,” and said they fail to account for factors such as bone and bite. The American Dental Association (ADA) has also openly discouraged people from using these aligners, and the American Association of Orthodontists (AAO) put out a consumer alert that reads: “Remember that orthodontic treatment is not a product or device. Orthodontic treatment is a professional, medical service.”

It’s a testament to the great challenge these brands have in building consumer trust. With aligners, there’s a big gulf between legacy providers and their DTC counterparts, the former of which used to be the sole provider of these sort of devices. And trepidation is understandable: After all, a person only gets one set of teeth—it’s not like buying a mattress, where a consumer can go buy another if one doesn’t work out.

Fenkell acknowledged the orthodontic community’s displeasure: “Whenever you disrupt an industry, especially one as old as the dental industry, there’s going to be some inherent friction.”

Byte, another DTC aligner business, launched after SmileDirectClub.
Courtesy of Byte

Many of these companies self-profess to be better suited to smaller tweaks, rather than major orthodontic issues, prioritizing the health of potential patients over the accumulation of customers. Fenkell said SDC, which has successfully fought off several complaints filed by the AAO, is for “aesthetic and cosmetic” changes, while Scott Cohen, co-founder of Byte, said its product is best used for “mild to moderate” cases, and patients whose needs are too aggressive for Byte’s product will be rejected.

“When we accept the patient, it’s because we know that we can deliver outstanding results,” said Cohen.

That transparency helps build brands that customers trust, despite the disapproval from the orthodontic establishment. Success has come quickly: SDC recently hit a milestone of 500,000 customers, and has 210 SmileShops, where customers can get a 3D scan of their teeth. These sites offer an in-person touch point that provides the face-to-face interaction that people may find missing from a DTC orthodontia experience.

To market themselves, Candid Co., SDC and Smilelove have bright, modern branding, reminiscent of the aesthetic we’ve come to associate with challenger brands. SDC partners with millennial-friendly events, like the Vans Warped Tour, as well as a slew of influencers, and Byte partnered with marketing agency Barker to put out a catchy music video with rapper Mac Lethal. This creates an atmosphere opposite of what people typically associate with dental treatment.

“They’ve found a nice way through logos, names and colors to make their product very relevant and appealing to the masses, removing any of the scaries that are associated with the traditional orthodontist,” said Ryan Goff, CMO of marketing agency MGH. 

This welcoming message is imperative: Without that doctor-patient relationship, these brands have to build trust in other ways. “Messaging and brand positioning is everything to a DTC brand,” said Colin McDowell, group director, VMLY&R Advisory. “It’s the proverbial front door of your store. If it doesn’t resonate, they won’t open that door.”

And as these brands grow, Fenkell said they’re even better prepared to face any further backlash. “But access to care is what motivated us early on and it’s something we feel that’s worth fighting for,” he said.

This story first appeared in the April 8, 2019, issue of Adweek magazine. Click here to subscribe.

@dianapearl_ Diana is the deputy brands editor at Adweek and managing editor of Brandweek.