History of Invisalign
For decades, the only option if someone wanted straighter teeth was to get metal braces. Metal braces, in and of themselves, were a great invention. Before the technology that made metal braces possible, if you wanted straighter teeth, you would have had to have been born with them. Once metal braces arrived on the scene, anyone could get the straight smile they wanted. It wasn’t fast, and it wasn’t easy, and it certainly wasn’t comfortable, but it did work.
In the years between the first set of metal braces and the first Invisalign retainers, technology, including the understanding of how teeth move and the plastics that would make these aligners possible, had to be invented. The history of Invisalign does not begin just with the first set of plastic aligners—it begins far beforehand, as its entire invention is rooted in the desire for more effective and comfortable teeth straightening solutions.
Before Invisalign
Anyone who had braces before 2005 probably had very few choices when it came to orthodontic treatment. Before Invisalign was invented, there were generations of teenagers (and adults), that had to undergo metal braces, with no alternatives. Metal braces are not as painful nor as annoying as your friends will probably tell you when you are first getting them on, but they do come with their own slate of discomfort and annoyances. This makes them not a great option for many people, especially those that do not like the idea of having metal in their mouth for however long their treatment takes.
There are other varieties of metal braces that have essentially the same configuration and use the same technology. These include plastic bracketed braces and ceramic bracketed braces. All of these are just metal braces, without the metal brackets. Most still employ metal wire.
Because one of the major complaints of those who had braces was that they didn’t like having all the brackets across the front of their teeth, systems were also developed in which the brackets could be placed on the insides of the teeth. These systems came along with their own set of problems, including that the interior of the bit is more difficult to clean and that the brackets themselves are more likely to be broken off and the wire pushed out of alignment, simply because the tongue and teeth have more access to the brackets and wire.
None of these options really solved the overarching problem with metal braces, which is, of course, that they are legitimately uncomfortable to wear. That’s not to say that Invisalign is without discomfort entirely, but that the brackets and wire system are inherently irritating to the mouth, on top of the soreness of moving teeth.
Before the invention of Invisalign, the bracket and wire system was pretty much the only way to get straighter teeth. For those that wanted straighter teeth but did not want to undergo metal braces, there were few, if any alternatives.
That all changed in 1997.
The Origins of Invisalign
As a young student at Stanford, Zia Chishti was finishing up his orthodontic treatment. Anyone who has had braces, knows that getting your braces off takes just as long as it takes to get your braces on. There are molds that have to be made of the teeth, and it takes a long time to get each bracket off and then to remove the glue that once held the brackets on. Your dentists might be scraping that glue off of your teeth for years of cleanings to come. As Chishti was having his braces removed, he was thinking about how he could develop a better way for people to get straighter teeth.
It was at that time that his orthodontist presented him with his plastic retainer. At that time, they were still the old-school retainers with a plastic piece that sits against the top of your mouth and metal wires that loop around the teeth to hold them into alignment. When he received his retainer, he realized that a series of retainers like these could be just as effective at moving the teeth as a set of metal braces. They would have far more benefits than metal braces do, including the ability to remove the retainer when you wanted to clean it or your teeth, and, most importantly, the ability to remove the retainer when eating.
Because he was an adult orthodontics patient, he knew that there are just as many inconveniences and annoyances for adults who get braces as there are for teenagers; there are perhaps even more inconveniences and annoyances, considering that most people expect teenagers to have braces, and there is a greater stigma for adults who are undergoing and orthodontic treatment.
While the finished Invisalign system is nothing like those old-school retainers, that was the moment that this inventor decided that he could change the face of orthodontics and create a product that could drastically change how people got straighter teeth.
The Invention of Invisalign
Chishti then returned to Stanford, where he discussed his idea with Kelsey Wirth. The two of them partnered up and began to look for ways that they could make this idea a reality. Over the next year, they worked with developers and drew two more partners into their project: Apostolos Lerios and Brian Freyburger. In 1997, the four cofounded Align Technology, and the journey towards the Invisalign we know today had officially begun.
Their idea was good enough and they had developed it far enough that Kleiner, Perkins, Caulfield, and Byers invested in the project. In a garage in Menlo Park, California, the small company began looking at how to create a set of aligners that could legitimately mimic the results that metal braces can provide, without being too expensive or too extensive for normal people to afford.
As graduate students still earning their degrees at Stanford, Lerios and Freyburger had access to design software in a computer lab at the university. They employed the talents of Marc Levoy to help them learn how to mimic a solid, physical object with a CAD model, and then how to recreate that object using 3D printing technology. It was through the development of this system that they wrote a program that could design all the different stages of the retainers that would become the Invisalign system. The program could model a person’s current bite and then design the retainers that person would need to achieve a straight, attractive bite.
After a year of development, the project was submitted to the FDA, who gave it approval. Align Technology was now free to sell the product in the United States.
The Proliferation of Invisalign
When the Invisalign system was first introduced to the world of orthodontics, most orthodontists did not want to use it. Like most doctors, orthodontists wanted to stick with the techniques that were proven to work and that had worked on a grand scale for their patients in the past. They knew it was risky to provide their patients with a system that might not work and which might necessitate an additional treatment if the first does not work.
Some of this bias against Invisalign started because the original founders did not have any orthodontic training. They were Stanford students who had an idea, but none of them had actually studied orthodontics. As the idea became more and more popular with consumers, it also became more and more popular with orthodontists, who discovered that Invisalign was easy to use, easy to maintain, and often just as effective as metal braces.
During this time, Align Technology was spending far more money than it was making. Their advertising campaign was what The New York Times named one of the most aggressive marketing plans in the history of orthodontics. They still had plenty of money left over from fund raising to fund these types of marketing campaigns, but they were simply not making it back, despite the fact that the company made millions of dollars with an IPO in 2001.
By 2003, both Chishti and Wirth, Align’s two original founders, had resigned from the company. Thomas Prescott was hired to be the new CEO, and his first order of business was to seriously cut the company’s marketing spending.
During the same time, Chishti moved on to build a new company, called OrthoClear. It was the exact same idea and, a court would later find in favor of Invisalign when they brought fraud, patent infringement, fall advertising, and defamation law suits against OrthoClear. By 2006, OrthoClear had agreed to take $20 million from Align and close down their shop.
By 2004, more than 175,000 patients were using Invisalign. It was winning awards left and right, and by the time to company expanded their offerings overseas to Japan and had bought General Orthodontic, very profitable. Soon, universities like Harvard began to require their students in the Dental Medicine program to complete an Invisalign certification before they were allowed to graduation. In between 2008 and 2012, the number of Invisalign patients grew to over two million, with those numbers continually increasing.
New Advancements in Invisalign
Since going mainstream and becoming a standard in the world of orthodontics, Invisalign has changed very little. The Align company has developed several certificate and continuing education programs to dentists and orthodontists who want to learn about and use the system. There are now very strict standards that dictate how much training a dentist or orthodontist has before he can become certified in Invisalign.
Other advancements include expanding into Invisalign Teen, which provides a system of aligners specifically for teenagers and their mouths. This enables not just adults, for whom the system was originally designed, but also younger patients to benefit from Invisalign.
What Invisalign Has Changed in Orthodontics
While medicine is constantly evolving and changing, it wouldn’t be an overstatement to say that metal braces saw very few advancements in between when they were first used and when Invisalign hit the market. For most of the last century, metal braces used the same bracket and wire construction, with some innovations being made in the type of metal used in brackets and wires, the placement of the brackets, and how the wire is inserted into the brackets. The introduction of rubber bands, spacers, and bridges have made it possible to significantly change a person’s bite, with all sorts of orthodontic applications. All of these inventions provided slight changes to how orthodontists work. Only Invisalign completely overhauled the profession.
Invisalign made it possible for those who would never choose to have metal braces, either for cosmetic or for health reasons, to get the straighter teeth they want. Invisalign has solved many of the most common concerns that come along with metal braces and their variations, the biggest change being an orthodontic treatment that can be removed from the mouth for eating and cleaning, but which is still just as effective as metal braces are.
What’s next for Invisalign? Aligners are really only suitable for mild to moderate cases and some severe cases. With new advancements in their own technology and new innovations that make it easier to move teeth how they need to be moved, it is possible that Invisalign will eventually completely replace metal braces. Because they are covered by most dental insurance plans and are of comparable cost to metal braces, it is possible that aligners could overtake and eventually completely get rid of metal braces altogether.
