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Corporate Profile: Align Technology Joanna Farber

by Joanna Farber  
Gary Brigham, DDS, MSD
Dr. Brigham, an Invisalign provider since 1999, has a successful orthodontic practice, Sierra Orthodontics, in Scottsdale, Arizona. He has 22 years of professional experience, and has served as an assistant professor of pediatric medicine and as a post-doctoral fellow at the Center for Craniofacial Anomalies at the University of Illinois Medical Center. He is an “Elite-level” provider in Invisalign’s Advantage program.
Daniel German, DDS (pictured far right)
Dr. German, an Invisalign provider since 2000, has been serving the Dayton, Ohio, community since 1987. He completed his undergraduate and dental school education at Case Western Reserve University followed by an orthodontic residency at the University of Louisville. He and his dental partner, Stephen P. Burke, DDS, own a 60-employee practice with offices in Beavercreek, Huber Heights, and Centerville, Ohio. Dr. German is a “Premier-level” provider in Invisalign’s Advantage program.
Earle A. King, DDS, DMD (pictured standing)
Dr. King, an Invisalign provider since 1999, is a native of Wexford, Pennsylvania. He attended the University of Pittsburgh School of Dental Medicine, earning his DMD in 1972, and a Master of Science in Orthodontics in 1974. He has practiced orthodontics exclusively in Wexford since 1976. He is an “Elitelevel” provider in Invisalign’s Advantage program.
Teen patients have long had only one option for orthodontic treatment – wires and brackets. But more and more, teen patients (and their parents) are asking for a less visible, less intrusive treatment option. To answer that, Align Technology, Inc., created Invisalign Teen, which it launched in July, 2008. Invisalign Teen is currently the only clear orthodontic aligner product designed to address the unique concerns of treating non-adult comprehensive patients. The device has features to address compliance, natural eruption of permanent teeth, and root-movement control.

Santa Clara, California-based Align Technology designs, manufactures, and markets Invisalign, a proprietary method for treating malocclusion. Invisalign corrects malocclusion using a series of clear, nearly invisible, removable appliances that gently move teeth to a desired final position. Because it does not rely on the use of metal or ceramic brackets and wires, Invisalign significantly reduces the aesthetic and other limitations associated with braces. Align Technology was founded in March 1997 and received FDA clearance to market Invisalign in 1998.

In a 2007 survey commissioned by Align, orthodontists cited patient compliance as their number-one concern when treating teen patients. In response, Align designed Invisalign Teen aligners with compliance indicators that provide a visual cue of approximate patient wear. When worn as directed, the indicators are designed to fade from dark to light blue or clear during the two-week wear period for each set of aligners - providing doctors, parents, and patients with a visible gauge of compliance.

In another move to help ensure continuous aligner wear, Align includes up to six free individual arch replacement aligners to compensate for aligner loss or breakage during active Invisalign Teen treatment. One of the benefits of Invisalign Teen treatment is the ability it gives the patient to remove the aligners for sports, music lessons, and for meals at school or on the go, provided of course they wear the aligners for the prescribed amount of time per treatment period. Because it is so easy for an aligner to get lost during a teen's hectic day, the replacement aligners can help ensure that compliance doesn't become a stumbling block during treatment.

In addition to compliance concerns, orthodontists identified dentition issues common to teen patients. Teenagers often begin orthodontic treatment while their permanent teeth are still coming in, or "erupting." Invisalign Teen aligners feature specially engineered "eruption tabs" to compensate for second molars that continue erupting during treatment. Invisalign Teen aligners also include a new feature called Power Ridges, which is designed to provide additional force in cases where certain types of root movement are prescribed.

We spoke to three orthodontists who have already begun using Invisalign Teen. Each doctor has been in practice for more than 20 years, and they are all too familiar with the many challenges of treating teen patients effectively. As longtime Invisalign providers, they were each excited to hear about the new Invisalign Teen product. But, as any successful doctor must be, they are also what is commonly known as "tough customers." Here's what they have to say about Invisalign Teen.

What were your initial thoughts when you were told about Invisalign Teen?
Dr. Gary Brigham: I was asked to participate in Align Technology's pilot program in April of this year. For me personally, it is the most exciting product that I've ever been exposed to in the field. It presents an amazing situation for orthodontists and patients alike. I was especially interested in the new features unique to the Teen product. I had already treated 144 teen patients with Invisalign, so the prospect of having a teen-specific Invisalign product was exciting. I've been an enthusiastic user since the Invisalign Teen product launched.

Dr. Daniel German: I heard about it in the spring of 2008. We became part of the extended pilot program and started submitting cases June 1. I had really positive thoughts when I first heard the rumors that there was a teen product in development. I knew there were a good number of younger patients who were reluctant to have braces placed on their teeth because there are too many milestone events during these years, so I was excited that I might have something to offer them. On the other hand, we were a bit apprehensive given concerns with challenges with patient compliance, lost aligners, and the partial eruption of permanent teeth. Once we realized that these three concerns were being addressed with the new product, our reservations about moving forward were subdued.

Dr. Earle King: We (Editor's note: Dr. King practices with his son) were first exposed to the concept of Invisalign Teen at the Invisalign Summit in Las Vegas in November 2007. We were asked if we were interested in participating in Align's pilot program and we enthusiastically said, "Yes!" We were very excited because we had been using traditional Invisalign all along for teens with a full complement of dentition, and had to turn down many teens and pre-teens in the late mixed dentition who were desirous of the Invisalign approach.

How many cases have you done using Invisalign Teen?
Brigham: I have 22 teens using the product since the pilot program launched in April. My key concern with Invisalign Teen was if patients were OK with the Power Ridges feature (used for palatal root torque). So far, no one has any complaints. I'm excited about them because if they work well, it will open the door to more (older) patients.

German: We are getting close to 100 case-starts already. We appreciate the ability to provide torque to the upper anterior teeth from the first aligner when implementing the Power Ridges. Patients seem to prefer these, which are built into the aligners over composite attachments that are placed on the upper anterior teeth to affect torque.

King: I immediately jumped on the Invisalign Teen bandwagon. I recognized the need for an aesthetic, removable system of precise tooth movement, even in the late mixed-dentition age group. We've now submitted about 30 cases, and have about 15 in treatment.

Do you offer traditional braces as well? If so, share your thoughts on using Invisalign Teen
versus traditional braces.
Brigham: Yes. Some patients know they won't be compliant, so traditional braces work better for them. As stated above, many teens are more sophisticated, socially conscious, and active than they were 10 or 15 years ago. These teens welcome Invisalign over traditional braces, and even support combination treatment when Invisalign alone cannot treat the entire malocclusion.

German: Yes. The majority of our patients still wear traditional braces, but a growing percentage of the practice is taking advantage of Invisalign and Invisalign Teen. Just as some patients can be treated better and more quickly with Invisalign Teen, others are still best treated with traditional braces. However, if we were to rate compliance levels of patients with Invisalign versus those with wires and brackets, we find there is more compliance with Invisalign Teen.

King: Absolutely! We give patients and parents all options, with the advantages and disadvantages of each. Our experience has been that the great majority of teens will choose Invisalign Teen when it is a viable option.
"If we were to rate compliance levels of patients with Invisalign versus those with wires and brackets, we find there is more compliance with Invisalign Teen."
– Daniel German, DDS




Dr. Daniel German (seated, far right) puts together an
Invisalign Teen treatment plan for one of his patients.

Explain some of the teen patient challenges that you think this product addresses.
Brigham: It readily and conveniently suits teens' active lifestyles and social agendas more than any orthodontic treatment modality. I honestly believe Align doesn't fully realize how good a product it has. Time will show them, though. It has revolutionized the way I practice orthodontics.

German: We live in a culture that has become accustomed to immediate gratification. Orthodontics has never been "immediate" – you put the braces on, and the teeth took 18 to 24 months to fix. Patients really appreciate having the option to remove the aligners for milestone events such as senior pictures, prom, musical performances, and other important moments.

King: Obviously, patient compliance is a key element of success with this product. So we let every prospective Invisalign Teen patient know that lack of adequate wear time will necessitate switching to fixed braces, and an additional fee for mom and dad. However, it has been our observation so far that the patients are well-motivated and enthusiastic about doing something different than their peers.

What type of feedback have you received from patients about Invisalign Teen?
Brigham: Teens are enthusiastic in general, which indicates that there is a great market for it. I put the brochure out in the waiting room, and kids as young as nine years old are asking about it.

German: The feedback we have received from our patients has been wonderful. Our existing patients who are having their braces removed become aware of our Invisalign products and sometimes say they wish Invisalign Teen had been available for them when their treatment started.

King: They're thrilled. It's so gratifying to see a teen or preteen break into a big smile when we tell them during their initial exam that they have an alternative to fixed braces. They go from not even wanting to be in the exam chair, to becoming an enthusiastic future patient. The responses from our patients have been unanimously positive.

Do you have any words of caution about Invisalign Teen?
Brigham: Not about the product itself. There is a misconception that there's an easy way to do things, and some doctors forget that this is a medical device. They really need to be committed to learning how to use the product so that they have positive experiences, and learning takes time. I have confidence in knowing that I've gone out there and studied (online materials, taking seminars, courses, and classes) and have a body of knowledge to draw on. It requires time.

King: Like any treatment modality, it takes a lot of experience and diligence to provide consistently excellent results, as well as a well-trained and knowledgeable, motivated staff.

Any words of wisdom for non-Invisalign Teen practitioners?
Brigham: Start slowly, choose your cases, and never give up. I believe any orthodontist can use it. If you hit a snag, Align offers tons of support, including live classes and online education. Not one time have I walked away without learning something. The company has outstanding doctors on staff who are willing to share their experience and mistakes. They also have territory managers who are responsive and really take the time to know the practice. Invisalign has already changed the face of the orthodontic profession. If orthodontists recognize that the profession is constantly evolving and improving – and embrace it accordingly – then it will permanently change their professional life in a most satisfying manner.

German: Yes! What are you waiting for?! If you are a seasoned Invisalign provider, you will find it to be a natural progression into the Invisalign Teen product. The online educational program is quite helpful in outlining the differences between regular Invisalign and the Invisalign Teen product.

For more information on Invisalign Teen, visit institute.aligntech.com/products/teen.
Author's Bio
Joanna Farber has been in the publishing field since graduating with a B.A. in journalism and public relations more than 10 years ago. She has held editor positions for dental/orthodontic newspapers, and has also worked as a freelance writer. Joanna lives in New Jersey with her husband, Golan, and their son, David.
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September 2025
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