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The Clear Aligners Market Faces Growing Scrutiny

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The Clear Aligners Market Faces Growing Scrutiny

What orthodontists are saying

The orthodontic community lit up after Align Technology’s most recent earnings call, raising questions about growth, competition, and patient satisfaction. Stock prices dipped, providers vented frustrations, and the once-untouchable leader in clear aligners suddenly looked more vulnerable than ever. What happened? In short, orthodontists are calling out a perfect storm of competition, patient dissatisfaction, and corporate missteps.

Patients are less starry-eyed
Twenty-five years ago, aligners were marketed as a magic bullet, offering straight teeth without braces. Now, patients are more discerning. They want more than just alignment; they want stability, efficiency, and fewer refinements. Stories of endless trays and five-year “unlimited refinement” journeys have left many second-time patients opting for braces instead. The general sentiment is that while braces aren’t glamorous, they consistently deliver results.

Competition is fierce
The days of Align’s monopoly are long gone. New players are offering faster turnarounds, better tracking, and setups at half the price. Companies like Angel Aligner were repeatedly mentioned as examples of how innovation and affordability are reshaping the market. Brackets and wires, bolstered by digital manufacturing, are also making a comeback, cutting into aligner starts.

Pricing and positioning are a mess
Some argue that Align missed its chance to raise prices during its monopoly years. Others counter that they were overcharging from the start. Today, their costs look inflated compared with competitors offering “just as good” products for less.

Provider relations are frayed
Perhaps the loudest frustration isn’t about aligners themselves but about how orthodontists feel treated. The complaints are familiar: iTero exclusivity, expensive scan tips, nontransferable scanners, lawsuits over reusable sleeves, data storage fees that make Dropbox look like a bargain, and sales reps who sometimes talk down to orthodontists. Many providers feel squeezed for every penny while being simultaneously undermined by direct-to-consumer pushes and GP-targeted marketing.

Public perception matters
Patients talk, and their experiences circulate on Reddit and TikTok. Increasingly, braces are being seen not as a step backward but as a reliable solution. Some orthodontists joke that TikTok has done more to bring patients back to braces than any industry campaign. Others note that adults still prefer aligners for aesthetics, but the shine is fading as word spreads about compliance struggles and refinements.

Financial markets are noticing
Align’s growth has stalled, its stock has slid back near 2017 levels, and investors are questioning whether the company is a technology firm or just a glorified lab. At the same time, many orthodontists see a conflict between the demands of shareholders and the needs of patients, creating frustration on both sides. Amid the humor and sarcasm in online discussions, ranging from jokes about status levels and FDA approval to digs at corporate bravado. The underlying sentiment is serious: orthodontists increasingly feel taken for granted. Many who were once loyal customers are now exploring alternatives or relying more heavily on braces.

The takeaway? Align is still a giant, but giants can stumble. In a specialty where trust, consistency, and relationships matter as much as technology, arrogance and short-term thinking may cost more than any competitor’s pricing strategy.

What do you think? Are we witnessing a temporary dip for Align, or the beginning of a long-term realignment in orthodontics?
What’s your take?

Share your thoughts in the comments below.

Disclaimer: The views expressed in this article do not necessarily represent those of Farran Media. It is a summary of online discussions among orthodontists and was developed with the assistance of AI tools and edited by the editorial team.
Orthotown Magazine
October 2025
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