- Email: [email protected]
Interview with Align Technology executives
INTERVIEW
Interview with Align Technology executives Editor’s note: Readers have responded in near-record numbers to the guest editorial (“What price progress?” Ackerman JL, Proffit WR. Am J Orthod Dentofacial Orthop 2002:121:243) in the March issue of the Journal. Although Drs Ackerman and Proffit did not mention a company by name, many readers wrote, emailed, or called to defend or criticize Align Technology and the Invisalign technique. Some of these letters are presented in Readers’ Forum on page 14A. In addition, Thomas M. Prescott, CEO, and Ross Miller, clinical director of Align Technology, agreed to answer some of my questions about their company and the Invisalign process. I believe you will find their comments straightforward and thought-provoking. Readers who are not familiar with Invisalign might also want to also read Techno Bytes in the May issue (“Invisalign A to Z.” Wong B. Am J Orthod Dentofacial Orthop 2002;121:540-1). David L. Turpin: I understand you are relatively new to Align Technology. What is your background, and what attracted you to take the position of CEO? Thomas M. Prescott: I am new to the orthodontic community; however, I have spent a number of years in the medical technology industry in key leadership roles at world-class companies, such as GE Medical Systems and Nellcor, as well as smaller entrepreneurial firms like Cardiac Pathways, where I most recently served as President and CEO. Before joining Align, I evaluated many other opportunities. What I saw in Align was the promise that has also attracted top investors, talented employees, and pioneering clinicians. Invisalign is an innovative and compelling technology serving an industry with large, untapped markets. In short, I saw an opportunity to help clinicians address a huge group of potential patients who were going untreated. DT: Long before you arrived on the scene, the Invisalign technique was launched in a big way. In hindsight, is there anything you would have done differently? TP: Align Technology was started by 2 very bright entrepreneurial people who saw great opportunity and potential growth, and sought out a way to use technology to bring to market an orthodontic appliance that would have esthetic benefits for patients. Under their Am J Orthod Dentofacial Orthop 2002;122:19A-20A Copyright © 2002 by the American Association of Orthodontists. 0889-5406/2002/$35.00 ⫹ 0 8/8/127320 doi:10.1067/mod.2002.127320
leadership, the company achieved tremendous growth and initial success. There are always some things that could have been done differently. But we are extremely well positioned for the future. What we’ve learned through our experience is the value of having wide acceptance and strong endorsement from the orthodontic community in launching an orthodontic product. And we’re committed to being a responsible player in this field. DT: Marketing directly to the public has its pluses and minuses. How to you see these balancing out in the long run? TP: Marketing directly to the public has been mutually rewarding to orthodontists, the orthodontic community, and Align. Never in the history of orthodontics has there been so much visibility for the profession. Align understands, however, that once a consumer enters the doctor’s office, it’s up to the doctor to recommend the best treatment option for that patient. Therefore, it’s important for us to demonstrate the value of Invisalign to doctors by investing in research that tests the capabilities and practical limits of the appliance while contributing to the general body of orthodontic knowledge. Balance is struck when Align has a marketing campaign that brings new patients to orthodontists who understand the applicability of the product. The end result is a happy patient—that’s our joint goal. DT: To its credit, Align Technology has allocated large sums of money to research and development. Are you satisfied with your return on this investment? When will the concerns of most clinicians be answered regarding the level of treatment that can be expected in most patients? TP: We believe very strongly that we’ll get excellent returns from research and development programs. For a clinical perspective, I’ll let our chief clinical officer, Dr Ross Miller, address this question. Ross Miller: Align Technology has done much research into its product. In the beginning, we had very precise case selection criteria that were based on nicely finished treatments. As more and more doctors began using our product, they wanted to treat patients without these guidelines. Align Technology thought that expert clinicians should have the right to use our product on the patients they see fit to treat. When it comes to return on investment, our research dollars were well spent. We could have designed a few studies a little better, and we could have picked researchers with a higher degree of 19A
20A Interview
interest in clinical treatment, but, by and large, we are quite satisfied. Straight-wire appliances have been used in orthodontics for over 30 years now, and not everybody agrees which prescription does the best for their patients. As you know, Align Technology has a software program called ClinCheck that allows the doctor to set up a virtual treatment. You also know that clear overlay appliances have their limitations. A doctor must go through a number of learning curves, including finishing cases, to really obtain a great understanding of the system and its promises. I suspect just as with each previous orthodontic product introduction— be it bonded brackets, NiTi wires, or straight wires—most of these issues will be played out in orthodontic offices around the world. Clinicians who are willing to try something new and take the time to understand what they are doing will have great success, just as with past successes in orthodontics. DT: What are your plans for research in the future? TP: Align will continue to fund research and development here in the United States and with appropriate partners around the world. Invisalign-certified clinicians and research partners are our best resources for ideas regarding clinical research. We’d also like to more fully engage with professional organizations such as the AAO and the ADA for ideas, feedback, and debate. Because of the learning curve for clinicians just starting out with Invisalign, as with other new procedures or appliances, Align is committed to testing the practical limits of the appliance both as they exist today and as the technology can expand in the future. RM: Much of the research we have planned is based on the large amount of data we have collected over the life of the company. Our main interests continue to be extraction, superimposition of initial and final treatments, materials, and speed of movement. DT: Most orthodontists struggle throughout their
American Journal of Orthodontics and Dentofacial Orthopedics August 2002
careers with the issues of treatment timing, arch length, compliance, and dental and facial esthetics, not to mention long-term stability. If these concerns apply to the Invisalign patient as well, what are your plans for promoting this new technology to the general dental community? TP: In the United States and throughout the world, many in the general dental community are providing quality patient treatment with a range of orthodontic appliances supplied by the same firms that dominate the orthodontics market. We believe that, in the right hands and with the proper training and support, Invisalign can be responsibly used to treat patients. So we plan to certify general dentists in the use of Invisalign. We’ve already seen that our efforts to increase awareness of Invisalign to consumers have increased the visibility and attractiveness of orthodontia, and have compelled many more patients to seek treatment. RM: Many general dentists do orthodontics, as well as endodontics and oral surgery. We think it is in the patient’s best interest to have an option for treatment, especially when it comes to esthetic methods of straightening teeth. Patients must have something other than veneers and crowns offered to them. Many current treatments destroy tooth enamel and might be offered as a means to avoid braces. We hope that general dentists will be prudent in the patients they choose to treat, but, as you know, no manufacturer of orthodontic products can choose its customers. DT: Is Align Technology sound financially? Can we expect to see a continuation of the same level of support you have delivered to clinicians in the past? TP: Yes and yes. We are appropriately financed to pursue our mission. Our goal is to consistently exceed our customers’ expectations. They can count on our support of their clinical practices and their efforts to achieve great patient outcomes.
Interview with Align Technology executives Editor’s note: Readers have responded in near-record numbers to the guest editorial (“What price progress?” Ackerman JL, Proffit WR. Am J Orthod Dentofacial Orthop 2002:121:243) in the March issue of the Journal. Although Drs Ackerman and Proffit did not mention a company by name, many readers wrote, emailed, or called to defend or criticize Align Technology and the Invisalign technique. Some of these letters are presented in Readers’ Forum on page 14A. In addition, Thomas M. Prescott, CEO, and Ross Miller, clinical director of Align Technology, agreed to answer some of my questions about their company and the Invisalign process. I believe you will find their comments straightforward and thought-provoking. Readers who are not familiar with Invisalign might also want to also read Techno Bytes in the May issue (“Invisalign A to Z.” Wong B. Am J Orthod Dentofacial Orthop 2002;121:540-1). David L. Turpin: I understand you are relatively new to Align Technology. What is your background, and what attracted you to take the position of CEO? Thomas M. Prescott: I am new to the orthodontic community; however, I have spent a number of years in the medical technology industry in key leadership roles at world-class companies, such as GE Medical Systems and Nellcor, as well as smaller entrepreneurial firms like Cardiac Pathways, where I most recently served as President and CEO. Before joining Align, I evaluated many other opportunities. What I saw in Align was the promise that has also attracted top investors, talented employees, and pioneering clinicians. Invisalign is an innovative and compelling technology serving an industry with large, untapped markets. In short, I saw an opportunity to help clinicians address a huge group of potential patients who were going untreated. DT: Long before you arrived on the scene, the Invisalign technique was launched in a big way. In hindsight, is there anything you would have done differently? TP: Align Technology was started by 2 very bright entrepreneurial people who saw great opportunity and potential growth, and sought out a way to use technology to bring to market an orthodontic appliance that would have esthetic benefits for patients. Under their Am J Orthod Dentofacial Orthop 2002;122:19A-20A Copyright © 2002 by the American Association of Orthodontists. 0889-5406/2002/$35.00 ⫹ 0 8/8/127320 doi:10.1067/mod.2002.127320
leadership, the company achieved tremendous growth and initial success. There are always some things that could have been done differently. But we are extremely well positioned for the future. What we’ve learned through our experience is the value of having wide acceptance and strong endorsement from the orthodontic community in launching an orthodontic product. And we’re committed to being a responsible player in this field. DT: Marketing directly to the public has its pluses and minuses. How to you see these balancing out in the long run? TP: Marketing directly to the public has been mutually rewarding to orthodontists, the orthodontic community, and Align. Never in the history of orthodontics has there been so much visibility for the profession. Align understands, however, that once a consumer enters the doctor’s office, it’s up to the doctor to recommend the best treatment option for that patient. Therefore, it’s important for us to demonstrate the value of Invisalign to doctors by investing in research that tests the capabilities and practical limits of the appliance while contributing to the general body of orthodontic knowledge. Balance is struck when Align has a marketing campaign that brings new patients to orthodontists who understand the applicability of the product. The end result is a happy patient—that’s our joint goal. DT: To its credit, Align Technology has allocated large sums of money to research and development. Are you satisfied with your return on this investment? When will the concerns of most clinicians be answered regarding the level of treatment that can be expected in most patients? TP: We believe very strongly that we’ll get excellent returns from research and development programs. For a clinical perspective, I’ll let our chief clinical officer, Dr Ross Miller, address this question. Ross Miller: Align Technology has done much research into its product. In the beginning, we had very precise case selection criteria that were based on nicely finished treatments. As more and more doctors began using our product, they wanted to treat patients without these guidelines. Align Technology thought that expert clinicians should have the right to use our product on the patients they see fit to treat. When it comes to return on investment, our research dollars were well spent. We could have designed a few studies a little better, and we could have picked researchers with a higher degree of 19A
20A Interview
interest in clinical treatment, but, by and large, we are quite satisfied. Straight-wire appliances have been used in orthodontics for over 30 years now, and not everybody agrees which prescription does the best for their patients. As you know, Align Technology has a software program called ClinCheck that allows the doctor to set up a virtual treatment. You also know that clear overlay appliances have their limitations. A doctor must go through a number of learning curves, including finishing cases, to really obtain a great understanding of the system and its promises. I suspect just as with each previous orthodontic product introduction— be it bonded brackets, NiTi wires, or straight wires—most of these issues will be played out in orthodontic offices around the world. Clinicians who are willing to try something new and take the time to understand what they are doing will have great success, just as with past successes in orthodontics. DT: What are your plans for research in the future? TP: Align will continue to fund research and development here in the United States and with appropriate partners around the world. Invisalign-certified clinicians and research partners are our best resources for ideas regarding clinical research. We’d also like to more fully engage with professional organizations such as the AAO and the ADA for ideas, feedback, and debate. Because of the learning curve for clinicians just starting out with Invisalign, as with other new procedures or appliances, Align is committed to testing the practical limits of the appliance both as they exist today and as the technology can expand in the future. RM: Much of the research we have planned is based on the large amount of data we have collected over the life of the company. Our main interests continue to be extraction, superimposition of initial and final treatments, materials, and speed of movement. DT: Most orthodontists struggle throughout their
American Journal of Orthodontics and Dentofacial Orthopedics August 2002
careers with the issues of treatment timing, arch length, compliance, and dental and facial esthetics, not to mention long-term stability. If these concerns apply to the Invisalign patient as well, what are your plans for promoting this new technology to the general dental community? TP: In the United States and throughout the world, many in the general dental community are providing quality patient treatment with a range of orthodontic appliances supplied by the same firms that dominate the orthodontics market. We believe that, in the right hands and with the proper training and support, Invisalign can be responsibly used to treat patients. So we plan to certify general dentists in the use of Invisalign. We’ve already seen that our efforts to increase awareness of Invisalign to consumers have increased the visibility and attractiveness of orthodontia, and have compelled many more patients to seek treatment. RM: Many general dentists do orthodontics, as well as endodontics and oral surgery. We think it is in the patient’s best interest to have an option for treatment, especially when it comes to esthetic methods of straightening teeth. Patients must have something other than veneers and crowns offered to them. Many current treatments destroy tooth enamel and might be offered as a means to avoid braces. We hope that general dentists will be prudent in the patients they choose to treat, but, as you know, no manufacturer of orthodontic products can choose its customers. DT: Is Align Technology sound financially? Can we expect to see a continuation of the same level of support you have delivered to clinicians in the past? TP: Yes and yes. We are appropriately financed to pursue our mission. Our goal is to consistently exceed our customers’ expectations. They can count on our support of their clinical practices and their efforts to achieve great patient outcomes.