But it will not last forever
On this we agree. 
I though my post was sufficiently hedged in the sense that disruption is possible but not likely at this time. You could have enjoyed IBM for 50 years before it was disrupted. I enjoyed IBM in Venezuela for four years before the damn Cubans took it over.
Denny Schlesinger
Now ALGN is spending a lot of effort and resource on patent protection. Personally I’m glad they are because I think it’s very necessary. If you disagree, then you surely must wonder what they’re doing.
Dan:
As reported at the NPI, this company is already going for the DTC market and I do not believe is using ALGN.
http://discussion.fool.com/another-align-competitor-at-home-3290…
So the time may be nigh for competition in the DTC market…a market I personally believe will be huge.
However, AT is best when employed in limited treatment cases that involve much less tooth movement…such as limited straightening of front teeth in adults who are much more compliant and motivated than young teens
Dr. J:
This is great that you have chimed in on this topic because it is a wonderful time to “drill” down to specifics regarding the prospects for ALGN.
Can you clarify for me a few questions:
Is there any financial incentive OR disincentive to use ALGN in an orthodontist practice?
I am reading that some 70% of kids get braces but that perhaps only 40% actually needed them (according to a study out of an academic institution). Could this be true and if so, since the lion’s share of that difference (30% or so) likely are doing this for purely cosmetic reasons, is this the likely target market for ALGN?
Regardless of braces used, everyone must wear a retainer at night the rest of their life…this is not ALGN specific…correct?
Are you saying that an orthodontist cannot make the decision on brace type purely from molds? What percentage of people would a personal exam have changed the proper bracing technique that could not have been ascertained by impressions?
As a matter of full disclosure, I am not invested in ALGN.
However, for me personally, I would ONLY be interested in the investment if, and only if, the DTC model were valid.
IMO, the MUCH larger market is the DTC market with less severe tooth displacements. They would be the folks such as:
Adults who want to improve their cosmetic appearance largely of the front teeth…look how vane our society is…plastic surgery, makeup, hair work, etc…ALGN teeth straightening is an natural extension of the same.
Kids with previous braces that failed to wear their retainer and now experience some early shifting…call it the ALGN salvage technique
People who cannot afford the additional cost of an orthodontist markup
People who cannot afford the lost time from work/school
The 30% of kids who now get braces that didn’t really “need” them from a overbite, etc. perspective.
Now, the rather compelling argument for ALGN in the above scenarios are that:
IMO, this would be a MASSIVE market worldwide…affordable and convenient.
I would appreciate if you would shoot as many holes in this argument as possible from an orthodontist perspective.
Thanks in advance:
Duma
Excellent job on Clorox. I’ve tried the Lysol product for toilets and it is not even close to what Clorox does.
Tinker, an interesting thing about a banana republic flushing itself down the toilet like mine is currently doing is that you rediscover simple home products that work. White vinegar is just as good for cleaning toilets, it dissolves the calcium carbonate (CaCO3) deposit of hard water. Just pour some in toilet, swirl it around with the brush and forgetabouit.
BTW, not finding softener for the wash you can also replace the phosphoric acid with vinegar. Not quite as good but it will do.
Denny Schlesinger
Fascinating the diversity of opinion about this company and stock!
Denny Schlesinger
Thanks Dr. J
Duma,
I will attempt to answer your questions in the order you have asked them:
Absolutely there is a financial incentive to use ALGN in an orthodontic practice. It attracts more patients to a practice. The orthodontist must manage patient’s expectations, however.
No one ever died, to my knowledge, from crooked teeth. However, the tremendous advantages of a nice white beautiful smile can be of tremendous worth to a teen’s self image and sense of worth…and to many adults as well. These are discretionary dollars well spent, IMO.
Retention is critical to preserve straight teeth regardless of whether “fixed braces” or ALGN is used. ALGN treated cases are more prone to relapse. In an ideal world, yes, lifelong use of retainers would be the ideal. However, we all know that in the real world this is not going to happen.
No orthodontist worth his salt is going to make an orthodontic treatment plan based solely on models of the patient’s teeth. A personal exam is always wise. Patients normally have many questions that need to be answered. When fully informed of all options, most will make the decision that fits their needs best.
IMO, the DTC market is not a wise nor a valid way to move teeth. The issues are simply too complex.
Suppose there was a DTC market for appendectomies. How many would send off for their surgical kit with a nice set of instructions?
Hope this helps, Duma.
All the best,
Jim
<<<Tinker, an interesting thing about a banana republic flushing itself down the toilet like mine is currently doing is that you rediscover simple home products that work. White vinegar is just as good for cleaning toilets, it dissolves the calcium carbonate (CaCO3) deposit of hard water. Just pour some in toilet, swirl it around with the brush and forgetabouit.>>>
It really is hard times in Venezuela, a brush?!? so Third World ;).
Bulwnkle did such a good job on Clorox that one does not even need a brush. Bacteria rings and dirt simply disappear after 10-30 minutes of saturation and then you just flush it away. I don’t even keep a brush anymore in any of my bathrooms, except one, where it came with the house.
And my ex-wife use to complain about the labor required to keep up a house. I got her three Roombas, she had Clorox for the toilets, like OMG! The poor thing…but getting three Roombas for X-Mas was probably not my finest hour ;). Oh, the Christmas of 2005, memories of that one.
But, as I am finding out, vacuum technology has continued to improve. Trading in my 10 year old Oreck for a brand new one, like night and day. It not only vacuums much better, but it is designed so that dog hair and other dirt is also sucked in from a distance. It maybe takes me 10 minutes longer to thoroughly clean with the new vacuum than it would take to properly set up the house and care for the Roomba and the new design is flat enough so it fits under the couch and beds.
And mops…I got one of those spinning scrubber things that polishes the floor. Oh my, the CLEANLNESS!
I must be on something getting so off on clean. Something new and interesting I guess. The science of clean, and the fact that I can do it better and easier than my ex ever managed. There is real satisfaction in that ;;;))). Oh…she has her good qualities, none of which I will air in this realm.
Tinker
As a retired patent litigator with 40+ years of experience, I would say there are only a small percentage of utility patents that cannot be “gotten around” (designed around or invalidated). A good guesstimate might be 5%, and that’s probably on the high side. The more important point is that statistics are worthless when it comes to assessing patents. The devil is in the detail, and most patent cases are won or lost on the basis of one or a few words in the claims of the patents (the claims legally define what the patent covers and often require intense parsing to interpret and understand). Unless you have detailed information about the issues in a case and many hours to devote to studying them (not to mention the expertise), you’re just guessing at the probable outcome. Patents are one of the most complex areas, if not the most complex area, of law.
DrillerJim
Never is a long time. When it comes to science, I’m not sure always and never are words that should be used. Think about it. At the beginning of the 20th century Henry Ford developed a method of mass producing automobiles. Within 10 years I expect most of them to be electric and self driving. I am sure most everyone in 1917 would have said that will never happen.
By the time I will be too old to drive, I will be able to get in my car and say take me to my favorite restaurant and I can sit back and relax until my car parks itself in the parking lot, or better yet, let me out at the front door, and go park itself. Who knows, they may even put valets out of business.
Tinker, an interesting thing about a banana republic flushing itself down the toilet like mine is currently doing is that you rediscover simple home products that work. White vinegar is just as good for cleaning toilets, it dissolves the calcium carbonate (CaCO3) deposit of hard water. Just pour some in toilet, swirl it around with the brush and forgetabouit.
Was a regular reader on this board some time back. Then got overwhelmed by trying to follow and keep up with wealth of daily information and fell away. New year, new time, recommitting to study and improving my investing have recently returned. Trying just to catch up with last two months of posts to be a little bit current with board, a bit of a rush at 500 or so posts per day. Taking notes on what to watch, research, study. Nothing, of course, to act on immediately. UNTIL THIS:
White vinegar to clean the toilet bowl. I never knew. And I have it in the cupboard now. Yes, will act on this tip IMMEDIATELY!!!
Thanks Danny!!!
okapimoon