Invisalign Creates Greater Profits for Orthodontists

Invisalign Creates Greater Profits for OrthodontistsIs Invisalign a smarter braces treatment for an orthodontist’s bottom line?

A new study suggests some truth to this by revealing that, while Invisalign clear orthodontic aligners cost more in materials than conventional edgewise braces, they require fewer patient visits and a shorter duration of treatment for dentists.

Researchers reported this finding at the recent American Association for Dental Research annual meeting, according to Medscape News.

Researchers evaluated the records of 150 dental patients with mild to moderate class I malocclusion. The types of orthodontic procedures were matched for the amount of initial malocclusion and the number of rotated teeth.

According to Medscape News, here’s what they found:

Conventional braces required a median of 13.6 minutes for a routine visit, whereas Invisalign required 9.9 minutes. Emergency, initial, and final appointments were all longer than regular visits.

Conventional braces required about 2.6 more visits than Invisalign, treatment for 2.4 months longer, 1.1 more emergency visits, 9.7 minutes more in chair time, 1.2 minutes more emergency doctor time, and 86.2 minutes more in total chair time.

However, Invisalign cost $500 to $1441 more in materials and required 5.9 minutes more doctor time than conventional braces.

Measuring profitability as fees minus the cost of materials, Invisalign was more profitable than conventional braces, the researchers found, especially for Invisalign providers who are charged $899 in lab costs, a discount that the appliance maker, Align, offers to orthodontists who do more cases.

For these doctors, Invisalign provided about $1000 of profit per hour of chair time with the first $2750 in fees to the patient, rising to $3250 with $6000 in fees. Doctors who are charged $1549 in lab costs by Align had a profit of about $500 with the first $2750 in fees, rising to $3000 with $6000 in fees.

Braces were less profitable overall, starting at $750 per hour of chair time with the first $2750 in fees, but reaching only $2000 with $6000 in fees.

Invisalign is clearly the profit-maker when it comes to adding value to an orthodontist’s practice.

For more on this story see: Study Shows Invisalign More Profitable Than Braces

Private Equity Dental Management Companies Come Under Fire

Private Equity Dental Management Companies Come Under FirePrivate Equity dental management companies are at the center of a U.S. Senate inquiry, audits, investigations and civil actions in six states over allegations of unnecessary procedures, low-quality treatment and the unlicensed practice of dentistry, according to a report released by Bloomberg News.

Federal lawmakers and state regulators are trying to determine whether a popular dental practice model funded by Wall Street is having a destructive influence on dentistry in the U.S.

The private equity dental companies only account for about 12,000, or 8%, of U.S. dental practices, according to Thomas A. Climo, a Las Vegas dental consultant.

In 2010, The Wealthy Dentist reported that All Smiles Dental Center Inc., a management company owned by Chicago-based Valor Equity Partners, filed for bankruptcy protection after a Texas Medicaid action cut off reimbursement payments because of their exorbitant amounts of orthodontic care at the expense of Texas taxpayers.

All Smiles was part of a state audit that discovered 90% of the Medicaid claims for orthodontic braces weren’t medically needed.

After years of criticism that the poor were being deprived of dental care under Medicaid, class-action lawsuits and public pressure forced Medicaid to change their health care reimbursements. As reported by The Wealthy Dentist in our story, Taxpayers Footing the Bill for Braces in Texas, some Texas’ dental practices went on to bill Medicaid $184 million for Medicaid orthodontics — more than the rest of the United States combined.

M. Alec Parker, executive director of the North Carolina Dental Society told Bloomberg News that the private equity industry stepped up its investments in dental management over the last 5 years partly because health care was one of the few areas that grew through the recession.

According to the Bloomberg report, Christine Ellis, a Dallas orthodontist, who testified before Congress in April of this year reported that the “flagrancy of the fraud” she found in audits she performed for Texas Medicaid “is truly unbelievable,” with only 10% of the paid claims she reviewed actually qualifying for Medicaid coverage.

Ellis told the U.S. House Committee on Oversight and Government Reform that Texas “has gained a lot of fraudulent orthodontic providers, including many private equity owned dental clinics engaged in the illegal practice of dentistry.”

Medicaid's Dental Boom - Bloomberg News

This May North Carolina is considering legislation that would subject agreements between dentists and the companies to state approval over concerns brought about by the the practices of private equity dental practices.

The Wealthy Dentist twice reported on the North Carolina Senate Bill 655 that would require the North Carolina Board of Dental Examiners to examine all business contracts entered into by dental practices in their state.

Our first article, Dentists Beware: The Government May Want To Tell You How To Manage Your Practice detailed information concerning inclusive authority over how dentists manage their business.

The second The Wealthy Dentist article, Dental Practice Management: North Carolina Senate Bill Wants Dentists To Do It Themselves discussed dentist responses to the impact this bill could have on their dental practices.

The measure has already passed the state Senate and has moved on to the House, where leaders have appointed a special interim committee to study the bill and its potential repercussions to dentists.

Reports have surfaced that the legislative proposal likely to be heard this month. The basics of the bill is intended to restrict contracts dentists can build with dental service organizations and give the Dental Board control of how dentists in North Carolina run their practices.

The North Carolina Dental Society supports the bill, stating that dental management companies often bill dental patients for unneeded care and opponents insist that passage of the bill will only drive up dental care costs.

What are your thoughts on private equity dental management practices?

For more on this story see: Dental Abuse Seen Driven by Private Equity Investments

Braces Patients and the General Dentist (video)

Braces patients: dentists and orthodontistsThere is lots of variation among dentists when it comes to referring braces patients out to an orthodontist.

While 1 in 4 treats most braces patients themselves, 1 in 3 general dentists refers out all dental braces patients.

“Minor tooth movement is within the purview of dentist and pediatric dentist,” said one oral surgeon. “Treatment planning for major malocclusions is better done by an orthodontist and an oral surgeon.”

The relatively high cost of braces can be attractive to doctors. “If we (GP’s) as a whole just knew how easy orthodontics are, the vast majority could increase monthly income by 15 to 25%,” said one dentist. “I love doing it, and now me and my stay-at-home wife are both driving Mercedes.”

Read more about child and adult braces: Dentists and Orthodontist Referrals: Survey Results

Braces: Dentists Share Their Orthodontic Experiences (video)

Dental braces dentist survey video

Adult braces, Invisalign, and teen braces are all popular orthodontic treatments.
And dentists don’t just provide dental braces; they’re also patients.

The Wealthy Dentist conducted a dental survey asking dentists if they personally have had braces, if any of their children had them, and if they had any further thoughts on their personal braces experience.

“I had teen braces, and I had them as an adult too, and my teeth still moved,” said a Texas dentist.

Jim Du Molin and Julie Frey discuss dentists’ experiences with braces and orthodontia in this video.

“They have become readily accepted and allow us to provide beautiful smiles and proper occlusions for patients of all ages,” declared a Michigan dentist.

“I wish I did not get them when I was younger,” said a Louisiana dentist. “Four bicuspids were removed, and it ruined my smile.”

“I had regular brackets and arch wire braces at age 40. Like many younger patients, I did not wear my retainer and had relapse,” said a Kentucky dentist. “I had Invisalign ortho at age 50 and loved it compared to brackets and arch wires. I continue to wear my Invisalign retainer going on 8 years now.”

What are your thoughts? Any personal experiences you’d care to share?

Dentists Love Offering Invisalign (video)

Invisalign dentistsDentists love Invisalign, we found in this survey. Three quarters of general dentists say they offer Invisalign braces to their patients.

“You are crazy not to offer this service," advised one doctor. "As a dentist, we do simple cases and refer out to an orthodontist the complex cases. There are lots of dental CE opportunities to beef up your skill sets."

When it comes to braces, more and more adult braces patients are seeking Invisalign, clear braces, and actual invisible braces. As a matter of dental practice management, it's a good idea to offer patients what they want!

Read more: Invisalign Orthodontics: Dentists & Patients Love Invisible Braces

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