Decoding the Decline: Why Clear Aligner Starts Are Down

CEO Pulse: Decoding the Decline

Vol 1, Issue 10

Dear DSO and OSO Executives,
As leaders in the dental industry, we’re all aware of the significant shift towards clear aligners in recent years. However, a concerning trend has emerged: clear aligner starts have declined by 5-10% year-over-year for the past two years. This dip in demand, particularly among adults, necessitates immediate attention and strategic action.
Decoding the Decline: The data from over 700 orthodontic practices on the Gaidge platform paints a telling picture of the industry’s trajectory in 2023 as compared to 2021. While the average contract amount saw a modest increase of 4.6%, most other metrics experienced a decline. Notably, new patient additions dropped by 8.3%, total starts by 10.8%, and adult starts by a significant 17%. Aligner starts also fell by 16.5%, suggesting a downturn in elective orthodontic procedures.

2021: the year Zoom and PPP loans took center stage. Suddenly, many found themselves in a digital mirror, critiquing the “social six” – those front teeth on full display during video calls. With pockets deepened by government assistance, the idea of sprucing up one’s digital facade became not just appealing, but almost a hobby. The Zoom+Cash effect led to a cosmetic spree, with people rushing to enhance their on-screen charm. This beauty boom saw a sharp uptick in the first half of 2021, but as the novelty faded and reality crept back in, the fervor for facelifts, virtual or otherwise, simmered down to pre-pandemic levels by the year’s end.

The decrease in case acceptance and net production points to broader economic influences and possibly consumer hesitation in elective dental care investment. This overview underscores the need for strategic adaptation within the orthodontic sector to navigate changing market conditions.

Decoding the Decline

Let’s delve into the three primary factors contributing to the decline in clear aligner starts: economic challenges, rising patient financing rates, and shifts in marketing strategies and Google’s algorithm changes.

Decoding the Decline: Economic Factors
The economic landscape of 2023 revealed critical insights into consumer behavior and spending habits, significantly impacted by rising inflation. This economic pressure eroded the purchasing power of the average American consumer, leading to a discernible shift in spending towards essential services over elective treatments like clear aligners. Reports from reputable sources throughout the year underscored a cautious outlook from consumers, with many delaying or reconsidering their elective healthcare expenditures amidst growing financial concerns.
After accounting for essential expenses, the average American household is left with a discretionary income of $8,981, which must stretch to accommodate various priorities, including orthodontic treatments like clear aligners. This challenge is intensified by the fact that Americans are grappling with a historic high in credit card debt, reaching $1.129 trillion in the fourth quarter of 2023, as per the Federal Reserve Bank of New York. This trend marks a significant increase from previous years, signaling a growing burden on consumers. With credit card interest rates averaging 21.47% and even higher for cards accruing interest, at 22.75%, the financial strain is palpable. The economic pressure, compounded by high interest rates and the sheer volume of debt, underscores the necessity for clear aligner providers to understand these financial pressures when proposing treatment options.
Patient Financing Gets Pricier:
The landscape of financing for clear aligner treatments has experienced a dramatic shift, with interest rates for such financial assistance climbing from previously manageable single-digit figures to a staggering 15-20%. This surge in financing costs, as evidenced by the rates advertised on platforms like Care Credit, has introduced a significant hurdle for patients considering clear aligner therapy. Dental practitioners have noted an increasing trend of patients hesitating or outright pausing their treatment plans upon encountering these unexpectedly high interest rates, highlighting a critical barrier to treatment acceptance and underscoring the need for alternative financing solutions that can ease the financial burden on patients.

🔎 Fun Fact: Unlike Gen X, Millennials aren’t turned off by interest with financing. They finance many areas of their life. Gen Z, however, are the children of Gen X, and high interest rates will turn them off.

Marketing Budgets & Google Changes: In early 2023, DSOs and OSOs faced a complex challenge: reduced marketing budgets, often dropping to around 2-4% of projected revenue, coincided with significant shifts in consumer spending and major updates from Google affecting analytics, ads, and search algorithms. This budget contraction made it difficult to allocate sufficient funds specifically for clear aligner campaigns. As described by a DSO CEO, this led to a two-part problem: not only was there less money overall, but the niche marketing efforts required for clear aligners—such as targeted AdWords groups and keywords—received even less focus due to the broader need to attract general dental patients.

Consequently, the emphasis on landing pages and other critical elements for attracting clear aligner patients diminished, impacting the ability to effectively market these treatments. This scenario underscores the importance of agile marketing strategies and the necessity for DSOs to rapidly adapt to maintain visibility and effectiveness in a rapidly evolving digital landscape.

Here's what you can do:

Choose the Right Marketing Partner: Select an agency with a strong track record in the dental industry and expertise in multi-channel marketing within multi-site framework. Look for partners who can create targeted campaigns, leverage data analytics, and adapt to changing market trends. Not all marketing agencies are created equal.

Decoding the Decline, Focus on Data-Driven Insights: Utilize tools like Patient Prism to gain a full picture of your marketing funnel and ROI on each campaign. Track performance at every stage, from lead generation to conversion and patient retention. This data will guide you in optimizing campaigns and allocating budgets effectively.
Decoding the Decline, Calibrate Your Funnel Daily: Don’t settle for a static marketing strategy. Monitor your funnel metrics daily and make adjustments based on real-time data. This ensures you’re reaching the right audience with the right message at the right time.
Go Beyond Leads: Remember, leads are just the beginning. Convert leads into appointments, and ensure patients show up. Focus on the entire patient journey, addressing concerns and providing seamless experiences to maximize conversion and retention.

Prioritize Conversions – Success Story: Improve sales skills and remove internal operational barriers to convert more leads into starts. For example, one DSO increased booked appointments by 15% and show rates by 20% within 3 months by addressing staffing issues flagged by Patient Prism data.

Flexible Financing Options: To further address economic barriers, incorporating flexible financing options through innovative fintech platforms can make a significant difference. These platforms offer patients the convenience of applying and qualifying for financing in just minutes, directly from their own cell phones or tablets. With minimal paperwork and frictionless processes, these patient financing companies are breaking down the financial hurdles to treatment, making it easier than ever for patients to commit to clear aligner therapy. This approach not only enhances patient accessibility but also significantly boosts treatment starts by removing traditional financial constraints.
Decoding the Decline, Embrace Transparency and Education: Combat misinformation by providing clear, accurate information about clear aligners and your unique value proposition. Educate potential patients on the benefits of in-office treatment compared to DTC options.
Go Beyond Leads: Remember, leads are just the beginning. Convert leads into appointments, and ensure patients show up. Focus on the entire patient journey, addressing concerns and providing seamless experiences to maximize conversion and retention.

🤫 Decoding the Decline – Secret Weapon – Treatment Coordinator: A proficient treatment coordinator is crucial for elevating clear aligner acceptance rates. Their expertise in patient education and tailored treatment plans directly influences decision-making, enhancing patient confidence. For rapid improvement, consider engaging a consultant specialized in treatment coordinator training. This strategy can significantly boost your team’s effectiveness, potentially increasing acceptance rates by double digits, by streamlining the consultation process and optimizing patient communication.

Patient Prism: Your Partner in Growth

At Patient Prism, we understand that growth is not solely a function of sophisticated AI; it’s about leveraging data comprehensively across our platform to make informed decisions at every stage of the patient journey. Our AI is a powerful tool, but it’s the strategic application of insights gained from this technology that empowers DSOs and OSOs to refine marketing strategies, enhance sales execution, and improve operational efficiencies.
Decoding the Decline: As DSOs and OSOs strategize to achieve same-store growth goals in 2024, the insights and operational agility provided by Patient Prism are invaluable. Our platform is not just about capturing data; it’s about translating that data into growth. By understanding the nuances of patient interactions, we help you fine-tune your approach to meet patients’ needs proactively, ultimately driving sustained growth in patient acquisition and maximizing the lifetime value of each patient.
Unlocking Growth and ROI

Join us on this journey, and let’s turn the challenges of today into the achievements of tomorrow.

CEO Pulse

Best regards,

Amol Nirgudkar


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