Quebec dentists and orthodontists want to make treatments that transform the smile more affordable and accessible. They believe that technology helps them achieve their goal and divert consumers from potentially dangerous options.
When they were young, Mostafa Altalibi and Steven Bouganim could not get the orthodontic care they needed because their parents could not afford it.
“Scientific research shows that having a beautiful smile improves your job prospects, your romantic possibilities, your quality of life. From a medical point of view, the absence of orthodontic treatment can lead to joint problems of the jaw, to the wear of the teeth, to the degradation of the gums. It’s unfair that some people don’t have access to it, ”laments the Dr Altalibi, now an orthodontist.
The two friends have just opened the Transforme clinic in Montreal. The small local in the Côte-des-Neiges district with peach-colored walls welcomes patients with spa music. Sitting on an examination chair facing the windows, Ashley Dupras looks out of the corner of her eye at the 3D digital imaging of her teeth that the dental hygienist is performing. After a dental X-ray was taken, Dr.r Altalibi takes over, examining the young woman’s mouth and offering her a treatment plan.
The price encouraged the patient to take action. “I had been thinking about it for years, but you had to pay even just for an appointment to get an estimate”, testifies to the Duty the one who is the friend of a friend of the Dr Altalibi.
The purpose of this clinic is to serve a clientele that would not otherwise have the means to pay for treatment. On its website, the prices are clearly listed. They range from $2,250, for a period of less than 12 months for a child, to $6,750, for a complex case of more than 18 months for an adult.
“Generally, with an orthodontist, prices can be between $6,000 and $12,000,” Dr.r Altalibi, who takes care of all the patients for Transforme. “With a general dentist, who can also offer certain orthodontic treatments, it can go down to $5,000. »
“It’s almost never below $4,000,” says the Dr Bouganim, dentist, who takes care of the management and marketing of the clinic.
It is difficult to know what the average price is in Quebec for orthodontic treatments, which depend on the complexity of the cases and the method used, and which are at the discretion of each professional. Moreover, many of them only disclose their prices after consultation. But according to offers and estimates posted on various websites, the claims of the Drs Altalibi and Bouganim seem realistic.
A different business model
Given the company’s social mission, the Dr Bouganim believes the profit margin has been thinner than elsewhere. Moreover, since the Dr Altalibi is considered one of the best sellers of Invisalign aligners, they get discounts for these products.
Treatments are done using rigid plastic trays that must be worn 20 to 22 hours a day. “Each week, you change your tray, and it brings you closer and closer to perfect shape,” says Dr.r Buganim.
But it is above all the virtual follow-ups that are at the center of their business model. Each patient also receives a small device, the Scanbox Pro from DentalMonitoring, on which he attaches his telephone and which he inserts in his mouth to take pictures. He sends everything every week to the Dr Altalibi using a mobile application.
“I can see if the teeth are moving as they should. You will receive weekly feedback from me in writing or by video, ”says the orthodontist.
This process is beneficial to patients, he believes. “That means fewer appointments that you have to take time off from work or school because you don’t have to come to the clinic as often. That said, that does not mean that the follow-up is less well done. We can potentially notice issues sooner, give you an appointment sooner, and take action to correct the situation,” said Dr.r Altalibi.
With the traditional way of operating, problems are sometimes only noticed after several weeks, during the first in-person follow-up appointment, he says. When the duration of treatment is thus extended, it is the orthodontist who absorbs the additional costs.
The importance of in-person appointments
According to the president of the Association des orthodontistes du Québec (AOQ), Sonia Lapointe, the use of digital tools and remote monitoring is increasingly present in the profession. However, she believes that these cannot replace the physical examination.
“There are a lot of microconditions in the mouth that you can’t intercept with a camera,” she says.
The Dr Normand Bach, Head of Orthodontics 1er cycle at the Faculty of Dentistry of the University of Montreal, is of the same opinion. Since oral telemedicine can only be added to in-person appointments, in a complementary way, he does not see how these technologies could reduce treatment costs.
The Dr Altalibi specifies that he disagrees with the big companies that sell gutters online much cheaper than orthodontists, without any face-to-face meeting with an orthodontist or a dentist. For example, SmileDirectClub, which promises a perfect smile for $2,700, has won over more than 10,000 Quebecers since 2019. The company makes custom-made aligners, either from digital modeling done in person at one of their offices, or from impressions taken at home and mailed in. She claims that dentists and orthodontists approve of remote treatments.
The AOQ is also concerned about the rise in popularity of similar practices. Mme Lapointe says his members regularly see significant problems, sometimes irreversible, when teeth have not moved properly after using aligners purchased at low prices on the Internet.
According to the Dr Altalibi, people who have a limited budget are more vulnerable to this kind of offers. Hence the importance of offering them options that are both affordable and professional.
The orthodontist is not the only one to think this way. The Dr Jean Lyons, from the Dents droites clinic in Châteauguay, also aims to offer affordable orthodontic services. He also performs some remote consultations. He finds that adults are giving more and more importance to the appearance of their smile in recent years.
“There might be the possibility of further supervising these treatments at home, without banishing them, but ensuring that there is adequate supervision,” says Dr.r Lyons.
For its part, the Ordre des dentistes du Québec will work in the coming months on guidelines intended to regulate the activities of dentistry that could be carried out remotely, “in order to adapt to this new reality and to keep the same quality standards with a view to protecting the public”. He considers this dossier to be a priority.