March 15, 2022


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Sources and Background

47 providers of clear orthodontic aligners, comprising 36 Invisalign providers and 1 former provider in the United States (28 orthodontic practices and 9 dental practices), representing more than 5,500 Invisalign case starts in 2021, and 10 Invisalign providers in Brazil, representing more than 450 case starts in 2021

REPEAT SOURCES 27 (21 in the United States and 6 in Brazil) from OTR Global’s December report

INTERVIEWS Feb. 15 through March 3

AVERAGES Weighted according to total Invisalign cases started in 2021, when appropriate

Invisalign Growth Forecasts Weaken

U.S. and Brazilian Invisalign providers have lowered their 2022 case start growth estimates since December, following a slow start to the year caused by economic concerns and a shift in consumers’ spending priorities.

  • U.S.: 1Q22 Invisalign inquiries increased qq for just 9 of 36 sources (vs. 18 of 37 in December); 1Q22 case starts still mostly meeting expectations, but only 4 of 36 exceeding (vs. 9 of 37 in 4Q21)
  • U.S.: 2022 ALGN case starts expected up 6%–11% yy (vs. 8%–13% in December), worsening for 10 of 36 sources; economic concerns hindering Invisalign case starts for 10 sources (vs. 2 in December)
  • U.S.: Invisalign still gaining share vs. braces for 14 of 28 orthodontic sources; 35%–40% of orthodontic sources’ teen patients choosing Invisalign (stable vs. December)
  • Brazil: 2022 case start forecasts worse vs. December for 5 of 10 sources following difficult 1Q22; providers growing frustrated as ALGN offering less support than in past
  • Area to Watch: ALGN continues to remain in dominant competitive position in the U.S. and Brazil, even as competitive landscape expands in Brazil
Aimee Hirsch