Update from AAO president John Callahan Regarding Invisalign’s “Barbaric” Expander Ads…

“In August, I sent a letter to Align voicing the AAO’s concern that their recent marketing initiatives were disparaging to orthodontists, and in particular, intruding on the orthodontists’ decisions on best tools to treat an orthodontic patient. It has been several weeks, and I thought I’d bring everyone up to speed on the follow-up. I now see this as more of a story that we will continue to tell as it unfolds.

I’d like to begin this chapter of the story by acknowledging the importance of relationships between orthodontists and all our industry partners who help provide the products and services that help us provide the best care for our patients and our communities. As a clinical orthodontist, I look at our industry partners and the orthodontist as a team with the patient’s/consumers’ best interests in mind. As one who holds a leadership position in our Association, industry partners can provide important support for the mission and activities of the AAO. In all partnerships, good relationships are based on trust and support with a belief in a common goal. With this global perspective in mind, here is what has transpired since you saw the letter dated August 20 to Align.  

Immediately after sending the letter, Align requested a meeting with me and Trey Lawrence, our AAO CEO. Several members of Align's marketing team and clinical/research team attended. Raj Pudipeddi, Align’s Chief Marketing Officer for the Americas and Executive Vice President and Managing Director led Align’s group in the discussion. 

We presented our major concern, specifically, their efforts to tell the public that traditional palatal expanders are medieval or barbaric—was disparaging of orthodontists. It is the orthodontist’s decision on what tools are best for individual cases. Our other concern raised at that time was a lack of clinical evidence supporting their palatal expander aligner appliance. From the start, Mr. Pudipeddi asked the clinical/research team to discuss their research in support of the appliance. The clinical/research team was very interested in being helpful and informative. I thanked the research/clinical team but returned to the main reason for the call: voicing the AAO’s members’ disappointment with Align’s apparent change in their support of orthodontists and what tools may be best for treating patients. Mr. Pudipeddi thanked me for the information and said, “they would pass this along to their marketing agency.” 

Align’s clinical/research team followed up shortly with additional information by email and offered continued support—but no response from marketing. I sent a follow-up email to Align’s Vice President and General Manager, US, expressing my concern that Mr. Pudipeddi’s comment saying that “information would be passed along” was inadequate, and that we were anticipating that the head of marketing would follow up confirming our concerns with updated action items that would demonstrate “they listened and heard,” fostering a positive relationship instead of heading in a toxic direction.  

Since then, we have heard nothing further from the Align marketing team. 

Over the last several weeks, we have done a deeper dive into possible reasons behind this apparent change in Align’s attitude towards orthodontists. What we have found are several instances where Mr. Pudipeddi, as the head of marketing for Align, has made similar disparaging comments toward orthodontists when discussing his strategic plan for marketing to consumers. Here are some examples (with links).  

Most recently, on or about September 23, Mr. Pudipeddi participated in a panel discussion at Brandweek, a major advertising industry convention hosted by Adweek AdBrand’s. During that discussion, as part of Align’s effort to market aligners as the future of orthodontics, Mr. Pudipeddi made the following comments about braces: 

- “So if any of you or your family members are still being subjected to this medieval torture called braces, please tell them not to do this, there are better, safer, more effective ways to do this.” 

- Regarding a new ad campaign, “[W]e wanted to humorously juxtapose the issues with braces, which are frankly barbaric, non-hygienic, incredibly painful, and a pain in the butt for parents. So, no reason why anybody should use it, but we kind of wanted to make it a little bit lighter.” 

- “So, if you just look at the science of it, Invisalign is safer, keeps your teeth and gums safer, less painful, fewer accidents, and frankly it’s more hygienic. It’s impossible to kind of clean your teeth, you know? Ever see anybody kind of struggling to clean the teeth with braces? That actually erodes self-esteem.” 

These comments by Mr. Pudipeddi echo his comments in an interview with LinkedIn, available on YouTube (https://www.youtube.com/watch?v=xM-c7WEnPAg&t=432s, at approx. the 7:10 mark), in which he described brackets and wires as a “medieval torture device.” 

It is clear that Mr. Pudipeddi heard AAO’s concerns but brushed us off.  

Mr. Pudipeddi’s strategic view of how to market a product does not align with having a positive relationship with those who deliver the product. As an orthodontist, I struggle to support any company that chooses a path that attempts to circumvent my doctor/patient relationship. As the healthcare provider I decide what is best for my patients. It could be aligners or, braces may be best for that individual case. As an orthodontist, I understand the pros and cons of each tool. I know the person having treatment and present what would be best in their case. 

So, is this a company-wide desire to change a long-standing understanding of the value of the orthodontist to their success, or is a marketing department or leader throwing caution to the wind? We don’t know, but it seems very odd given that orthodontists are still a major revenue source for the company. We all agree that orthodontics should be done by orthodontists, but this marketing strategy also disparages all dentists.  

The AAO, our fellow international organizations and individual orthodontists have had long relationships with many industry partners that are positive due to an understanding of what is best for the patient under the care of the orthodontist with support from the industry partner. It comes down to trusting that this system works best for all. In stark contrast, Mr. Pudipeddi’s stated views of what is best in marketing and branding are industry-centered, apparently believing “relationships be damned.” Doesn’t seem like a good overall business strategy to me.  

So, that’s the story at the moment. I believe that members want to know what happens when the AAO sends a request to one of our industry partners to listen to members' concerns and how that industry partner reacts and responds. We are still on this journey. I will update everyone as this story continues to unfold. 

Source: AAO - American Association of Orthodontists.