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Douglas County Orthodontics

Douglas County Orthodontics, 9362 South Colorado Blvd. Suite D–14, Highlands Ranch, CO 80126, (303) 427-6300

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Cost of Invisalign on the Rise…Temporary or Permanent?

April 30th, 2012

Time will tell. Having been so vocal about my significantly below market cost for Invisalign treatment, I thought it necessary to comment on the fact that as of June 1st, my advertized fee for Invisalign treatment will change from the current $3,995 increasing to $4,495. This, quite frankly, is still well below the fee being quoted by the vast majority of both my colleague Orthodontists as well as my competitor General Dentist Invisalign Providers.

One could think that this fee increase is strictly profit motivated…which certainly has its place in the decision but I assure you it was not the primary factor. What was the primary factor?….Credibility and/or Believability. It has been interesting that the vast majority (perhaps all) of the prospective Invisalign patients contacting our office seemed to all have grave concerns about the credibility, accuracy and quite frankly…what was the “catch” to my unusually low pricing. Yet, interestingly enough, most had very little concern or interest in my credentials, experience as well as testimonials from previous patients. In fact, the question of expertise and experience was very seldom even mentioned compared to the typical, traditional new patient interview and evaluation.

Due to the overwhelming concerns that there was some “catch” to a $3,995 Invisalign fee, I can only surmise that perhaps I had reduced the cost to a “too good to be true” point. It was simply too far below the perceived market rate which subconsciously created a subliminal feeling of distrust.

Why might this be the case? Two reasons come to the surface as I see it. First, is the fact that traditionally fees and cost of healthcare services are typically not openly published to the general public by the provider. Third parties like insurance companies will dictate a fee schedule for its members and providers. But otherwise, it is currently unusual for a provider to do so directly, consequently by doing so against the trend, a question of “is this for real?” arises.

Secondly, was the mode I chose to advertize this $3,995 fee offer. I used primarily internet based marketing methods. Due to the non-personal nature of the internet, the rampant fraud and destructive software we have all been ingrained to fear, I believe most people naturally have a certain degree of distrust of virtually all internet offers or solicitations.

I have a rather dark humored analogy about the current state of the internet’s evolution. Some younger readers of this may not get the connection but the Internet seems to be similar to the old traveling Carnival/Circus caravans. In their day, everyone knew to be wary of scams, shames and slight of hands if one ever went to the traveling circus grounds. Same thing has occurred within the virtual grounds of the Internet but now the wagons never move on and there is not a local sheriff to protect the public. I am no more immune to questioning everything I come across on the Internet than my prospective patients. In fact, if I am suspicious of the validity of an Internet offer…a “too good to be true” offer…I simply close the internet page and move on, not even bothering with a reply or request for information, why take the risk? I have come to appreciate the potential conflict and distrust that may arise when one sees my extremely low fee posted on Internet marketing spots. I am now wondering how many prospective Invisalign patients did not even bother contacting us and simply dismissed my offer as “too good to be true” and moved on to a higher fee provider for this reason.

On a brighter note, another interesting observation was how much simpler and less stressful the initial meeting and exam was with a prospective client responding specifically to our advertized fee. Once they realized we were in fact going to actually offer them Invisalign, honor the fee and offer financing just as advertized, they all seem prepared to make a positive decision to proceed with treatment on the spot at that very first appointment. This is opposed to the more traditional dental referral based orthodontic patient, who is appointed for an initial examination and introductory appointment which involves the presentation of the fee for treatment at the end of that process. Since that is the first time they had any idea about the costs, a very common reply is “I have to go home and think about it”. I intent to expand this topic and my observations further in future blogs.

We shall see what happens with this slightly higher fee that is still well below what I believe to be the average fee being quoted. Who knows…maybe I’m still too low? Time will tell.

About Dr. Paul Hamersky

I have been gratefully given the opportunity to have over 25 years of experience in orthodontics while living in the beautiful Denver Metropolitan and Rocky Mountain area since graduation. My “real” education in Orthodontics as well as Life has occurred during these years and while treating the thousands of patients I've had since my formal education ended. The evolution and the experiences I have gained and witnessed in Orthodontics have been truly remarkable. By embracing those experiences of success and challenges, it is now my mission to use this growing wisdom and insight as a gift to you and your children as you journey through the World of Orthodontics.

$3,995 Invisalign Special…Open reply to Orthodontists

February 8th, 2012

Question:   “ Do you really want to do this?”



This was a posted comment from an Orthodontist regarding our recently fee reduction for Invisalign treatment.  I have no way of knowing for sure the intent of this short question but my guess is…have I considered the consequences to my dental colleagues who are commanding fees upwards of $6,000.+ for Invisalign care.

I decided to post my reply for all to consider even though it is directed toward and written to the orthodontic community.  In this age of consumer driven business decisions, if you happen to be a consumer reading this, you may find this point of view and my rational for this extreme price reduction on Invisalign treatment interesting.

I would like to preface that the following statements are based solely my personal opinions and conclusions.  They do not represent any information provided by Align Technology nor are they directed at anyone or any dental care provider in particular.


Dear Doctor:

Yes…I am absolutely certain I want to offer Invisalign treatment for $3,995.  The decision to significantly reduce my Invisalign fee was done with a lot of thought and perhaps contrary to what one may think, not a decision out of business desperation.  In fact, you may see that it is much more altruistic than you might imagine.

1.         Invisalign Generation 3.0 (2010) and 4.0 (2011) now actually works to my satisfaction as a fully trained orthodontic specialist.  Invisalign has and is aggressively addressing the mechanics and proper force applications of tooth movement.  They certainly have not addressed all the orthodontic force system challenges we face daily. But, certainly have shown their commitment to continue improvement of Invisalign through significant ongoing research and development of their product.  I believe Invisalign is now as effective a tool in our orthodontic toolbox as fixed braces for most orthodontic treatments (note: I did not say all).

2.         Let’s look back: If you recall, Invisalign was first introduced in 1998/99 to only us, the Orthodontists.  No General Dentists were initially certified or allowed to order Invisalign from Align Technology as a treatment.  I jumped on board, as I believe most of us did.  After doing many Invisalign cases in those early years, I quickly found Invisalign Generation 1.0 did not work very well.  Almost every case required some braces to finish it.  I spent a lot more chair time with my patients in Invisalign than those in braces and simply was not getting the results I expected of myself and my treatments.  I got so frustrated; I virtually stopped using Invisalign from 2002 to 2010.

3.    I believe, many orthodontists felt the same frustration and either quit using Invisalign (like I did) or limited its use to the very simple cases.  On top of that, we were charging upwards of $6000, in my opinion, as a “nuisance” fee and because we simply could get it.

4.     The fact was, the Public was becoming more and more aware of Invisalign and wanted a no-braces braces alternative.  Therefore, many of us Orthodontists began using Invisalign primarily as a marketing tool to get patients “in the door”.  Once in our offices, we would professionally guide these patients seeking Invisalign to fixed braces.  We passively did this with those extremely high premium fees for Invisalign or diagnosing the malocclusion to be conveniently “beyond the scope” of Invisalign. Which at that time was for the most part was true.

5.     The long term result of us marketing the use of Invisalign and enticing the public into our offices with perhaps little or no intent to use it, inadvertently was in fact  helping to create the Invisalign Brand and consumer demand.

6.    The Orthodontists were solely responsible for initially establishing the market fee for Invisalign treatment.  We apparently determined the market would or needed to pay a premium for the luxury of hiding ones braces.  As well as to properly compensate us for the nuisance of using a mode of treatment that did not work as effectively let alone the fact we also incurred a high manufacturing laboratory expense.  Quite frankly, I believe we all set such high fees for Invisalign because we could by charging what the market would bear.  Folks simply are willing to pay dearly for the privilege of getting that beautiful smile without fixed metal.

7.   During all this time, Align Technology, the manufacturer of Invisalign, also continued to market and Brand their product.  Then, much to the criticisms of the orthodontic community, Align Technology began certifying the Family General Dentist on how to order Invisalign.  As we all know, Invisalign Provider Certification by Align Technology does not mean the dental provider understands or is trained in the treatment of dental malocclusions.  Rather, simply how to order it.  Align Technology’s only real responsibility is to limit the sales of their product to legally licensed dentists, nothing more.   Only the governmental licensing boards are responsible for qualifying healthcare providers for the legal practice of their profession.  Invisalign is a legally available mode of treatment to anyone licensed to practice dentistry.

6.     The demand and consumer awareness of Invisalign is and has been growing.  Orthodontist were limiting if not eliminating the use of Invisalign.  Most of us, I believe, were doing everything possible to talk or price our patients into braces and away from Invisalign, perhaps for the right reason…Invisalign did not work very well in those early days.


Look who was happy to step up to offer Invisalign…the General Dentist!  Why not…Orthodontists had already established a nuisance value, high premium fee for them to apparently simply take some impressions and get back an instant orthodontic treatment…right?  What a business opportunity!   

7.     Moving a tooth it easy…just continuously push on it.  The trick is getting it to go in the direction and stop where you want it.  I am still trying to prefect that after two years extra orthodontic specialty training and 30+ years of practice of doing nothing but orthodontics.  The vast majority of General Dentists who offer the world Invisalign have very little if no really understanding of biomechanics and orthodontic force systems.  Invisalign has somewhat freed them of that requirement…they just know Invisalign moves teeth without braces and that fact alone sells.  Ignorance is bliss and blame free.  The General Dentist was not saddled with the knowledge that Invisalign results and tooth movement was extremely inconsistent in the early days for a reason.  It had biomechanical design flaws that we as orthodontists, if nothing else, intuitively seemed to know.

8.     So, in my humble opinion…our actions as orthodontists to passively direct our patients to fixed braces rather than the Invisalign care that we likely were heavily internal and externally marketing, basically handed Invisalign orthodontics on a silver (maybe gold) platter to the General Dentist.

9.    What have we inadvertently created?  The “gate-keepers” of many orthodontic referrals have now established themselves as the Invisalign orthodontists in the eyes of the public.  And worse yet, I believe that we trained Orthodontic Specialists are now viewed by many as Fixed Braces orthodontists.  You want fixed braces…see an Orthodontist.  You want Invisalign…any Dentist can do it.

  Here’s the bad news for us, the “Fixed Braces” orthodontists…

Align Technology is rapidly fixing their product and is absolutely committed to supplant fixed braces as the primary appliance of choice for routine orthodontic care in the future…I believe they are likely to succeed.

10.     I recognized with the release of Invisalign Generation 3.0 that Align Technology was finally addressing their biomechanical design flaws and I began tip-toeing back into using Invisalign.  The improved results and the ease of use were immediately apparent.  Now with the very recent release of Generation 4.0 right on the heals of 3.0, further demonstrates to me, Align Technology’s commitment to creating an orthodontic appliance system that now biomechanically works on an expanding range of malocclusions as a true alternative to braces in a continually growing group of orthodontic patients.

11.    What has most impressed me with new and improved Invisalign is the efficiency of time management within the daily practice of orthodontics over fixed braces.  Briefly, the primary reasons Invisalign is more time efficient to use are:

a) The new software enhancements have made manufacturing instructions very easy.  Very seldom do I revise the online treatment plan more than once.  In the early days, I would spend hours trying to create an acceptable treatment plan with, at times, up to 4 or 5 separate revision requests before the Aligners were even produced.

b)  Patient check-ups and aligner delivery appoints are typically shorter and less frequent than fixed braces.

c)  There are virtually no emergency repairs or appliance breakages throughout Invisalign treatment compared to fixed braces.

There are many other areas to compare the pros and cons of appliance types but in general, I believe, time efficiency is the great balancer for the high manufacturing cost.

12.  I believe, what the Invisalign General Dentist is seeing, is the significant treatment result improvements rather than the time efficiency.  Being held to a different standard of care requirement due to their limited education in orthodontics, results and expectations have always been allowably different.  Whatever they achieved with Invisalign was simply and acceptably “the best we can get”.  Now…this best we can get is getting better whether they are aware or not that the all those funny looking attachments are the “Sorcerers’ Key” to success.  They have to be “giddy” with joy seeing a continuing higher profitability with the extremely high fees that have been established. As well as a growing confidence to expand the range of malocclusions they are choosing to accept for treatment, solely due to Align Technology’s continued improvements of the biomechanics of Invisalign.

SO…What has ALL this to do with my advertised $3,995 Invisalign fee?

13.   I want to state…I believe that only a trained orthodontist should be doing orthodontics.  I do not believe there are ANY “simple” orthodontic cases that can be definitively diagnosed in advance.  After over 30 years of exclusive orthodontic practice, I am still surprised daily with the simple cases that become nightmares and the pretreatment malocclusion disasters that seemingly fix themselves to perfection almost magically.  I also believe there should not be a different standard of care allowed any provider that voluntarily chooses to treat a dental malocclusion.  Since neither of these statements is ever going to be mandated, I conclude that it is our own personal mission to do what we each individually can to serve and guide the Public ethically.

14.    As I look at the alternatives to getting the Public out of the Invisalign General Dentist office and into an Invisalign Orthodontist office…the most preferable method is through public awareness education.  The problem is, that will certainly involve ethics issues and an undermining of the public’s confidence of our profession and that serves no purpose.

15.   The most reasonable alternative that became apparent to me which can be directed at the Public because remember the “gate-keepers” are Invisalign providers too, is PRICE.

16.    I can do orthodontics including Invisalign more efficiently that the General Dentist.  I believe the vast majority of Orthodontists can too.  Our offices, business systems and support staff are all designed and trained to see a greater number of orthodontics patients per day.  The time efficiencies of Invisalign fall right into our business design. We can provide orthodontics, including Invisalign and its high laboratory bill, cheaper than the Invisalign General Dentist.

17.   I have decided to significantly reduce my profit margin on Invisalign to a point that maybe the Invisalign General Dentist can not justify the significant profitably loss especially considering the nuisance of blending orthodontics with all the other facets of dentistry to competing with me at this price.

18.   We, orthodontists sent the Invisalign public away years ago, it’s our responsibility to considering lowering our expected big profits to get the Invisalign business back in the orthodontic offices like it should be….provided by specialists that are properly trained to use all the tools in the toolbox because not every one works every time no matter how well designed it is.

Where will your Orthodontic Specialty practice be in 10 years if Align Technology supplants fixed braces as the primary appliance of choice with the Public for routine orthodontic care?… 

And it actually works!

About Dr. Paul Hamersky

I have been gratefully given the opportunity to have over 25 years of experience in orthodontics while living in the beautiful Denver Metropolitan and Rocky Mountain area since graduation. My “real” education in Orthodontics as well as Life has occurred during these years and while treating the thousands of patients I've had since my formal education ended. The evolution and the experiences I have gained and witnessed in Orthodontics have been truly remarkable. By embracing those experiences of success and challenges, it is now my mission to use this growing wisdom and insight as a gift to you and your children as you journey through the World of Orthodontics.

$3,995 Invisalign Treatment…What’s the Catch?

October 31st, 2011

Douglas County Orthodontics is making Invisalign Treatment more affordable to everyone….here’s why.

Many folks out there, including the majority of my colleagues, will likely view this price reduction as strictly a move to attract more business.  A “Sale” price on Invisalign if you will and yes, I certainly expect and hope this price reduction does increase our business here at Douglas County Orthodontics.  But honestly, there is a more to it than that….

The continually evolving Invisalign technology is making it cheaper and easier for me, as an orthodontist, to provide both Invisalign for Adults and Invisalign Teen to my patients.  Therefore, I have decided to pass that savings on to you…something not commonly done in the healthcare industry…lowering fees rather than raising profits.

Invisalign is really a technologic product.

Is it really that surprising that it is getting both cheaper and better?

Align Technologies, the manufacturer and developer of the Invisalign, has in fact reduced the cost of Invisalign slightly over the years as their manufacturing process has improved.  But, quite frankly, the greatest cost savings is a result of the significant improvements recently in how efficient Invisalign is to use and how well Invisalign now “works” as an alternative to fixed braces.  This is especially true for the Orthodontist vs the Family Dentist doing Invisalign along with everything else (A topic for a future posting).

Our decision to reduce the price to a single fixed rate for Invisalign and Invisalign Teen was a result of the release of Invisalign’s 3rd (2010) and 4th (2011) Generation production software upgrades.  The details of these major software upgrades are really only of interest within the orthodontic community yet are resulting in a significant improvement to the overall success and efficiency of Invisalign.  This saves me time and costs to provide you with a better service, why shouldn’t the costs to the consumer go down?

Price reductions are certainly uncommon in the healthcare industry but seem to be the norm in the technology world.  We all know that technologic products tend to get better and cheaper as time passes.  Just think of the ridiculous cost and limited features of cell phones of yesterday.  And today, look at what technology has done to phones and data service for pennies compared to previous costs, simply amazing.

The Invisalign Technology is making Invisalign more efficient therefore less costly for an orthodontist to provide it to you. 

There is no catch…we simply have decided to pass our savings for Invisalign and Invisalign Teen Treatment to you by reducing our fee to $3,995 plus a pre-manufacturing molding and submission fee.


Visit our website for details on our $3,995 Invisalign and Invisalign Teen Treatment

Or call today for your free initial evaluation to see if Invisalign is right for you or your family.


About Dr. Paul Hamersky

I have been gratefully given the opportunity to have over 25 years of experience in orthodontics while living in the beautiful Denver Metropolitan and Rocky Mountain area since graduation. My “real” education in Orthodontics as well as Life has occurred during these years and while treating the thousands of patients I've had since my formal education ended. The evolution and the experiences I have gained and witnessed in Orthodontics have been truly remarkable. By embracing those experiences of success and challenges, it is now my mission to use this growing wisdom and insight as a gift to you and your children as you journey through the World of Orthodontics.

It’s Invisalign’s Fault !

March 18th, 2011

My Dentist says: “It’s Invisalign’s Fault!”

My bite just feels a little off from what it was before I got my Invisalign.  My dentist says: “It’s Invisalign’s fault… sometimes that just happens with Invisalign.”

This front tooth right here just didn’t get straight when I had Invisalign before. My dentist says “It’s Invisalign’s fault…sometimes that is all the straighter Invisalign will get the teeth.”

As an Orthodontist, I have heard comments like these many times in recent years from patients who have come into my office for a consultation regarding the results of their previous Invisalign treatment.  They have come in because they feel Invisalign didn’t work and it’s all Invisalign’s fault.  The only way the typical lay person would know what to blame is if their Invisalign Provider told them it was Invisalign’s fault rather than  offering any further recommendations or treatment alternatives to further correct these legitimate concerns.  Or, if they did offer an alternative, quoting an additional fee to “fix what Invisalign messed up”.

As I have made perfectly clear in these writings, Invisalign is not a cure-all and straight-all in orthodontics.  Yet, neither is any other “tool” in the Orthodontist’s available range of braces and appliances.  In fact, there are certain types of orthodontic mal-alignments and problems that there simply is no complete fix available short of extensive facial-jaw surgery to correct.  Generally speaking, these can and should be identified in advance before Invisalign or any braces are even recommended.

So…Is it really Invisalign’s Fault?

Well…let me tell you about the “Plumber with One Wrench”.

Let’s imagine your home is equipped with a relatively standardized valve to turn the water on…and your homes valve is stuck closed.  So you call out a plumber to open the valve.  The plumber shows up with just one wrench that he knows how to use to open the valve.  He gives you the fee estimate, explains the process and shows you THE wrench he always uses to open the valve.  You assume he is “the expert” knows that wrench must be the answer to your problem, no other alternative was mentioned.  You approve, pay him the fee and “put him to work”.  He returns saying the job is complete but the value is only open half-way, the water is running but very slowly.  He says as he leaves your home…”It’s THE wrench’s fault…sometimes that is all the further THE wrench I use will open some valves.  Now that I tried it, I know yours happens to be one of them.”   As the door is closing you vaguely hear: “Oh by the way, THE wrench caused your valve to be struck in this position.  If you want that fixed…schedule another service call.”


So…is it really THE wrench’s fault…well…the wrench had a part to play, yes.  Certainly the wrench has some limitations since it apparently doesn’t work quite right sometimes.  Unfortunately, the Plumber seems to only knows that after there is a problem.  With only one wrench to work with, this Plumber fixed it the best he could.

And so it is in orthodontic care, Invisalign is an absolutely wonderful orthodontic “wrench”; it works beautifully most of the time.  But what if by chance it does not, what does your Invisalign Provider have in their Orthodontic “toolbox” to offer you?  There is nothing wrong with asking…”What if Invisalign does not work for me the way we expect, what do you typically recommend to do about that?  If additional treatment beyond Invisalign is necessary to complete the straightening, do you charge me for that additional treatment?”  You decide what the right answer is but at least get an answer other than: “Don’t worry; Invisalign always works”.  My suggestion following an answer like that…leave the office ASAP and get a second opinion because it does NOT always work as we would expect or hope.

Every type of orthodontic appliance works; just not every time…that includes Invisalign.

Do NOT blame Invisalign for “not working”…it’s not THE wrench but the Plumber who fixes the leak.


Thinking about getting Invisalign?   Always look for this logo:






Choose a member of the American Association of Orthodontists (AAO) to provide your Invisalign care. Membership requires training in all aspects and types of orthodontic braces including Invisalign.  All members of the AAO are referred to as Orthodontists or Orthodontic Specialists…they possess all the orthodontic “tools”.

Dr. Paul Hamersky DDS, MS is a member of the American Association of Orthodontists and a Preferred Provider of Invisalign and Invisalign Teen.  Here at Douglas County Orthodontics we proudly offer a full range of fixed braces, clear, colored and removable appliances including the extensive use of Invisalign…each chosen specifically as the best available treatment for you and your family.         


About Dr. Paul Hamersky

I have been gratefully given the opportunity to have over 25 years of experience in orthodontics while living in the beautiful Denver Metropolitan and Rocky Mountain area since graduation. My “real” education in Orthodontics as well as Life has occurred during these years and while treating the thousands of patients I've had since my formal education ended. The evolution and the experiences I have gained and witnessed in Orthodontics have been truly remarkable. By embracing those experiences of success and challenges, it is now my mission to use this growing wisdom and insight as a gift to you and your children as you journey through the World of Orthodontics.

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