Add orthodontics to the growing list of industries being altered by the pandemic.
Even before the coronavirus, the sector was being disrupted by companies like SmileDirectClub and Align Technology, which offer plastic aligners that replaced traditional braces. Then stay-at-home orders triggered by the virus put office visits on hold. That has created an opening for the teledentistry startup Byte, which does everything remotely.
The closely held Santa Monica, Calif., company said sales surged 1,000 percent in the first quarter and revenue should exceed $100 million in 2020. Byte, founded in 2017 by serial entrepreneurs who had sold previous companies, reached 10,000 orders for its aligner system in January and expects to hit 100,000 by December.
‘‘We think this is the new normal,’’ said Scott Cohen, a cofounder who previously started a digital marketing firm.
But that vision could be hampered on multiple fronts. While teledentistry offers advantages during a pandemic, some states are considering ways to crack down to ensure patient safety. Doctors in the $12 billion US orthodontics industry argue they need to see patients in person to care for them properly.
And when the virus fades, the demand for Byte’s services might wane.
Align Technology’s Invisalign shook up the orthodontics market in the early aughts by using a series of clear plastic aligners to shift patients’ teeth. Customers liked that they didn’t have anything permanently attached to their teeth, and demand took off. Last year, sales rose 22 percent to $2.4 billion.
Then SmileDirectClub began offering direct-to-consumer kits and swapping trips to traditional orthodontist’s offices for visits to its own locations, which now number more than 400. All that helped it undercut the price for traditional braces by half and take market share. Revenue surged 77 percent to $750 million in 2019.
Now Byte has taken it further. Its customers skip the in-person consultation and regular check-ups that traditional orthodontists and other aligner companies require, and instead consult doctors remotely. In a typical experience, a shopper buys a $95 do-it-yourself impression kit and sends it to the company for an orthodontists’ assessment. Afterward, there’s an e-mail or phone consultation, and then the aligners arrive four to six weeks later.
That need to see patients in person has derailed Align and SmileDirectClub this year. Align recently pulled its financial guidance, and analysts expect its sales to fall 47 percent this quarter. Since going public in September, SmileDirectClub’s stock has fallen about 70 percent. Meanwhile, purchases of Byte’s $1,895 system, which is equal to or cheaper than competitors’ products, keep gaining.
Byte’s growth can partly be chalked up to using digital marketing that so many direct-to-consumer brands have leveraged in recent years to grow quickly. That means loads of social media and trying to be a little irreverent in what’s been a stodgy industry. Its website features quippy slogans like ‘‘Byte Me.’’ Online celebrity endorsements include singer LeAnn Rimes, actor Ben Affleck, and Super Bowl champion Rob Gronkowski.
Straight Smile, the parent of the Byte brand, was founded with no outside investors. A year ago, the company brought on Neeraj Gunsagar, former chief revenue officer of the car sales platform TrueCar Inc., as president to help scale up the company.
Like any technology unseating an established moneymaker, there has been pushback. Some dentists and orthodontists say patients should be seen in person to ensure good treatment. One concern is that teledentistry is being done by doctors out of state.
‘‘It’s really hard to treat someone that you haven’t seen physically in the office,’’ said Dr. Jill Tanzi, a dentist and owner of a practice in Hopkinton. ‘‘Teledentistry is such a fad right now and may end up costing consumers more in the long run.’’
The field of teledentistry has been hotly debated across the country, with regulation of the industry being dependent on local statutes. While Byte operates in all 50 states, it’s had to argue with state dental boards that insist patients be seen in person. Last year, California passed a law that tightened regulation of the practice. The company is responding by backing pro-teledentistry legislation in a handful of states.
Teledentistry ‘‘saves time and money, not just for the patient, but also for the dentist,’’ said Dr. Jon Marashi, Byte’s lead dentist. ‘‘If you don’t have to have a patient come into the office, you’re creating a massive efficiency of the process.’’
Take Lane Flores, 22, who lives outside Houston. She had traditional braces in high school but was left unsatisfied. In early March, while scrolling through Snapchat, she saw an ad for Byte and ordered the do-it-yourself impression kit. After she sent it in, Byte e-mailed her an image of what her teeth would eventually look like.
‘‘The instructions are so easy,’’ Flores said. ‘‘A toddler could follow them.’’