The mouthpiece works great and I would recommend everyone get tested for sleep apnea if your insurance covers it, but I have to admit that paying for it bothered me. Even with insurance covering some of it, it cost me about $600.
I know that there's a deceptively high amount of engineering required for these kinds of things, but it was very hard to wrap my head around paying $600 for what amounted to a couple pieces of clear plastic. I actually got them to send me the STL of the scan of my teeth, and some back of napkin math indicated that it would have cost me about fifteen cents of resin to print it out myself. Instead I'm paying about 4000x that price.
Obviously this is not apples to apples, I'm sure they're using different and/or better resin that what I have, and as I said there's probably engineering and fine-tuning for this, but even still it was not fun to pay for.
All the same, I sleep like 10x better, so I suppose that considering that $600 is a cheap price to pay.
First time?
Price is not determined by cost to produce.
It’s determined by the price a customer is willing to pay.
Since I do have the 3D scan of my teeth, I've debated designing my own, but I'm not sure which resins to buy that I could safely put in my mouth every night.
I think there's a deceptively low amount of engineering required for most medical and medical-adjacent tech. The high costs are rooted in pervasive industry-wide centuries-long FUD campaigns.
1. A treatment plan: simulated movement of teeth at every step, taking into account all forces. That’s specialized software or external lab service.
2. Precision. You put too much pressure at the wrong angle and you will need a surgery to fix the damage, because the tooth root moved in wrong direction.
3. Plastic. You cannot use ordinary 3D printer ink. You need a plastic that can survive the chemical environment in your mouth, maintain the pressure, and you probably want it to look good (no discoloration etc).
4. Finish: Align Tech, Straumann etc do not stop after 3D printing, there are few other steps involved to make sure there’s no sharp edges etc.
5. Maybe you will need attachments (to focus pressure in the right direction on certain teeth) or wires.
Align Tech is Apple of clear aligners, but now competition exists, producing aligners at scale is commercially more efficient, considering all the risks and required qualifications, and of course the best materials for aligners are patented and not sold OTC to everyone.
Disclosure: I worked at Align 10 years ago and later was CTO of European DTC competitor.
That is to say, how good is “good enough” when done at small-scale in developing nations or medically underserved communities?
They were a company theoretically doing the same thing with still more resources than an average individual has, and ruined people's bites and teeth.
I don't think there's a good enough here
They used a specialized sort of 3D camera on a stick to get an incredibly accurate model of my mouth, any open source solution would need an equivalent. And you’d also need open source code from somewhere to work out which teeth need to move where and at what stage in the treatment.
The 3D camera was really neat. A little faster, and I didn’t once dry heave.
I could watch the software and a 3D model slowly form of my mouth. Looked surprisingly user friendly. Missed areas were highlighted, for example.
Dry heaving would have been great. I would regularly vomit from impressions. My orthodontist would just prepare two sets if impression trays, cause the first one was going to go in the medical waste bin.
Impressions for invisilign (when I did it, about a million years ago) weren't so bad though. Unfortunately invisilign resulted in an open bite for my molars, which I really should go back to an orthodontist to address, but I'd rather not.
AFAIK Align's 3D scanning system is more or less branched from the same Israeli tech that went into the Xbox 360 kinect camera and the iPhone face-ID.
The difficult part is not the manufacturing, but knowing how to do it properly so you don’t harm the patient.
And yet I read plenty of horror stories of bad orthodontic results. Ask me how I know.
Went to 3 different orthodontist to fix what a bad orthodontist did to me when I was a kid, and each gave me a completely different treatment plan. I feel like being an orthodontist is just eyeballing and patching your way as you go to an acceptable resolution.
Manufacturing them requires a resin printer and a vacuforming setup, but that's still the easy part. It's a whole system with a dental 3D scanner, software for rearranging your mouth, and attachment points that have to be epoxied onto (and later removed from) your teeth by a dentist.
But it’s also something that’s not responsible to shortcut. Shifting teeth around too fast can result in permanent root damage and even loss of teeth. There was a whole cottage industry in the US for a while focused on under cutting Invisalign with a reverse-engineered product, but they often moved on accelerated treatment timelines that caused a not-insignificant amount of harm to patients, and cut corners on intake (DIY at home mold kits) that also contributed to problems. Pretty sure all of the companies doing this are basically dead now.
If you keep them on soft food young, the jaw muscles don't get stimulated enough to grow so that the teeth that are coming out sit properly. Misalignment and opportunity for decay ensues.
If you give them decently hard food early on in life you solve most problems.
After that it can still happen but there's less chance.