Should people be worried about chewing microplastics?
No, we've never had one complaint about microplastics since I've been here. If you do enough research, there’s a lot to be learned on what's real and what's not real, what's toxic. There's so much plastic use in medicine, and it's all over the place. Water. All these plastics have different compositions. When we start to look for a plastic that you're going to wear, we don't use any components that have any degree of toxicity, so that we know when we move into FDA approval or regulatory approval of it, we know we're good. We didn't put anything in there that would be considered toxic.
On the treatment plan, one thing that I would've loved is a way to know which aligner was going to be most painful. Was this week going to be a painful week or a not painful week?
That's funny. I just had another person tell me the same thing. My son told me that, Tyler.
Great minds think alike. It seemed to me that AI should be able to solve that if you collect enough data. There were some weeks that were like, I can eat anything, do anything. It's great. And other weeks I wanted to punch a wall.
I've actually talked to Srini [Kaza, Align’s executive vice president for research and development] about it. He looked at me cross-eyed the first time I told him. But now that I have two data points, I can draw a line through it.
Really, I think it's viable and it's not like it's a big deal for us. We know when a massive movement's coming that's going to upset you. And we know the delicacy of certain teeth that will be affected.
In terms of efficacy, one thing that I noticed was you said “touch-up cases” shipped last year were over 136,000, which was up 36 percent. Isn't that bad? Shouldn't you be doing less touch-up cases?
That touch-up is when someone didn't wear the retainers and the doctor said, “Oh, I have to touch that up because you got some lower crowding or whatever,” and they'll order anywhere between five and 10 to 15 aligners.
There's also a lot of passion, excitement right now in the country for bringing back manufacturing to the US. You’re in Mexico, Poland, and China currently. Is it ever going to be viable to make aligners in the US?
It could be. Labor is a huge component. As we get to manufacturing that's much more automated, having it in the United States could make sense. We'll certainly look at that as the time comes. Because I do think that, again, that shipment cost that we talked about, there is a piece to that, too.
How many people does it take to make these in Juarez, Mexico, right now?
Thousands.
That seems crazy. Isn't it just a machine doing all these things?
Oh my goodness, 3D printing at this level is a monster. You can 3D print these things, but remember, you have to take these aligners, and you have to put them in bags. Sometimes, you have to treat them in some way. It's hard to explain, but it looks like the inside of a Costco in a lot of ways.