Ladies and gentlemen, please welcome Shirley Stacy, VP Corporate Communications and Investor Relations.
Good morning. Good morning, everyone. Thank you. Thanks for joining us today. We appreciate you taking the time to spend a few hours with us going through, we think, a really great story. Before we kick things off, I've got a couple of housekeeping items to take care of, and want to just be clear that the presentation today and the Q&A sessions are being audio webcast for your enjoyment at our investor website, investor@aligntech.com. Presentation soft copies will be posted on our website after today's meeting. If you need any assistance, please, the registration desk where you checked in this morning our team there is happy to help you, or if you come to the back of the room, one of us can also assist you.
The facilities for the event today are in the back of the room as well, and each of you should have two or three Wi-Fi cards on your tables if you're looking to access the internet. The password and the internet to log on is on your tables right in front of you. Before we start the meeting, I also want to remind you that the presentations today will include forward-looking statements, and we want to steer you towards our filings with the Securities and Exchange Commission, our most recent Form 10-K and 10-Q. We obviously, want to make sure that, any of the forward-looking statements that we make, obviously, there's no update to that. Please be aware of all of our forward-looking statements. I'm going to actually cover very quickly, not in a lot of detail, but we've got a jam-packed agenda for you today.
As you can see, we've got 10 of our executive team presenting, but we've also got the entire team here in the back of the room. I want to make sure that you can see there's a couple of breaks and lunch opportunities for you to spend a little bit more time talking to the management team. We also have some really great subject matter experts in the room in our Invisalign pop-up store. Please, during the breaks and during the lunch, take an opportunity, and also take an opportunity to get your teeth scanned at the Invisalign pop-up store. I also then just want to remind you very quickly, at each of the breaks, there will be a brief Q&A session, so you have an opportunity to ask questions in between the presentations.
Again, at the end of the session today, there'll be the entire team available to ask any questions. With that, I'm going to actually turn it over to the emcee for the day, our General Counsel, Roger George.
Pretty quiet in here. Welcome, everybody. I will add my welcome to Shirley Stacy's on behalf of my colleagues on the executive team, our board of directors, and everybody at the company. We're delighted you're here. If you've followed us for a while, you may know that I'm the longest-serving executive here, and I know where all the bodies are buried, and I know how to bury them. That's why I'm the emcee today instead of presenting anything substantive. When I joined the company 16 years ago, we had exactly three analysts who followed us. An Analyst Day was something that we would do at a Starbucks, and we would use gift cards because we couldn't afford any other way of doing it, and we had to beg people to come. For me, it's very gratifying to see everybody here. At that time, we were pretty much insolvent.
Our annual revenue was about $70 million. We were losing money hand over fist, and our market cap was $235 million at the end of 2002. It's a lot more exciting to be talking today about where we're going based on where we've come. When I joined, we had a new CEO, and his name was Tom Prescott, and he got to the company, and he started looking around, and he realized that it was a mess, and he needed to find a good lawyer. He couldn't find one, so he hired me. Together, we've been on this journey. When Tom decided to retire, he gave us the best retirement gift that he possibly could have given us. He convinced Joe Hogan to come and join our little popcorn stand after running companies with tens of billions of dollars of revenue.
It's always a dangerous thing to introduce your boss on a webcast, it's my honor and my privilege to introduce to you guys, Joe Hogan, who's going to kick off our session today. Again, thanks for coming.
I'm not so sure about the honor and the privilege part, okay? I'm really happy to be here. It'll be three years in June, and we've accomplished a lot. We've really been excited for this day. Two years ago, we gave you a look at the company and said this is where we thought it was going. We'll give you an update today. We've met almost all those goals, and we're going to paint a picture of what this future looks like and business at really Align is driven. You'll see the entire team's here today, and we'll each present, and hopefully, you'll get to see the enthusiasm and passion we have for the future of the business. We got a great platform for growth. This chart is one of-- it's a revenue chart from-- We're at this for 21 years now.
It's really hard to believe. I heard someone call us a 21-year-old startup at one point in time. If you look at this path, it's basically the line is a revenue line. You can see there's three key areas here. Products that we have basically developed, milestones we have in the sense of the size of the business overall, and also the number of patients that we have done over time. As you can see how that curve has really, since basically the $500 million mark, has really gone up dramatically and then another spike here in the last few years. When you look at that, I think you can see it as a story of revenue, as a story of growth, but that is a torturous path. As competition comes in this marketplace, I think that you all have to consider that and think about it.
There are more mistakes in that line than successes. No one's ever done what we have done, producing over 400 million unique parts since we've been together. This is a prototype business before, and no one's ever done that. Along the way, there's a lot of bones, there's a lot of learnings, and it's inside this company that we've been able to do that. We really rely on that from a structural standpoint to scale this business to meet a demand pattern that we're so excited about, that's way outside of the demand pattern we've described before of just orthodontic cases, and I'll get into that. In a lot of ways, we think we're just hitting our stride after 21 years. Since we met in 2016, here's what we've done. We've grown the business 72%.
Our iTero install base, this is really important, is up 3.5, and it's just so much better to have a digital front end on your system, and we'll hit that hard. Operating income, we produced $600 million of operating income. Invisalign cases, really approaching almost 2 million, 1.6 million, and another close to $40,000 docs trained all around the world to do this. Another important metric too is when we stood here in 2016, our ratio of international to domestic was 70/30, and now it's 60/40. It's 60 North America and 40 overseas. That's not because North America hasn't been growing well. Chris and his team have been doing extremely well. It's our overseas businesses, EMEA and APAC, have really been driving a tremendous amount of growth. A lot of accomplishments in a two-year period. I didn't ask for any musical accompaniments. Sorry.
We have a convergence going on between demand, technology, and capability. I want to talk about demand for a second. Demand is just the most important component that we deal with. Someone said the other day that smiles were never so visible as they are today. It's a really simple statement, but it's true when you think about it. I was on the Golden Gate Bridge the other day. I had a friend in town, they never saw Golden Gate Bridge before. You almost have to wear a hard hat from all the selfie sticks that are there. Of people taking pictures of themselves. They're just everywhere. Never before have people had such. Everybody has a camera in their pocket.
Many people are tied to social media, straight teeth are really at a premium now because people want to look their best, and look, these are head shots going on. These aren't scenery shots. The focus on a smile and having straight teeth is never been more than before. Our business model, it's been founded out of necessity of balancing a consumer brand and driving consumer need, and pairing that together with providers and with doctors. That's our business model. We're staying with that. That's basically what we do. You have to move between those two poles in order to make this business work, drive a consumer brand, get it as close to consumers you possibly can. Get those consumers and the docs that can take care of those pieces along the way. That demand piece is extremely strong.
We'll paint a picture in a sense of where we think this is going to go globally over the next several years. From a technology standpoint, I think you all know that we stick every year $hundreds of millions into technology to expand our capabilities to do this. At a point in time now, we're about 70%, we feel, in general, of the orthodontic cases out there that we can address with Invisalign, soon to be 80 and 85 with some inventions Joe will talk about later on. The whole excuse is you walk into a doctor and a doctor says, "Oh, you don't qualify for Invisalign." That's becoming more and more untrue every day that goes by. Technology's really in a good place to service the demand. The last piece is capability, which is about scale.
Can you really scale to meet the demand that's going on? You saw the growth we've had the last two years. That puts pressure across this entire value chain of the business, whether it's the clinical side, the clinical support side, whether it's on the manufacturing side, salespeople, just throughout the business, it's an incredible amount of pressure. We've been able to keep up with this demand, but hired terrific people now. With the success of Align and notoriety of the business, we can go out in the marketplace and we find terrific talent now that we could have never touched before when you look back three years ago. You take all these three things and drive them together, what do you have? You have market expansion. It's going on in a dramatic way. You see it in our numbers.
You see it in what our forecasting is as we raise guidance. Let me just walk you through this. This really creates room for a vision. Our vision is not the 12,000 orthodontic case starts that we have a 9%-10% penetration rate in today. Our technology is geared to doing that. Our vision's about hundreds of millions of patients out there that want to have their teeth straightened, not the 5% of the population that's been treated to orthodontic kind of procedures in the past. It's really the top end of society that's really been driven. This is hundreds of millions of people that want to have their teeth straightened, can have their teeth straightened. That's the kind of vision we have around this business.
It's an expansive, not just that 12 million case starts, but the people out there that have malocclusions, fancy word for crooked teeth, that want to have them straight at some point in time. When you look at that, those are the 12 million case starts that we have, annual cases a year. When you break that out, you get about 4 million in APAC, 4 million in Americas, 4 million in EMEA, general. Again, 9%-10% utilization or penetration rate into there, but a technical capability now to do 70%, soon to be 80%-85%. The real story here is not that.
The real story is that when you take a look at 70%-75% of the people in society today have a malocclusion of some type that should be addressed either aesthetically or should be addressed clinically in some way to save their dentition for their lifetime. That's our vision. There's no other company in the world that can address that like Align can address it. With a combination of consumer awareness and being able to drive consumer demand and understanding, and bringing that home from a standpoint of scaling from a clinical standpoint and a manufacturing standpoint to really meet that demand. There's no one. It's not bragging about it or whatever, it goes back to that 21-year-old line of all the mistakes we've made over the years to be able to get to this point.
We really know what that is, and we really know how to do it. When you think about competitive aspects, we're built for doctors and consumers. You're going to hear that time in and time out today. That's our business model. That's how we work these things. The polarity of those two pieces and how we work them are really important to our business strategy. We have a 100% digital approach. There's no other company in the world that has a digital front end. You can see that out there today with our store, with iTero and what it does, and marrying that together with 3D printing business on the back end, a completely touchless order entry system to be able to produce hundreds of thousands of unique parts a day.
If you go back in time, remember, stereolithography was used, and I was back in the plastics businesses back in the 1990s. They were used for prototypes. It was a prototype business, which is basically, you made one-off of stuff, right? Like hundreds of thousands of unique parts a day, and that knowledge internally, and Emory will talk about it, the knowledge we have, you can't go to 3D Systems today and tell them to set up a 3D printing line like Align has. They don't know how to do it. They can deliver the machines, but they don't have the internal knowledge to be able to do what we do. We had to understand that. We had to take the time to learn it and to drive that. Unrivaled experience in that sense. The global scale.
You'll see how we're moving more and more globally to get clinical capability outside of the country now in China, also in Spain, also in Germany. We'll move as assets from a global standpoint, as close to customers as we can when it makes economic sense, and we can establish a better footprint there competitively. Look, we say it's built for doctors and consumers. When you look at our traditional business like orthos, our orthodontic business, I call it a B2B2C business, right? Our business to a doctor's business. Then C is the consumer piece. That was a classic Doctor Locator piece where people would be interested in Invisalign, access Doctor Locator, throw in your zip code, the top doctors that might have Invisalign in that area, that you'd be directed to that piece. We still do that.
We drive that part hard all over the world. We also, from a general practitioner standpoint, too, with general dentistry, it's cultivating new channels. I think we trivialize GPs sometimes in a way that we shouldn't, right? GPs want to straighten teeth. They just don't want to do it as their orthodontist. They want us to be able to work within their workflow, which is a restorative workflow, is where the majority of their business is. More and more, you'll see us specifically focused on GPs from a technical standpoint, having a product that works in their workflow. It has to be a digital system in order for it to fit that way, and you'll hear more about that today. Those are both B2B2C aspects.
Now, when you go to what we've done recently with Smile Concierge, where we actually contact the patient directly, we have a dialogue with that patient as far as what their needs are. We direct them to a doc that we think can provide them with the best experience and the highest chance of getting Invisalign in that sense. That becomes a B2C2B business, right? Us to the consumer, taking that consumer by the hand and walking me into that business. Talking to the consumer when they're done to make sure they had the experience that they had really wanted, and the doctor provided what was needed in some way. I mean, we've delivered millions of dollars of business to our customers through this concierge service that they can count and understand, and we'll hit that.
The most recent piece, which is out there today, Jenn, here, will talk about the Invisalign store, is just carrying through on this B2C2B business. Remember, this business model in stores, this is not a retail store. We're not selling Invisalign in this store. What we do is we scan customers, we tell them what the opportunity is in a sense of a Signature Smile or Deluxe Smile. If they're interested, we take that and we move them to a doctor where they can have a physical scan or a physical understanding in a doctor's office and examination, and then they can order those aligners at that point in time, right? This is, again, driving more consumer awareness, driving more consumer demand. We have two stores right now, and we have two more coming up on the East Coast shortly. 21 years, 100% digital approach.
I wanted to stand back from the slide for a second and just tell you, as Roger indicated, I've been fortunate in my career. I've had a lot of different businesses, hundreds of P&Ls in my life, right? I have never seen a business like this in my life, ever. It's truly a digital business. Everything you read about and the books say about disruptive technology and artificial intelligence and machine learning and 3D printing and all that stuff, we do that. We don't just talk about it. We do that. The products that we have in the marketplace, like when we get to One Week Wear, there's a lot of just mining our databases of 5.5 million patients and figuring out if One Week Wear really works.
Machine learning to understand how does a tooth really erupt in a teen, how big is it going to be, how is it going to play, so we can have our aligners and design our aligners to compensate for that eruption of that tooth at that point in time. Emory will show you some great indicator of machine learning in a sense on a manufacturing floor. All the 3D printing to the extent that no other company in the world has ever 3D printed parts like this with this kind of efficiency before. All those things that I think a lot of companies aspire to, this has been survival for us. This has been a necessity for us, not a dream in the future of what we'll be able to do in some way. We harbor that talent inside of Align.
Look, let me take you on a journey, just really quick, okay? This is how this whole thing works. I'd say, pretend it's a journey, and you start with iTero and Invisalign Outcome Simulator, which basically you saw out there, you get an impression, you get a digital impression, then the Outcome Simulator will tell you how your teeth look now and how they'll move to be in a perfect position, right? This is basically, anytime you go on a journey, you're basically going to say, "Here's my destination." You kind of got to map a location, and that's what iTero does along with our Outcome Simulator. Secondly, you've got to pick your mode of transportation. How are you going to get there, right? That's what our smart systems do, SmartTrack, SmartForce, SmartStage. Each one of those.
SmartTrack is our material, patented in 2013, uniquely designed to move teeth in an orthodontic manner. I think from a patentability standpoint and a proprietary standpoint, you can't overlook that. Secondly, SmartForce are attachments and features. Not just any attachments, where those attachments go, exactly what the shape of those attachments are. Lastly, SmartStage, program tooth movement. We say not displacement, not saying the tooth is here and it should be there, but actually understanding where you're going to move that tooth to. That's what this does. That's, again, 21 years of experience to be able to figure that out. That's basically the mode of transportation you use. ClinCheck Pro is a GPS, and what that basically does is it says, "Here's where we are today.
Here's where the teeth are." When you do program tracking through iTero, when you go back in to see your doc, the doc will say, "You're good. Teeth are tracking. You're on path to complete your journey," or you're not. Scan again, another set of aligners to make it work. That's a GPS system, and it all ends up in aligners and retainers and expanders in the end, and better outcomes, more predictable outcomes, in a sense. That's the digital ecosystem we've been talking about for years, and you're going to hear various parts of this value chain today that we work on from a technical standpoint, adding more and more perfection on what we can do to reach that demand. Look, global scale is really important. This is Juarez, Mexico. It has shipped, I think it was, I don't know, May something.
I don't remember the date we took it off, but it was May 5th this year of some type. Remember, this is huge. Again, we're doing hundreds of thousands of unique parts in here every day. You have to remember, too, that when you walk through this thing, too, that that digital printing business that we have, the 3D printing business, a lot of it is us. It's what we've done. It's what we know how to do. The magic's not in the equipment. It's in the manufacturing execution systems code that really makes that operable in some way. This is our global scale chart. Emory will give you more detail on this, but basically what this says is we're taking some capacity out of Juarez, Mexico. We're moving it to China, right outside of Chengdu. We were just over there last week in Deyang, China.
We already have treatment planning up in place there. Great treatment planning facility in Chengdu that we saw last week. Wonderful training center for customers to take full advantage of, that Julie will get into in some way. You can see 103 countries, 136,000 trained docs, sales and marketing professionals of over 100,000, and manufacturing, CAD/CAM designers of 4,000. It's truly scale, and we're going to move that scale closer and closer to customers so they can have a better experience and a faster kind of a lead time with us. Look, when you think about the advantage of Align and how Align competes, obviously, it's a brand advantage. A lot of people know. There's doctor advantage in the sense of the largest network of trained docs we have. You can go down through this piece, 5.5 million patients, moving to 6 million here shortly. Operational advantages.
All those things are moats around our business from a competitive standpoint. I believe what we told you back in 2016, where we thought about competition coming in with 10-year-old technology, was pretty much confirmed by the AAO in May. It is basically what we saw. At prices that I think, frankly, surprised a lot of people, but not us. This is very expensive to do, and that was reflected in our competitor's pricing, too. Basically, our competition has come out with a product that we had and a system we had 10 years ago, and they are going to have a ways to go. We are not negating the competition. I live paranoid every day, they pretty much showed us what we thought we would see, and there was some comfort in that, in that we were not surprised.
Look, our strategic imperatives of this business have been, for the last three years, international expansion, number one, orthodontic utilization or penetration, number two, patient demand and conversion, you have seen that, and GP dentist treat and refer. We have kept these. It works so well from a strategic standpoint. We just get better and better in each one of these four categories every year that we work together to bring these things for the business. Look, this is a unique opportunity, and it is really enormous. As you leave here today, just think, it is balancing a company that has a good brand and has good contact with consumers and drive it, with a technical capability and a market capability that is really unrivaled in the world. I am going to leave you with a quick story, it happened last week.
It is something that I want you to appreciate in this business that I think sometimes we lose as a team. I was in Chengdu, China, last week, and two wonderful women came to interview me from a business times in China and also the government agency. We are talking about Invisalign and our investment in Chengdu, in Dejiang. We are going through the whole thing. I could tell that one of the ladies was confused. I realized that she did not really know what we were talking about in the sense of how we move teeth. We had an aligner, and I took an aligner out of my briefcase and put it in front of her. She said, translated from Chinese to English, she said, "That? That moves teeth?" She said, "Like what?" "Yeah, that does that." She said, "That is magic.
It is magic." It is. I think we often forget that, the people that do not really. You look at that piece of plastic, it is hard to believe all the sophistication, everything it can do, because so many people have been fixated that only metal can move your teeth. You need something that rigid and hard to do it. I think as the world is going to open up to really understand this, that is what drives that demand pattern we are talking about. With that, I will turn it over to Raf, who is in charge of marketing and business development, and he will give you more details on it. Thank you.
Morning. Thank you, Joe. My job over the next few minutes is just to start going a little bit deeper into some of the points that Joe spoke about, and really talk about that unique moment that is ahead of us, where 21 years of experience, a very unique end-to-end digital workflow, and a tremendous brand appeal are really converging to bring new experiences to our doctors, customers, and to the patients. I'm going to start going into a little bit deeper into these points before Zeljko come on and talks to you about the technology that is behind this dream that Joe has spoken about, of bringing clear aligner therapy to a much, much broader group of patients beyond the 12 million. Let's not forget about the 12 million.
As we keep telling you, we've got about 10% share, and our job is to keep taking share of that marketplace, and we'll show you how we're going to do that with innovation and brand and demand generation. Really, the key for us is how do we go out and try to take clear aligner therapy to the 300 million people around the world that we believe have crooked teeth, people who really need to change their smile and may not have access to it, may not know about it, or may not be able to afford it. Really, the key for us is to try to marry our technology and our brand appeal into trying to bring more of these people to an orthodontist or GP practice to get treated. We keep talking about those 21 years. 21 years of experience count for a lot.
During those 21 years, we really shaped the industry like nobody else has ever done, through our technology and through our brand appeal. We brought 5.5 million patients to our doctors, 5.5 million patients over 21 years. That's pretty remarkable for a company like us, still in the startup mode, apparently, with just plastic. Our brand is the most known and renowned brand in the marketplace, with 80% awareness in the U.S., a little bit less outside, but it's a very well-known brand with a lot of appeal. Really what underlines all of this is the fact that it's a fully digitized system. From the scanner all the way to 3D printing, we can offer a fully digitized workflow, which I'll try to explain to you why it's so important in today's world, where digital is winning.
We've got three really unique foundation that create the success that we've experienced in the past, but also allows us to think very positively about the future. The first one is around the product. The product is very appealing to consumers. It's transparent, nobody knows you're wearing it. It works fast. It's available pretty quickly. You don't have to go to the doctor so often. From an appeal perspective, patients love Invisalign, and they tell us that. The second part, as I talked to you about, is our technical and clinical proficiency. Let's not forget that in many ways, we are setting the standards for clinical outcomes today. We're setting the standards for what is good clinical outcome with plastic.
The third one, of course, is that when you take all that apart, when you peel those ideas apart, in the end, it's a very financially viable product offering for everybody on the value chain. We wouldn't be here today if this product moved teeth, but nobody was making money out of it. Those are really the three foundations. It all starts really with creating demand, creating awareness on the marketplace, with the hundreds of millions of dollars that we have invested over the years in advertising. As I said before, we brought 5.5 million patients to our doctors' practices. That actually creates hundreds and hundreds of millions of dollars of production revenue for our customers on a yearly basis. We started many years ago by advertising. We changed our approach to the market in 2017 with our Made to Move campaign.
That's really a way for us to start connecting patients to their smiles. As Joe said, there's a lot of changes around us in terms of how people see themselves, and Made to Move is really designed to bring patients and doctors together closer to their future selves. Back in 2017, we also started to invest a lot more in teenagers. We know teens is a large part of our future opportunity for growth. Over the years, we really didn't go after the teens in a sustained way. We started that in 2017 and again in 2018 with heavy investments, especially in the U.S., but also outside the U.S. We're reaching them in a way that is very different to what we do with adults.
We reach them through their peers, through bloggers, through media like AwesomenessTV, that really creates this sense of they are in control of their future. We're not going to force a treatment on them. They're going to listen to their peers, not to people like us. The good news is, when we look at all this, two years ago, we talked to you about a 10 million orthodontic market that is available to us. We're talking to you about 12 million. This 12 million is really down to our investment in geographical expansion, it's down to the investment we made in brand, but also in the innovation, in expanding the applicability of Invisalign to more and more cases. 70% now, and we keep on expanding that market. We are going after 12 million as I would say the traditional orthodontic market.
Really, it all comes down, in the end, to our fully digitized end-to-end digital workflow. I want to talk to you about a couple of things. It starts with iTero. iTero is more than just an impression. It's more than just replacing a physical impression by digital impression. It's also a diagnostic tool. It's also an analysis tool with iTero SIM, and TimeLapse. It's much more than that. When you talk about ClinCheck, and some of you may have been at AAO, I've heard about some of our competitive treatment planning software. ClinCheck is not just a CAD software. ClinCheck is a very intelligent software that uses machine learning and that understands how to do proper staging. It also gives the doctor the control that they need to be able to go do treatment.
When we look at this, we believe we are number 1 in all the categories that we today compete into. Number 1 by many, many years. We could argue that a first-mover advantage of 21 years is probably still quite real today. Align is also a company, as you know, that innovates. We talk about innovation all the time. It's in our DNA. About a few weeks ago, we actually announced the release to the marketplace of five new products. Most company, I would imagine, would be very happy with just one new product launch a year. For us, that's not enough. We're doing five in the space of a month. Most of them are going to be launching on July 1st. I just want to go through a few of them. The first one is Mandibular Advancement.
We launched that last year, we're really starting to see the real impact of it this year, notably in Europe and Asia, and we'll be launching that in the U.S. later on this year. A Mandibular Advancement feature is really significant from a treatment perspective, but also in terms of what plastic can do. It does not just move teeth, it also creates collateral changes. I can assure you that 21 years ago, even five years ago, not many people thought that anybody could achieve this type of outcome with plastic. The second one is Invisalign First. Invisalign First is our first dedicated product that targets specifically kids from the age of seven to nine years old. That represents 25% of the teen market today. 25% of the market that we've never really tried to compete into.
It follows a strategy that we stated many times about expanding the applicability of Invisalign. The third one is Invisalign Go, specifically designed for GPs. We launched that in Europe last year, we're going to be expanding the clinical scope of Invisalign Go and changing the entire ClinCheck workflow to be very specific to the needs of GPs, and to talk the GP's language. We're doing a lot of work on Vivera too. Retention is actually a big business for us, and we improving Vivera very regularly to bring new features to it. Of course, the last one is the two new iTeros. We launched Element back in May 2015, exactly three years ago. We brought to the market two new products that Yuval will talk to you in more details a little later.
We believe we're 21 years ahead, and we have that first clear mover advantage. We set the standard for clinical efficacy, for digital workflow, for brand appeal. Those of you who were at AAO probably saw that. Our competitors are trying to somehow confuse the marketplace by coming in at separate parts of our value chain. You have to remember that to be able to obtain the results we have, you have to have that whole entire technology ready and integrated, something that our competitors don't have today. Despite all this, we keep scratching our heads regularly as an executive team to say, "How on earth, after all this innovation, all this, the 21 years, do we still have 10% market share?" Actually, we look at this in a very positive way. For us, it's great.
It means we still have 90% of the existing market to go after. We also have 300 million patients to go after. When we look at growth and our potential for growth, we feel very excited. The key though is how do we get after these 300 million patients, which we never went after before? I just want to share with you a couple of statistics. The first one really is that three in four people out there around the world, you can look around you if you want, three in four people actually need teeth straightening of some sort. The majority of people don't have access to that treatment or don't know about it or don't know they need to have that treatment. What we need to do is change that dynamic.
The second important dynamic is only one in five people who go to the dentist and get a treatment proposal from the dentist actually accept that treatment. We have a huge issue here of people not accepting treatment. If we can change that dynamic to consumers accepting treatment more readily, we believe we can really go after those 300 million patients. How are we going to do that? Well, we're going to try to combine our technology, the digital technology, with how the society is changing today. Joe started referring to you about that a little bit a few minutes ago. Really, this idea of that digital evolution, people are looking. We are looking at the millennials, the Gen Zs, are shopping and behaving differently today than they did three years ago and five years ago. It all has to be mobile.
It all has to be convenient. People want to be able to have access to whatever they want to buy now, not tomorrow. They want it now. They want a different experience. As a brand, we have to adapt to that. We believe that technology allows us to be able to do that, and nobody else in the market out there. The really important one is the smiles on display, the Snapchat, people taking selfies. They want to look good, and they look at their teeth a lot more than they used to in the past. Everything needs to be instantaneous. I want to have access to my treatment now. I don't want to wait three months. I want it tomorrow. I want it tomorrow because I do. That's it. That's my choice. Let's take the example of Jessica.
Jessica is going to be graduating in four months. For a number of months here, she's been looking at her smile, and her smile is okay, but she'd like to be able to have a better smile. It's Sunday evening. She goes on our website. She takes a picture of her teeth. She sends it to us, and within a few minutes, she gets back a picture that shows her what she could look like with a new smile. It's not a fake picture. It's her with her real teeth that our machine learning in the background will have redesigned and reset for her to look different. On that website, she goes on Doctor Locator, and we have doctors that are lined up waiting for her the morning after, not far from her house, for an appointment. The morning after, she goes to that doctor, she gets scanned.
It takes about two minutes. For those of you who want to try it, you can do it here. It takes two minutes to get scanned. That scan gets sent to us. Within a couple of minutes, we have automated data that comes to us, comes back to the doctor with multiple treatment options. While Jessica is sitting on a chair, the doctor and Jessica can see different options for treatment. Does she want a short treatment? Does she want an ideal treatment? What does she want? They can decide together. We're giving her and the doctor the choice of what they're going to do. We're putting her in charge of the future. They decide on a treatment. The treatment gets sent to us. A few days later, the aligners come back.
Jessica wears them for seven days at a time, no more 14 days, one week. She's ready for graduation. She's happy. Not only she's happy, the doctor is happy because they have created a connection, and together, they really own that treatment. That vision, in the most part, is pretty real today. It's very unique, and there's a lot of technology behind it to allow us to have that vision. Zeljko will talk to you about some of that's behind it. We also offer choice. Joe talked about the Smile Concierge program, the stores. As a consumer, I may not want to go on Doctor Locator to find a doctor. I may want to go to a scan. I may want to talk to somebody that knows about it. I want to pick up the phone. This is what we're offering our consumers today.
We're offering them choice. We're also offering relevance to the GPs. We've done a lot of innovation for orthodontists. We continue to do so with Invisalign First. We're also adapting our product to the need of the GPs, talking their language, being very relevant to them, because today, dentists are looking to do comprehensive dentistry. They're looking to include Invisalign as part of a broader treatment, and our software allows them to do so. Our vision and the vision that Joe set out, which is to really bring clear aligners to the masses, is really based on this idea that seeing is believing. We're trying to bring patients closer and connected to their future self, using the doctors and the patients together to do that.
We really believe that as a company, because of our technology, we're really the only ones who can get from one to five, who can really get the doctor and the patient at the chair side to look at the treatment potential, to visualize them, say, "Yes, I'm going to get treatment. I understand what I'm going to look like. Yes, doctor, I trust you that you're going to give me the best result possible." Going from one in five to five in five to get up to those 300 million people. To conclude my presentation this morning, I think we really are on the edge of a unique new chapter, if you wish, in Align Technology.
For 21 years, we developed technology that helped our orthodontists treat more and more patients, more and more complex, and we brought a lot of patients to their practices. We're also adapting our product to fit with the GPs, what they're looking to do. They're looking to do better dentistry. They're also looking for new revenue, and we believe that with our new solutions, we can do that. I think more importantly, with our technology, we're converging in creating appeal and desire for our consumers, so the consumers out of the 300 million people to come to us and to our customers and ask for more Invisalign. On that note, Zeljko is going to come on stage to talk in a lot more details about the technology that's behind it. Thank you.
Morning. Feels a lot less than two years since last time we were here together, more like two months. Really what happened in the last two years, it's more or less of the same for us in R&D. We continue to work hard on creating digital solutions and trying to maintain our leadership, and we remain committed to clear aligner therapy with our mission to make it a standard of care. Two years ago, I showed you this slide, and in the last 24 months, we just did a lot more of that. Invested almost $190 million in the last 24 months in R&D, added close to 300 patents to our portfolio, and treated successfully another million and a half patients all around the world. Our core competencies, we just keep growing. We added some more.
As digital leaders, with our web, mobile, and cloud technologies as our core competencies, we can provide digital solutions to our doctors. Information security, I know it sounds trivial, but really important for us, and that we can be the best trusted partner to our doctors and our patients. Of course, over the course of the last 24 months, a lot of new product releases. Our investments are accelerating. Our output, I believe, is accelerating, and the clinical confidence among our doctors is accelerating as well, based on pretty much a long history of clinical innovations. I don't think any company can claim to have that, and I can tell you we are committed to continuing on this path as much as we can. For us, after all these innovations, we used to try to explain to doctors that you can indeed move teeth with plastic.
This is no longer the case. We have proven that. For us, it's really about digital-to-analog approach. Today, many doctors can use Invisalign and treat patients more successfully than with braces. Many doctors choose Invisalign over braces. Many doctors actually don't want to do some treatments with braces. We have more work to do, but we are definitely very capable appliance as far as orthodontic treatments. Let me give you an example. Open bite. This is when you have a gap up front. Many of our doctors are choosing only Invisalign to treat open bite. I can give you many quotes from many doctors. The reason is very simple, because we have the ability for a vertical control there. We can do this anterior extrusion and posterior intrusion and close that bite.
Especially in the posterior, you probably can't see the arrows, but changes in the height of your teeth in the back actually means three times more up front. The problem with arch wires is that actually you can get unwanted, which only makes your open bite even worse. This is just an example. I can give you many more. There is a lot of work we are doing to make sure we have the best appliance for all treatments, but a lot of areas we have far exceeded the capabilities of traditional braces. For us, it really is about digital versus analog. We've been at it for 21 years now, and we continue to do so. I don't need to tell you that the world around us is digital. We see it every day.
I want to point out that the acceleration in technology is like never seen before. Technology leaps used to take decades of years to make. Now we see them in months, in weeks. For those who don't recognize that, who don't get on it's getting harder and harder. It's a train that's accelerating, and it's going faster and faster. Our job is to help our doctors make that transition. We see actually that a lot of doctors recognize that. They are digitizing their practices. They're moving patient data into patient management systems. The imaging equipment is all about digital data capture. They have more and more computers and mobile devices in their practice, which gives them a pretty good digital platform. Pretty much every single step in a practice can be improved or connected through digital technology.
Furthermore, our doctors also recognize that their patients are also consumers. Those consumers know what they need, and they want to get it. Doctors need to give them an experience that they get as consumers pretty much anywhere else. Only digital can make that happen. What does it mean to us in R&D? Very simple. It's about building the best digital orthodontic system. In the most simplistic way, it has 4 main areas, digital patient data, digital analysis and diagnosis, digital treatment planning, and digital orthodontic appliance. Digital patient data is all about patient data being digital form. It can be a patient information, their personal information, treatment information, scans, or anything else in digital form. Once you have a digital patient data, we can provide a lot of applications to help doctors better understand and assess patient needs and decide on the treatment options.
We give them digital treatment planning tool, like ClinCheck, to finally define desired treatment outcomes and how to get there. Finally, with digital appliances, we give them those perfect 4 systems to make that happen. Let me take you through them in more detail. As far as digital orthodontic patient data, there is no better source than the intraoral scanner. I think iTero is the best one. That's my opinion. Take a look at this chart. You've seen that, but it is phenomenal. Just over two years, the acceleration of digitally submitted Invisalign treatments is phenomenal. In international, that means almost 100% growth in two years. It's just a matter of time when these charts come together close to 100%.
There's no question that every practice in the future will have a scanner, probably more of them, and that the patient is going to be scanned at every appointment. It is a very small investment for a doctor to get such valuable information about their patients. More information they have, the better off they are. That's why we continue to heavily invest in iTero development to drive that adoption and utilization of scanners. Yuval is going to talk more about it. Mobile photo uploader is another utility to help doctors quickly and easily acquire more patient data. With a mobile app, you can take photos and upload them to the cloud in a matter of minutes. Digital analysis and diagnosis. It's simple, a means for us to provide doctor with more high-quality data about their patients.
You see here a lot of numbers, this is the data the doctor gets based on the patient data. This is the data that you cannot process in your head very easily. Of course, we also give doctors a lot of analytic applications like Invisalign Outcome Simulator, Progress Assessment, iTero TimeLapse, for them to better understand patient needs and also to better communicate with those patients. Digital treatment planning. This is the core, this is where ClinCheck comes to power. The most sophisticated orthodontic treatment planning software. Many years of development, a lot of biomechanics, a lot of 3D modeling, data analytics, machine learning. Very complex on the inside, we try to make it as powerful and as simple to use on the outside. I want to give you a little example.
Doctors use ClinCheck to achieve the perfect clinical outcomes for each patient based on their clinical treatment preference. Two doctors are probably going to treat the same patient in two different ways. When we give this ClinCheck to doctors, we have to make sure we address patient needs, and we also understand how doctors want to get these outcomes. Very often, doctors try different things because you cannot be sure what is what. For us to give them multiple options at the same time, it's very powerful. These options can be clinical. Let's say you do IPR or attachments or extraction versus no extraction to resolve severe crowding. Those options can be actually based on patient preference on the treatment outcomes. What are their chief concerns, and how much they want to see fixed?
Let me give you an example, and I'm not going to be too clinical. I'll give you example that there are multiple treatment outcomes based on the level of complexity of those outcomes and how much the patient might want to have working with a doctor. This is the initial. You can probably hardly see this, I'll try to explain what you're seeing here. Let's say that the first treatment option is a pretty good one, which addresses a patient concern. I broke this. On the anterior alignment. The outcome aligns these teeth. They look pretty good. We don't address too much in the back. It's a pretty good outcome, and a lot of patients will be happy with this. Another option can be. Sorry. Something that's better than that. It's a more alignment.
You see the deep bite opens up more, there is better alignment in the posterior. There could be the best one, which is ideal if you wish. Perfect. Look at this nice arch, expanded, perfect alignment. The doctor and the patient can have a very good understanding of what's possible. They can make a choice. The best choice is probably the best choice to choose, but for whatever reason, treatment duration, complexity, any preferences, you can choose something else. This is what we can give to doctors and to the patients. They can make their choice. The important thing is that good, better, and best, they are still excellent treatments. As much amount of movement you see, these movements are good, predictable, healthy. They have to be stable outcomes, which is very important.
I don't want to talk about competition, I don't want to sound arrogant, from what I see so far, our competition, they still have ways to go before they can do good treatments well at best. Invisalign Go for GPs who want to introduce clear aligner therapy into their thriving comprehensive practices. This is what it does. Doctors can choose filters and get those options instantaneously. Before they would send instructions to the technician, wait, and it comes. Now, they can get different options, very simple ones for GPs IPR, attachments, and things like that. Very powerful tool. I can't emphasize enough how much technology is behind those ClinChecks. They look very simple. When we take a scan of teeth, we see these teeth in thousands of triangles and points. No eyes can see that.
When we measure two teeth, two adjacent teeth, it's hundreds of thousands of measurements and operations to understand just two teeth together. Every ClinCheck has tens of millions, literally tens of millions of measurements and operations in between. That's absolutely not possible for any brain, for any doctor, as trained, to make those calculations. We do those things to help doctors leverage their clinical expertise and experience even better. They are better doctors with this than without. Finally, this orthodontic appliances. This is the essence of what we do. No matter what you do on the digital side, if the appliance doesn't work, it doesn't matter. Appliances are like medicine. The doctor diagnoses the issue, the disease, prescribes the treatment, then you get your pills. If they don't work, nothing matters. Not all aligners are made equal.
With SmartForce, SmartTrack, and SmartStage, we give you the best medicine the doctor can ask for. As Joe and Rapha said, our plan is to provide a comprehensive suite of Invisalign products for all orthodontic treatments and patients of all ages. We are doing well on the far right, and we are moving into the left, to younger and younger patients. With Mandibular Advancement, we are going into this thin segment for Class II correction. Again, I can't emphasize that this is SmartTrack, a soft plastic that applies gentle forces on your teeth, and we figure out how to make a design so that this small appliance, soft plastic, can move your jaw, can do skeletal movements. At the same time, while moving the teeth as well. Invisalign First goes to even younger patients. So far, extremely strong results and feedback from doctors.
They have options to stage the movements, we use machine learning to predict the eruption of the teeth. Very powerful solution. This is for the dental arch expansion. If the child needs a more expansion and a palatal expansion, it's about replacing this appliance. Don't get me wrong, this works. This requires a parent to go with a wrench inside a child's mouth, 6, 7 year old, and find this little screw and turn it a full rotation to expand this wire by quarter millimeter. Two years ago, I showed you the prototype of what we had in mind because this was the best we could do at that time. Same process as thermoforming is used for the aligners. I'm happy to tell you that we've come along on this one, this is how the appliance is going to look. It's directly fabricated.
Our first Invisalign product, directly fabricated. With which we can get a full control of dimensions to provide perfect and accurate forces for every stage, for every patient, for every arch form, every palate. It looks like this. You basically get a series of expanders the same way you get a series of aligners. Doctor's going to define the treatment in ClinCheck, the patient will change one every single day or as doctor prescribed. It's usually a quarter millimeter per stage. It can be anything the doctor prescribes. Compare this to that massive piece of wire permanently fixed into child's mouth. Here's how it's going to look. As you put each expander quarter millimeter wider, you're expanding the palate. Each expander is designed in mind with how the palate changes, the angles, and the dimensions to apply perfect forces. Okay.
Rod talked about seeing is believing. We as consumers, we know what we want. We want to see it before we buy. We are making sure that we can provide that proof. As Rod said, imagine this, the guy takes a selfie, not within 2 minutes, few minutes, within less than a minute, gets this. A very nice simulation of their smile with better teeth. Guy that's like this might want a smile simulation, he's going to need a little bit more work, he too can get within half a minute, something like this. Now, to do this, we need to do a lot more than just an orthodontic movement. He's going to need some implants here. That's why what we'll give to doctors the ability to plan orthodontic movements, tooth alignments, in conjunction with those implants, with restorative work. Here is another angle.
He actually needs six implants. Another thing, to do this tooth movement and plan this space, this is very hard with braces. Space management with Invisalign is much more accurate and much more easier to achieve. Okay, one more patient. I show you the whole face because he's from research and development team. A pretty good-looking fella, he could use help with his smile. If we were to visualize his smile after orthodontic treatment, you would get this. It's a pretty good improvement, it could be better. With restorative work after ortho, he can get this. Actually, his wife saw that, he said, "Honey, I love you, I love you even more this way on the right." Let me zoom it in so you can see the difference. See, going from initial to final without doing ortho, it's not good dentistry.
You want to align these teeth so that your restoration can be minimally invasive. If you don't do this, you have to grind these teeth in order to put restorations on. Grinding teeth, taking healthy tooth mass away is not good healthy procedure. That's why you're going to see more and more comprehensive interdisciplinary procedures in dentistry. Like this. Remove these teeth so they can be in a perfect place to complete the restorative procedure. This is healthy dentistry. This is the future. Patients pretty soon will know very well that they need to get the ortho, they need to get these teeth aligned so they can last longer before they get a restoration. I'm pretty sure that in the future, most of the restorative procedures will start with the ortho, with tooth alignment.
Actually, a lot of the ortho procedures will finish with restorations because you can get this even better smile. That's why we are building a comprehensive orthodontic system, because doctors will be able to do that extremely well with a comprehensive end-to-end solution. If we do that, our dream to make clear aligner therapy and dental care can be reality. We're going to give doctors high-quality care, in hands of trained doctors, available and accessible by the masses. Thank you very much. Shaked. Thank you.
Thanks a lot. You need this?
Good morning. My name is Yuval Shaked, and I run the iTero business for Align. Joined the company a year ago. Prior to that, I was 20 years with the medical device companies, mainly with GE. That's the fourth business I'm running, and by far, the most excitement for me. iTero is, the way I see it's really the gate for Align's vision. It is the gate in two ways. It is the gate for digital workflow, end-to-end digital workflow starts with a scan. The fact that we are developing iTero and Invisalign together guarantee the best customer experience with our combined solution. The other area is the gate into comprehensive dentistry, comprehensive digital dentistry. iTero provide comprehensive solution across restorative diagnostics and, of course, Invisalign. When our customers has Invisalign in their hands, they are the best enabler for Invisalign.
Our vision is really to scan every patient at every visit, everywhere in the world. This trend is already happening. The adoption of our technology is growing rapidly. We've been growing from 45 million three years ago to more than 200 million this year. There are two reasons for that in my mind. One is the technology is proven, it's fast, it's accurate, it's easy to use. Now anyone can take a scan very fast. The other is that our customers see the value way beyond digital impression. They can grow their practice with Invisalign, they could be more efficient and consistent, and they can create stickiness for their practice. Let's hear from one of our customers about their experience.
My name is Dr. Aman Dhindsa, and I'm a general dental practitioner from Manchester. Our practice specializes in cosmetic restorative dentistry, and I have a keen interest in cosmetic orthodontic practice as well. Well, digital's around. We need to be part of that system now. Looking at the different scanners on the market, the iTero was perfect for us with the Invisalign Outcome Simulator. For me, in practice, patient communication is essential. It's the cornerstone of dentistry, really. If the patient understands what's happening, it's much easier for us to do our jobs, and we get much more success. With the iTero, the visualization that you get for the patient means the uptake of treatment is much higher, but also their understanding is much more advanced than what it was before.
Now every single patient sees a therapist first and has a full scan done before I actually see them and do the examination next. Yeah, we've had to integrate a second scanner now because we bought our first scanner, and then a month later, we realized it was so successful and we're scanning every patient, that we needed the second one so that I could actually do the restorative work that I needed to do, as well as the first scanner being used to scan a new patient for the orthodontic simulator.
When our Invisalign customers, as iTero, they grow their practice. It's proven. The iTero Lift Study looked at more than 1,900 clinics around the world, and the result is that the return of investment for iTero is less than one year, and this is consistent in year two. That's the most powerful solution and evidence I've seen in my career. How does it work? The Invisalign Outcome Simulator is available only on iTero. The way it works is that the patient is being scanned, and within minutes, the doctor can visualize with the patient how their teeth looks like today and how they're going to look like in the future. We know that our customers are studying in the chair side, having this visualization tool simplify the patient communication and increase treatment acceptance for Invisalign.
Then with tools like TimeLapse, they can visualize with their patient how much their teeth moved since the last visit. TimeLapse goes much beyond Invisalign. That's a tool that help our customer diagnose gum recession, tooth wear, tooth movements, and much more. Let me give you an example. Honestly, I just ignore it because I think nothing changed, and I don't see it. If my dentist had this TimeLapse, and they showed me how things are evolving with my teeth, how they deteriorate, and what might happen if I don't do something about that, I'll probably take action. I probably would want to go back to this clinic because they have these tools and they have my data. Just to complete the comprehensive offering, iTero is a robust restorative scanner.
It can support all the restorative procedures like crown, bridges, implants, with a proven accuracy and speed. We have more than 7,000 restorative scanners in the install base. We have more than 2.7 million scans, and we have more than 3,000 labs in our network. To bring it all together, the value of iTero is way beyond digital impression. It is about 60 seconds data acquisition that help our customer grow their practice by increasing treatment acceptance. It's about providing efficiency and consistency across all the restorative procedures, and it's about provide superb customer experience for their patients and create stickiness for their clinic. This is what really drives adoption. It's a proven technology and a significant value for our customers. When you look at our install base, our install base is growing rapidly, both in the ortho and the GP.
Obviously, that's an asset we're going to leverage for our services business and for future technology upgrades we're going to bring. When you look at the utilization, it's growing faster. The more of our install base are going to move from scanning every patient every time, we'll see that growing even faster. That's a lot of data we have in our cloud. Today with our machine learnings, we are going to continue and bring innovation to the market. I'd like to focus now on three key growth drivers for our business, our portfolio, our sales coverage, and then our international expansion. You heard from Rapha and Zeljko, we just introduced two new team members to our Element portfolio. We launched that in AAO and got a lot of excitement.
Our customers love the power and speed of iTero Element 2, the enhanced screen, enhanced visualization with a large screen. They love the mobility now that they have battery and they can really move it around in their clinic, and they love the ergonomic and slim design of the product. Then Flex is all about transportability. It's great multiple practices, and they can carry that with them from one practice to the other. It's also great for some customers that can use it as a second unit, so they keep the Element in their primary clinic and carry that to the other clinics. When we look at the future, we're going to continue and enhance our scanners portfolio so we can address the different needs in the different segments and different markets.
With a goal to have a scanner at every chair, we're going to have multiple treatment plans on iTero minutes after the scan. We're going to continue and enhance patient acceptance, choosing patient acceptance. We're going to continue and innovate with visualization diagnostics with tools like TimeLapse, continue to enhance our restorative workflow across the world so our patients can do more with less. When you look at our coverage, we have a direct and indirect channel, then we have iTero set specialists that support both. The majority of our sales is going through our direct channel, where we leverage a significant sales force of Align. All of them are selling iTero to the ortho GP and DSOs, and they really help our customer make the most out of our technology and really grow their practice.
This direct access, together with our unique training offering, services, and customer support, is a unique asset for us, it's a key enabler for our rapid adoption. In order to deepen our access into the GP, we've been working with selective partners around the world, we're going to continue to expand our partnership with labs, with distributors, and other partners to execute on our strategy. When you look at expansion, we've been growing in North America for many years. In the last 3 years, we see rapid growth in North America and still a lot of opportunity, not only with ortho, but even more with DSOs and GPs. At the same time, we've been expanded into EMEA, APAC, and Latin America. EMEA, we tripled the business in the last 2 years.
APAC, we started from almost nothing to be the same size or similar size to EMEA this year. Latin America, we just started in Brazil and see great momentum there. If you look at the 3 strategic countries we penetrated in the last 10 months, what's common to all of them is that we are investing fast, we get immediate results, and we are just scratching the surface in terms of the opportunity we have in front of us. Japan and Brazil, we launched the iTero, we got immediate results, good momentum forward. China, we just started. China is very strategic for us. We're going to localize our capabilities there, including manufacturing, training, customer support, we expect great momentum in China. To summarize, we are in this unique moment where we've proven the value of our products and services.
Rapid adoption is happening, we are just scratching the surface. We are still less than 20% penetrated into the Invisalign customer base. Overall, intraoral scanners is less than 10% penetrated into the GP market. As our in-service grows, we see a lot of opportunity in our services business. I'm super excited about this opportunity and looking forward to continue the journey to scan every patient at every visit everywhere in the world. Thank you. With that, I'm going to invite Joe, Ralph, and Zeljko up to the stage for a Q&A. Is that correct?
Actually, thank you all. We're going to skip this Q&A, do it at lunch, and have a quick break. I know that you guys have been sitting here for a little bit. Maybe get up and stretch your legs, join for a cup of quick coffee, and then we'll get back in about five, 10 minutes.
Ladies and gentlemen, please take your seats. Our program is about to begin. Good morning again, everybody. How many people went and got scanned just now? Awesome. I see a lot of smiles. That's what we're all about here. It's my time to introduce to you our four commercial leaders, and they represent our regions and the direct-to-consumer channel. It's going to be Simon Beard, who is EMEA. Simon told me to say that it's in order of importance, and that's why he's first, but now I don't owe him the money anymore. Then we're going to hear from Julie Tay, who is the executive who runs the Asia Pacific region.
You're then going to hear from Chris Puco, who is our executive who runs the Americas pole to pole. Then you're going to hear from Jennifer Olson, who is the creator and the owner of the Invisalign stores, the Doctor-Directed Consumer Channel, example of which is in the other room. I'm going to turn it over now to Simon.
Thanks, Roger. Good morning. It's a pleasure to be here to talk about the EMEA region. I want to start by really talking about position in the EMEA region. It's pretty diverse, quite complex, but there's enormous opportunity, as referenced earlier in the presentation. Think about the EMEA region, really. If you compare it to the other regions, we don't have colossal economies like China or the U.S., but we do have a large number of medium-term, medium-sized opportunities that we're looking to focus on as a group. There are over four million patients or four million procedures done across the region, and we have less than 10%. In teen, we have less than 2% of the volume share, so we're dramatically under-penetrated there.
What really excites us, what gets us out of bed every morning, is the huge opportunity, the underserved need of the consumers across the EMEA region. Because there's certain laws around advertising to consumers in many markets, our primary focus is partnering with doctors to really untap that opportunity. Just to give you a shape, and really this shape defines our commercial strategy in the EMEA region, is that we have an expansion group of markets. They're essentially the new markets outside of the EU, and we have a separate division that really focuses on those fast-growing, really startup countries for us. We then have quite a large orthodontic business and sales force, and they focus really on driving the under-penetration that we have on the teen side of the market.
More recently, we've been developing the GP side of our business, which we see as the way, the gateway to this vast adult population that exists within the EMEA region. Last year, the team performed pretty well. We grew around 38%. We doubled our install base for iTero. Actually, Spain became our third largest market globally, and that's become a real benchmark for us within the region. We increased our share of worldwide revenue. Just some kind of details around that. That acceleration in growth came from a combination of our expansion markets, our GP business, but also improvements in our teen growth. For the first time last year, we actually grew our teen business quicker than our adult business after we really focused on that more in the second half of the year.
You can see that we've got improvements or impressive improvements in our utilization rate with ortho. Clearly still far behind our North America business, but we're really starting to see some trajectory there. Our GP utilization dropped because we really went a lot wider, and I'll explain more about that later. Last time I presented at the investor meeting a couple of years ago here in New York, we kind of laid out some of the plans, some of the focus for the business moving forward, and we talked about our desire to become a bigger part of the Align family. We also wanted to really rapidly refine and improve our go-to-market model with a specific focus on GP. We saw that as a really important part of our strategy.
The expansion opportunities, a vast number of countries and populations that we were currently underserving. Whilst we haven't got a perfect scorecard over the last two years, I think the team have done a wonderful job. We've definitely accelerated our revenue growth, and we've opened up a number of new markets and brought significant operational infrastructure closer to the customer. One of the biggest changes that I'll talk about is the way that we're structuring our business around the orthodontist and the general dentist. As you know, the world of an orthodontist and a general dentist is very different. Yeah? Whilst they see patients, they have a very different focus, a very different workflow, a very different cadence. We've actually, in several markets now, entirely split our organization.
We have separate leadership teams driving specific clinical marketing, customer care, and sales people so that we can really understand those needs. Those needs are very different. In the EMEA region, the orthodontist depends on referral of patients, and they focus purely on treating malocclusions. Their workload is primarily teen, and they treat complex cases, and really depend on that for their living. Whereas with GPs, we see this as really as the gateway to the consumer. They have hundreds, if not thousands, of patients walking through their doors every single day, and many of them who would benefit from teeth straightening.
The way that we define our proposition to the GP to make it efficient, profitable, and successful, it requires a different approach, that's why we've entirely split that organization so that our teams on the ground think purely about those customer needs on a day-to-day basis. Joe laid out our strategic priorities, what I want to do is really take you through those and see how in the EMEA region, we're actually executing against those priorities. Starting with international expansion. Since we last met, operationally, we opened an order acquisition site in the Netherlands. Last year, we opened our first treatment planning center in Europe, in Germany, to serve the German-speaking markets, the DACH, which is Germany, Austria, Switzerland. Later this year, we'll open a treatment planning center in our largest market in Spain.
Since we acquired Dental Couture last year, who controlled most of the countries outside of Europe, we started to rapidly expand our business. We've moved into direct operations in UAE, Saudi Arabia, which is a critical market for us, and more recently, Turkey. We have plans to expand further into Russia and into Israel. What I would say as well, though, is whilst we're expanding and investing in those markets, we continue to invest in our European business. Like I said, we're less than 10% penetrated, there's just still huge opportunity there. It's not all about expansion. It's also about how we expand our existing business. Just to give you a flavor of that, we actually prioritize 10 markets. We serve 44 countries in EMEA, and we're direct in 27. We prioritize 10 as the biggest opportunities.
In Europe, the top five are Iberia or Spain, where we do a fantastic job year-on-year. We've seen progress in France and U.K. We're actually expecting the U.K. business to boom now that we've got an American member of the royal family who has good teeth and dental hygiene. Our real geographic focus in Europe is around Germany and Italy. These are huge orthodontic markets. Whilst we've improved in the last few years, there's a massive runway for improvement there. Moving to our expansion markets with the top five countries there are the Netherlands, which does a huge volume of orthodontic procedures, where we're very active in Poland. Our CE business has been very successful. We're focused on Turkey, Saudi, and Russia. These markets, we've got huge expectations around how fast they're going to grow. We're driving that growth aggressively.
Just think about these, they're huge populations, and the consumers here have the wealth, they're connected, and they have the same desires as people in Europe and North America. They want a beautiful smile. It's no different. Moving on to the orthodontic channel. We're pretty relentless in how we're driving the orthodontists. They're our most important customer. They're our biggest customer, and they're very important to our business going forward. One of the big changes for us or big opportunities has been the launch of Mandibular Advancement. We now have the largest region for this product, and we're accelerating its usage. One of the most exciting things that we've found is that customers who use MA actually grow their team practice six times quicker. That product has been a really big game changer for us.
We're excited about Invisalign First, that Raph and Zeljko talked about, and we'll launch that in July. We see a big opportunity for that. It's not just about products as well. In each market with different reimbursement programs and different approaches, we've had to define specific go-to-market strategies, whether that's looking at commercial teams, firms, or looking at specific training and mentoring. Many of you will be familiar with TFM. We've kind of created the son of TFM, which is called 360. We have a specific program on how we can support doctors move the bulk of their practice towards teen, and that's a very different proposition to moving adults.
With GP, as I said earlier, we've made some very bold moves in the last 18 months, and we see the huge potential within GP by really defining specific organizations that look after this customer group. GPs, they're sophisticated doctors, they have busy practices, developing Invisalign Go has really helped us approach this customer group in a very different way. We're very focused on segmenting the 600,000 GPs that exist across the EMEA region. With that segmentation, we either can approach customers around the Invisalign Go product, which I'll explain more about in a moment, or they can work with our existing full product. They can start with one and move to the other. I think the critical thing here is that we started off quite conservatively in Germany less than two years ago.
We've continued to develop both the product, the system that supports that product, which is absolutely fundamental, but also our go-to-market strategy. We now have achieved over 11,000 cases. We're starting to see that business really accelerate. Invisalign Go, we're about to bring a new update, as the guys mentioned earlier, which is going to offer multiple treatment plannings, but also a wider choice, an opportunity for GPs. It's all about making the system intuitive, automated, efficient, but also ensuring that the doctors have the freedom to do what they need to do for the patient, whether that's simple teeth straightening or a pre-restorative procedure. A lot of this technology is connected to Elements. Whether it's Element 2, or Flex, this is a key enabler for our GP business.
One of the things we don't often talk about or don't talk about quite as regularly as some of the other regions is our consumer strategy. How do we connect with consumers? The one thing that you'll be aware of is that due to the regulations and legal landscape within many European markets, we're restricted, and it's very different in different countries. In certain countries, we cannot actually advertise to consumers, or doctors aren't allowed to advertise as well. It's quite prohibitive. In other cases, it can be more open than that, and we have to adapt and adjust our strategy to do that. It doesn't stop us necessarily, but we have to do things differently. Some of the things that we're investing in this year. Digital first is a big focus for us.
Last year, we connected with over two and a half million consumers across EMEA. That is accelerating this year. We're seeing our find a provider with Doctor Locator also accelerating. We're also investing heavily in an influencer program. We've just started that in March, where we've got 50 influencers across eight markets, and they've already connected with over 130,000 consumers. There are different ways that we can achieve the same thing, but it is important to our growth going forward. One of the things we actually have just invested in, and it kicked off yesterday in the U.K. We've copied the North American concierge, Smile Concierge model. We've taken exactly what Chris and the team have done. We've planted it in London. We'll find over the next few weeks how successful that's going to be.
The early signs, i.e., one day, look very, very promising. EMEA region, as I indicated at the beginning, has got huge growth potential for Align, both Invisalign and iTero. I think the team are really passionate and excited about that opportunity. Whilst we have to modify our approach across different countries, I think we've got the right focus now geographically, but also from a channel perspective. We're really excited about how we can partner with our doctors to really bring more patients to their practice, but also enable them with the technology we're introducing to treat more patients. Going forward, we'll continue to invest in some of the models around direct-to-consumer, but also in the new products that we're bringing, particularly around teen, the new solutions for GPs, and anything we need within the expansion market. Thank you for your time.
I'm now going to hand over to Julie Tay, who will take you through the APAC region, specifically talking with China. Julie, over to you. Thank you.
Thank you, Simon. Thank you. Good morning, everyone. I'm Julie, and I'm going to take you to Asia Pacific, the fastest-growing region in the Align world. You heard Joe and Raph talking about the 4 million patients that we serve, the 100 million consumers out there. I think we can do more than this in the turn to Asia Pacific. Today, I'm really excited to share with you what we've done over the past couple of years since we last met, and what the next few years is going to look like. 2016, two years ago, we put out some really fairly aggressive goals for ourselves. We say in four years, by 2020, we're going to do this. I stand here, and I'm very proud to say that the team has made tremendous progress on every single one of these.
Actually, we're two years ahead in most cases. China is the number 2 largest market in the Align world. We've made massive investments so that we can really become the indispensable partner to the doctors we serve. I'm going to talk a little bit about this as we move along. If you look at Asia, it's huge geography, extremely diverse. No one single currency, there's no one single market that's even similar. 90% of our business comes from core markets, and there's tremendous opportunity for us to do even more. If you take that one step down. 2017 is a record year for us, 53% growth in volume. We've trained more than 5,000 new Invisalign doctors in excess of that, and continue to drive utilization. If you look at this, I just want to bring your attention to teens, where we continue to grow the adult segment.
Look at the growth in teens, 75% growth in 2017 over 2016, and a lot of that has to do with Mandibular Advancement that we launched last year. With the complexity of cases in Asia Pacific, comprehensive remains the bulk of our business. I'm going to take you further down and really look at by markets. This is our core business, and if you look at that, even Hong Kong, 7 million people, 60%-70% penetration, we continue to grow at 23%. Same story for emerging markets. Look at that. In India, in excess of 150%, we just entered India about slightly less than two years ago. We continue to make progress, but I want to pause here and say, it's all good when you look at 2017. Remember, Asia Pacific is a very young organization. We really just started bringing the whole region together in 2013.
I want to show you, how did we perform over the past four years. In terms of shipment, we double the business in China every single year. Even in a very mature, traditional business that we have in Japan. We're in Japan for the 12 years this year, right? iREX. Look at that, 45% CAGR growth over four years. I don't think there are many medical device companies that deliver this kind of growth consistently across every single market. Tremendous opportunities. The team has done really, really well. Two years ago, I also talked about this program called TFM. You heard Simon talking about it. I want to bring you back to this. We've since branded as iPro. Last year alone, we put 6,000 doctors on this program. This is really for the advantage tier programs, the lower tier programs.
You're talking about bringing 30 doctors, coming together, put a team, work with them for three months, understand their needs, and help them to achieve a higher tier. Amazing growth. 37% of our 2017 growth comes from just this program alone, and we continue to see a sustained momentum from these doctors. What do we do? It's beyond the product. It's actually going out there and really working with the doctors very specifically on what they need. We have training for them, obviously, master class, study clubs. We also train their clinic staff on how do they communicate with patients, take questions, explain to patients their whole Invisalign treatment. We help them to host open days, the concept of bringing the patients into the clinic so that they can see what it is like, ask questions, and it's an education session for those patients.
Now, we heard about the four strategic pillars from Joe, Raph. I'm not going to go through those four pillars, but what I really want to do is to give you a sense of how do we take each of those strategic pillars or strategic directions and execute it in a manner that is relevant to the market. I'm going to give you specific examples. Geographic expansion, I'm going to talk about China. Education, I'm going to give you a feel of what we do for Asia-Pacific. Consumer, where we talk about Australia specifically, it's the closest market to North America. Innovation, I'm going to give you an example using Japan. With all the investments that's going in, we're going to talk about the whole customer experience for the doctors and what are we trying to achieve here. Let's take China, our second-largest market now.
For orthos, we are in tier 1 and tier 2 cities. The whole idea now is really to help them to go after teens with Mandibular Advancement. We're going deep. Non-orthos, we're looking at GP specialties, aggressively go them, giving them the right product that makes sense for the market. iGo 26, we're going to go into tier 3s and beyond, and really becoming relevant to this group of GP specialties. We're going to do that restorative relevance using iTero. That brings me to the iTero launch that we just did in China. Massive. We launched this to 1,200 doctors in Hangzhou, China. What's important is now Align in China is the first and only company that can truly create a full digital workflow for our doctors.
This is going to be massive for us, and you heard Yuval talk about the rapid acceleration of how we're going to localize that. I'm going to show you a couple of the pictures on the iTero in China. This is huge for us. Newly launched, just last month. Geographic expansion, we currently are in almost 100 cities in China, and we continue to push beyond tier 3. We're going to tier 4 and tier 5 cities. Lots to do, lots of potential, and we're very clear how we're going to go about in China. If you take it a step, I think you've heard about this, you know that we have set up the first treatment planning center in Chengdu, the first outside of Costa Rica.
What's really meaningful is doctors in China can now speak the same language at the same time zone, but they can come to the treat center and really have a conversation talking about the protocols that they want, talking about their treatment philosophy, and having the very meaningful engagement. That's what we would say enhancing that entire doctor experience when they use Invisalign. One of the big challenges we have is how do we train thousands of doctors across Asia-Pacific in a manner that's sustainable, that they can continue to go out and do cases. Since we revamped this whole training program, we're really excited about it because it's modular, it's online, it's offline. The doctors can do the training at the pace that they want. What's most important is including this hands-on component into this whole training program. And what do I mean by hands-on?
This is the first training center that we've established in Chengdu. A doctor can come in, get hands-on, learn to do, how do I do an attachment? How would I want to do an IPR? You can do it all at the training center. You can sit with the treat technician, learn how to do ClinCheck in a language that you're familiar with. And of course, we have the iTero. How do you use an iTero? How would you scan? How would you communicate to your patient? We have it all in this training center. Moving on. This is Joe. He was just in Chengdu. Ziyang. Ziyang is about 100 kilometers away from Chengdu. We were there last week and visiting the first manufacturing site outside of Juarez, I believe now, in China.
We're going to manufacture both the clear aligners and iTero, and you see here the very first iTero that's been assembled in the Ziyang facility. We're excited. I'll move on to Japan and talk about the innovation that matters. Very complex cases that they see. We launched Mandibular Advancement. We're going to launch phase I this year. It moves beyond just product. The request has been, look at the packaging. We've looked at the packaging that we have. We've sized it down. We've made things that is relevant to the markets that we participate in. The other feedback is we need to be able to serve each of the different segments, the orthos and the GP orthos. With that, we're going to split the team and create relevant digital workflow for each of those segments. I'm going to move to Australia.
I mentioned it's a market that's closest to North America, a market that we can go full swing in terms of consumer marketing. Last year, we started a technology campaign. Beginning of this year, we work on a campaign with moms. The whole focus is really to drive teens, and we're seeing very encouraging results. I want to spend just a couple of minutes talking about iTero. We're the probably the last region to launch iTero. With China, we're now complete, as in every single major market in Asia has an iTero. You heard about seeing is believing, but it goes more than that. With the Outcome Simulator, the doctors are now able to explain to the patient what the outcome looks like. More importantly, for the patient, it's no longer that gooey stuff that's in your mouth. That whole patient experience is now down to two minutes.
Some of you have tried that. It's a game changer. It's different for us. iTero is available in every single market, and we're ramping up our presence. When you look at the innovation that Zeljko talk about, the infrastructure that we have built over the last few years, the resources that we have moved into Asia Pacific, what does the next three years look like? We feel very good about it. We believe momentum will increase. China will become a very strong number two. We're going to add a third Asian market to top five globally. At least 70% of the submissions are going to come from iTero. Half of the volume will be made in Asia, and we're going to continue, and we're committed to be an indispensable partner to the doctors who use our product. Before I go off-stage, I'm going to share with you a video.
It's an Asian campaign that we've just launched. Gives you a sense of how we are bringing things closer to Asia. You're the first to get a sneak preview of this because we're launching this at the Asia Pacific summit next week. It is the largest summit that we have ever hosted, 1,100 doctors from across Asia Pacific will come. That will be next week. So enjoy the video, and once the video end, you will have Chris coming up to talk about the Americas. Thank you very much.
Hi, good morning. How are you? I'm excited to present to you the Americas strategy, at least update you. I want to also say, seventh presentation here, largest market. I want you all to just look ahead, pay a little attention, because I know that can happen. We do this quite often. Let's start off with the Americas opportunity, the marketplace, right? We've been in business for quite a while. You've heard Joe and Raf talk about the 12 million current patients that are being treated out there in the globe, and we represent about 4 million of those. The vast majority of those are in teen. Now, if you think about our penetration in the Americas, primarily North America, we're at about 30% in adults, single digits in teens, with a blended average of about 15, right?
Then you take that and you put it up against our product and how well it works, and it's 70%. I'd say that's even conservative. If you start to add on the new products that we're introducing, it goes beyond that. You get a real sense of how big the North America or the Americas market really still is. When you widen that and you look at the total available market that we know is at least 100 million patients out there, it's not a big opportunity. It is an enormous opportunity, and I think you would agree with that. From a geographical perspective, our business is still primarily in North America at 98%. 2% is in the expansion territories of Latin America.
We find this extremely exciting because you're taking the most tenured business and you're partnering it with a brand-new, huge opportunity, the synergies that happen there are going to produce amazing results. Our orthodontic partners, they continue to gain share in our marketplace at 60% now. That's while our general dentist partners continue to grow, and they're at 40%. Teen represents 27% now of our patient mix. Last year was a record year for us in so many ways, 25% growth. We retained 63% of the worldwide volume, and I appreciate my peers in Simon and Julie, but we intend on maintaining our share of the world. We look forward to driving that. We trained 6,000+ new Invisalign doctors, and this is a really important stat, and it's a remarkable one.
Our North American orthodontists have a utilization rate of 39 cases. That is the highest in the globe. When you look at the metrics, you see increases across the board, right? Increases in volume, increases in utilization, teenager and adult on the patient basis, both increased. What I would call on the balance side of this equation, mix, comprehensive and non-comprehensive, growth in both areas. It's really good to see growth and balance in this, and that is exciting for us to have performed that way. You've heard this a lot. I won't spend a lot of time on it. Orthodontists are specialists, right? They are extensively trained in treating orthodontic procedures. You know that. It's no surprise their utilization rates are higher. General dentists are skilled at what they do. They primarily will do restorative procedures.
It's no surprise, though, that some do more orthodontics, but most do not. They do some orthodontics. It's no surprise to see the utilization rates there be lower. The point is what you've heard before, it's about a customized approach to these uniquely different doctors and practices. The landscape looks like this. It's 10,000 orthodontists, 150,000 general dentists, and DSOs, the consolidations that are going on within DSOs right now, especially in North America, are happening fast. They represent between 20%-22% of all dentistry being done today, and they continue to expand. Just take a look at the trend here on how the market is trending. You have top elite DSOs. I'd say they're getting past 60 accounts right now, but these are large dental service organizations. They're growing. They're looking at consolidation, but they also have the infrastructure to invest in digital, right?
They invest in specialty. Just inserting a specialty into that practice is not insignificant, they have the ability to do that. They obviously leverage their buying power. I think one of the things that's really important to think about, the industry is thinking about, is that university doctors, there's a demographic shift that's happened, graduates coming out, at least half of them are seeking jobs within dental service organizations. The mid-market is thousands of accounts. These are fast-growing. They're really in a consolidation mode. They're really looking for leverage. There's a lot of acquisition going on. They're really focused on driving top-line for that reason, right? They have less infrastructure, less ability to insert specialty, but they do build their ortho business, in our case, through consolidation. Even down to the solo practice, the single practice, they're under enormous pressure right now.
First, what's sitting above them are the dental service organizations, but also payer pressures. Those are actually on the decline in the market. If you look at the metrics from a channel perspective, again, you see a great story, increases across the board, both in orthodontic and GP. On the utilization side, a really great story, you get to that 38.5 cases per orthodontist, but do not overlook the general dentist. That half a case across a wide body of a number of general dentists has a very good impact, positive impact. If you go down below, you see between the teen and adult, remarkable growth for orthodontists at 40%, yet still drove the adult population, and the same thing in general dentistry. Growth all around.
As I said, on the balance side of this, on mix, the comprehensive and non-comprehensive really grew, in the orthodontic space, especially in the GP space as well, but that was a controlled, planned expansion into the light and lower aligner cases. From a DSO perspective, while DSOs are primarily general dentists, it's great to see that our orthodontic doctor partners grew actually 46% against the general dentist growing 33%. Still, you can see the impact that's had on the business in growing their top line. You're all familiar with how we look at our strategies, and I'm going to start with international expansion as it relates to, and I like it, Roger, our pole-to-pole market. I hadn't thought about that, but that's fantastic. Latin America, a very, very big opportunity. We went direct in Q2 of last year.
We are very excited about what we have been able to accomplish there with 110% growth. Please keep in mind, that's coming from a zero start and getting started. We're very excited about what the team has done down there so far. There is much more to come, though, out of this market, and the ways we're going to do that are first about doctor activation. Training new doctors and getting new doctors on board is critical. We have many training programs going on as we speak, and they are at full capacity. The energy is exciting. The doctors are very excited and fully on board. It's not enough just to bring doctors on. You have to get their utilization up, otherwise, that's the end of the story. We spend a lot of time and effort with clinical training around utilization.
That effort, again, many courses, many doctors in attendance, those two go hand in hand, new doctors increasing utilization. That's a big focus for us getting started. Another key focus for us, you all understand the value of our brand. It's no different in Latin America. We've begun to establish our brand down there. We've had some pretty good results with the investments we've made so far. Things like our Made to Move website, just kicking off here in early 2018, has already received over half a million visits. Our digital campaigns, our online campaigns, have already made over 100 million impressions in that market. Just like training and utilization go together, creating demand and then driving it through to conversion are important.
We've also installed a consumer conversion team down there, that team is primarily just getting started, but they've already processed thousands of leads, they've scheduled hundreds of patients into our orthodontic partners' practices. Very excited about the future there. You've heard a lot about iTero. iTero was launched in Q1 of this year into Brazil, with spectacular success. It was very well received. The orders that we took and the momentum that we gained, almost instantly, was very exciting. We look for great things out of what iTero is going to do in that market and also in that market, we'll update you as we move along. Just going north now, Canada is a little bit of a different expansion story. Canada was a part of our business for 20 years as a North American business.
Really to drive focus, we invested in that business to separate that business and created a team up there that can do that. They're really working hard on personalizing their business to the Canadian market, which is really important. It's not only to the marketplace, but the results that they've driven with that have been 31%, we know that there's a lot more to come. The team's done a fantastic job kicking off so far. The doctor response has been incredibly positive. Both orthodontists and general dentists are being, I would say, serviced in a more customized manner. Our programming has been customized more for that market and how they think, even take all the way just to Montreal about French speaking, right? These are really important things for those doctors to continue to grow.
I think a really good example about how positive it's been with these investments is around Mandibular Advancement and what that team did with teen last year, which was 44% growth. Again, we're just getting started there, but exciting things to come. You saw on Yuval's slide, "Scanners everywhere," and it is the truth. Scanners are critical to that business. We just launched Element 2 and, excuse me, Flex into that market, they were extremely well received. The team is actually very excited about that. More placements, I think you guys know the story now, more utilization, better patient experience, and so on. The last piece I'll tell you about Canada is that we, for the first time in 21 years, invested in a Canadian consumer program, which was really important.
Again, it's a customized approach to that, so far, we've learned a lot, the successes have been great. Just like in every other market, though, you can't drive demand without converting it, we also have a consumer conversion team there. That team is located in Raleigh but is dedicated to Canada, it has already produced some incredible results. Overall, we're very excited about these two early starts, we'll keep you updated as we get together here going forward. I want to turn a bit to our orthodontic partners and how do we drive utilization and partner with these doctors. 75% of the business in an orthodontic practice is teen. It's our largest opportunity.
We have spent a lot of energy over the last year and a half or so partnering with our orthodontists to drive teen, and together, we have really created quite a momentum. I think you can see by the charts what has happened in the market, I do point out Q3 because that's the quarter that most teens will go into treatment, so therefore, the volume is high. The doctors are very excited about that. We've had some great results, and we continue to build on that success. I think just like the balance that I talked about with creating demand and closing, or training and then learning more, the programs I'm showing you here are really more progressive programs so doctors can increase their utilization. These are doctors who are currently doing Invisalign in these examples, but they want to do more.
They want to do more teen. Invisalign Orthodontic Masters Edge program, a series of meetings over a period of time. These are great learning environments that provide support around them for a period of time, the results have been remarkable. Invisalign Pro, or iPro, as you saw, was the original TFM. A great example here of a 90-day program. We surround the doctor with clinical training, sales, customer support for a period of 90 days with a dedicated set of meetings and learnings. Orthodontists who went through this program in Q1 grew 52%. You get a sense of the impact of these programs and why they're so important. That's important to us, I have to say, it's probably even more important to the doctors.
Because they have a patient at the end of all this, they want to make sure that the outcomes are right, and it's a really important part as you really push through and become better partners. I'm sorry, iTero everywhere. Here's another great example of the power of iTero. This is iPro doctors, as they go through the program, these are all orthodontists. Those who have a scanner do four and a half or four to five times more cases than those who do not. That's everywhere. Everywhere there's a scanner, increase in utilization, increase in patient satisfaction, increase in production. It's throughout our business. In orthodontics and in dentistry in general, universities are a very important focus for us, we do a lot with our partner universities, and there are also a lot of them.
This is another really important aspect for both our orthodontic and general dentist doctors. They understand the needs, they have a lot of regard for the universities, and they definitely appreciate the support. Last year alone, we invested almost $15 million in universities, that spend's gone up for 2018. We're very excited about doing that and what it means to the community and to our future overall. When I talk about GP, I want to talk about treat and refer, right? Treating and/or referring to an orthodontic partner. You've heard a lot about that, I just talked about the differences between the general dentist and the orthodontist, and it's pretty straightforward. General dentists, they are busy, right? They're specialists at what they do every day, they need to really Some will do a lot of cases in orthodontics, but most do some cases.
Therefore, we have to really streamline that and help them integrate that into their practice. That's what Invisalign Go does. It is a product designed to address those needs. It has a simulator, it gives you visualization, it guides you along the way. It helps you simplify the choice to treat or refer, but the best part about it is it helps support you with either decision. That integration is important in a general dentist practice, and we're excited about this product as we go forward. If you're talking general dentistry, you have to talk restorative. They go hand-in-hand. Our roots in iTero are actually in a restorative scanner. The production power that that scanner has, especially in a general dentist's hands, are critical. Every 100 procedures that are presented today to a patient, only 20 are accepted.
You can imagine if you can increase that to 25, what a difference that would make to your practice. If you multiply that in a dental service organization, you can imagine what that means to your top line. This is the reason why many DSOs are rapidly acquiring scanners and implementing them. That's not because it's a scanner. It is an end-to-end solution. It's an open network. We have an expansive lab network, which is critical for our general dentists. We have a lot of strategic partnerships with them. As I said, the DSOs are an important part of that. DSOs are a force within our business right now, and they really appreciate our partnership. We do not just sell them a product. We don't just give them a discount.
We partner with them, and we drive top line with them, and we do it in the ways you see here, and they greatly appreciate that. The major DSOs really partner with us, and they really do appreciate the type of services and top-line growth that we can bring to them. Last year, patient demand and conversion was integral to our success, and I really want to start off by talking a little bit about the Made to Move campaign. You've heard about it from others, and for us, the Made to Move campaign spans across from seniors to adults to millennials to teens to Gen Zs. It is a brand that stretches and has longevity, right, across generations. You've heard a lot about the campaign.
I want to focus on one thing that I think you'll really like to see, which is about teenagers and taking the behavior from, "I need orthodontics," or, "I want braces," over to, "I want Invisalign." That's a significant shift from what the business has been. There's no better example of that than our AwesomenessTV series that we did last year. You have to think about it this way. We are now speaking to teens in teen, where teens go to listen. That's a really important concept to understand, and we did it in these ways. We told the stories of talented teens who were Made to Move, and we did it around some very specific topics: filmmaking, sports, music, science, tech, dance. This was original content that was widely viewed and well accepted. 42.5 million minutes were viewed of this original content.
It was a campaign that really helped to drive a lot of teenagers into our orthodontic partners' practices, mostly, and GPs as well, but mostly orthodontic partner practices, and it really helped to make a difference. There's one thing that gets in the way with a teen, and that's the parents, those of you who are parents, especially moms in our business. Moms have questions, and I think you should. Our orthodontists didn't sit idle. They jumped in. They created at least 17 videos really answering moms' biggest question, to really close that gap and help that teen over the hurdle that now is very excited from the campaigns that they just witnessed. We had two and a half million views in the first six months of that launch. It's very, very exciting.
I've talked a lot about creating demand and closing demand into conversion, and I'm going to show you here a little bit about how we go and do that. Of course, the demand generation creates the "I want Invisalign" concept, but then we have to nurture that and get that across to an Invisalign treating doctor. There's no better vehicle that we have than this consumer call center right now, where consumers are on the line, and I tell you, I listen to these calls. There's relationships being developed. It's not just a call and, "Can you help me?" It's a very emotional decision. There's also another byproduct of this. It's a safe zone to go if you're interested in getting treatment. It's a different level of commitment to go into a doctor's office, because now you're in.
With this, they call, we help them walk through, and then we schedule them with our partnership practices. We do a lot of that. A lot of that. Our doctors love this. We do not just sell a product. I know a lot's been made about competition. I have a high regard for competition, and I humbly say, though, we go beyond that. We are a practice growth engine. We have the most innovative products. We have the best training. We have the best programming. We are the only vendor, we just left the AAO, we are the only vendor that drives patients to their practice to help them grow. We are committed to that long-term doctor relationship. Just in summary, I'd say we're very excited about the expansion opportunities that I described. They're critical to our long-term success.
You've heard this all day today, channel segmentation, channel segmentation, channel segmentation. I think that we've done a good job at training dentists specifically to do orthodontics. We are turning to help general dentists do dentistry. There's a big difference. We're customizing that approach, and that's key. Driving more teens and getting more teens to say, "I want Invisalign," we will continue to press on that lever, and our doctors greatly appreciate that. As I said, GP is important, but we have to fit their model. They're busy. They are really talented at what they do. To insert orthodontics in there, it has to be done right, and it has to be done well, and that's what we're doing. Last, I'll say that we are going to continue to press on the brand lever.
We're going to continue to drive patients to these practices and continue to build our partnerships with our doctors. Concierge and even the store, another safe place to go if you're an interested consumer, where you can then be nurtured and then go into a doctor's office for treatment. With that, I'm going to thank you for your time, and I'm going to leave you with this video. I can't overemphasize in the teen market what I mean by we talk to teens, like teens, where teens want to listen. This video, I think, really summarizes all of that. You'll see in this video as you watch it, that it answers specific questions along the way that a teen can help, let's say, talk to mom, or maybe have on their own about their lifestyle. I thank you, and please play the video.
I know I need some straight teeth to be all I want to be. With a face full of braces tied up with my name. How can I rise to my fame? Oh.
Invisalign aligners. Are you ready? Changing the game with a brand new style. I got a sick trick that will fix your smile. With Invisalign, baby, this is certainly a line. Put your gloves on and wave bye to the haters. I'm so hot, so fire, so fine. Look at me now with Invisalign. You're so lit, so bright, so fine. Look at you now with Invisalign.
Don't need no brackets or wires getting in my way. Could clear all the haters if I stay all day. Struggling is real, but it felt more like, because I'm living that Invisalign life. Yeah. I'm living that Invisalign life. I'm living that Invisalign life.
You go to your doctor for a 3D scan. Feeling VIP with a custom treatment plan. They'll fit your teeth with clear aligners. You grow up fast, you've never looked finer. You wear them all day, but nobody can see that your teeth are aligning secretly. You only need a checkup every few weeks. Who cares about your eyebrows when your teeth are all fleek? I wear them at school and I wear them when I play, 20-22 hours a day. With removable aligners, you eat what you want. Caramel apple tops, corn on the cob.
With these new aligners, I live my life easy. On and off with care, never get too breezy.
Now that I'm through with my analysis, let's get to website and get this smile quick. Smile quick, smile quick.
Don't need no brackets or wires getting in my way. Could clear all the haters if I stay all day. Struggling is real, but it felt more like, because I'm living that Invisalign life. Yeah, I'm living that Invisalign life. I'm living that Invisalign life. Oh. Jordan, I'm down, sounds good to me. My mom, she's still climbing on, she'll agree. Still have a lot of questions, can you help me out?
I got the soft spot, she went three, no doubt. Breathe you easy on the very first day.
I got free replacements coming my way.
How can we afford this? That's a lot of cash.
Braces got the payment, no worries, trust.
We request questions from the day to day.
There's a doctor with us every step of the way.
Good morning. I just told Emory that I've always wanted a walk-up song. I just didn't know it was going to be an Invisalign teen rap song. For those of you who I haven't met yet, my name's Jennifer Olson, and I'm excited to be here today to talk to you about our doctor direct-to-consumer channel. By now, you've seen this slide, and you've heard a little bit about the products and the technology, and now from our regional leaders on go-to-market strategies for how we plan to achieve this market. What I get to talk to you about is actually something that we've been doing for 20 years, and that is our commitment on what Joe was talking about on this B2C2B, of building brand awareness, what Chris just talked about, finding consumers and driving them into our doctors' practices.
Today, specifically, I'll talk about the Invisalign store and how that's just one more iteration of this direct-to-consumer marketing that we've been doing for 20 years. Before we get to the store, I thought we'd talk about what's changed a little bit. This is my 16th year at Invisalign, going into, and what has changed have been dynamics outside of Invisalign on consumers. With the on-demand generation, I know we talk a lot about millennials and how they want speed, convenience, and accessibility. There's also been a shift even in the parents of our teenagers going into practices. So now in the U.S., 2018 statistics show that 61% of families have two working parents, and I can raise my hand saying I'm one of them.
The demand that places on families is that consumers will still take the time to take their teenagers in and their kids in to the doctor, but they may not want to invest the time themselves or make the time in their schedules to invest it themselves. As we talk about that $300 million in our direct-to-consumer efforts, what the Invisalign Store is trying to do is to take this to the masses. These themes of speed, convenience, and accessibility have not been lost by others. It seems that every week, a new true, and this is B2C, not B2C2B, a true B2C aligner company is springing on the market every day. Here are just some names of those that have come on the scene in the last two years to try to take advantage of these new consumer dynamics.
Now, of note, the one you probably are most familiar with is SmileDirectClub, of which we are their sole outside supplier of their aligners. It's not Invisalign, as you know. It's an EX30 product, straight line, no attachments. Additionally, we have a 19% equity investment in them. Now, as we talk about the stores and transparency, when we did our Q1 earnings, we talked about how SDC has alleged that our Invisalign Store pilot program constitutes a breach of our non-compete and our agreement with them. We disagree. We will defend ourselves and intend to continue our Invisalign Store pilot.
The Invisalign Pilot Store, as we mentioned, is really bringing consumers to us, helping educate them, providing a brand experience, and then directly connecting them to a doctor's office for a physical exam and then disbursement of aligners on a schedule that the doctor works out with the consumer. Let's talk about retail in general before we talk about the Invisalign Store. I bet you guys all have your computers open. If you type in "Retail is dead," you'll probably get about 100 hits about how brick and mortar is going by the wayside, that's really not the trend. It's really a shift, the shift is going towards experiences. It's less about visual merchandising and product announcements.
It's more about the experience, understanding about the shift in consumer behavior and focusing on that experience to the end result, be it a good or service. We're no different. If you walked outside of our Pilot Store in San Francisco and walked up and down the street, you would see several examples which I've noticed here. You have Casper, a way of just getting a mattress, right? You've got the Warby Parker. You have the Starbucks Reserve, right? It's no longer just about the order ahead. It's about the experience of a premium coffee. You also have things like One Medical, who are embracing this shift in consumer behavior and bringing experiences to life in a brick-and-mortar establishment. That's what we're doing with our Invisalign Stores. The first two stores are in the Bay Area.
Our first one is in San Francisco on Union Street. It's a street-based location, and that was opened around mid-November. Our second pilot location was opened in Valley Fair Mall, which is right near our corporate office in San Jose, and that opened in February. We've announced two additional stores that will open this summer. One is in King of Prussia, Pennsylvania, in the King of Prussia Mall. The second one is in Bethesda, Maryland, in the Montgomery Mall. Let's talk a little bit about the experience. Really, when we set out to design the store, we wanted it to be, no pun intended, but clear, so you could walk by and see that it's Invisalign. We have prominent branded experiences.
We have digital technology that allows consumers to come in and interact with, to see smiles like theirs and to talk about what is the digital scan. We take it for granted that people know what that means, and when you tell them we're going to scan them, you kind of see the fear in their eyes. We talk about how it's just taking thousands of pictures a second. We talk about smiles like yours. For those of you that have been in the booth, you've seen that we show social media posts of other consumers who have gone through treatment and how their experience may have been. We try to answer their top questions about cost, length of treatment, and truly the one that we've heard, at least I have for almost 15 years now, Am I a candidate?
We try to show this to them, and I'll talk about that in a second. We have a pretty great team. Hopefully, you've been able to meet some of them today. We have certified dental assistants to do the actual scanning of the consumers. Again, it's really supposed to be a non-threatening environment. I'm sure this won't come as a surprise, as I said, of taking this to the masses. These consumers were not coming in looking to find a doctor. These consumers thought about Invisalign at some point, really never took action, never really made that appointment, maybe just wanted to know more.
In Valley Fair, I was talking to one of you earlier saying, they were maybe coming in to return a T-shirt, and all of a sudden see Invisalign, and they're diverted, and they find themselves with us, and they weren't intending on doing that. The environment that we try to provide for them as a brand experience is not obligatory. The scan is complimentary. They're not on the hook, we just try to answer their questions and get them some ideas of what their treatment could look like. In that, if they choose to be scanned, then we. Many of you went through this today. It's about a three-minute scan. Our dental assistants are pretty quick with it, they can preview their new smile. Now, this is not Invisalign Outcome Simulator. This is some proprietary software that we use, we show them two outcomes.
It goes back to what Zeljko was talking about earlier. There's a limited treatment. Really, it's like your selfie smile, right? It's the social six. We're not really moving the back teeth. And/or you can visualize in a side-by-side the Deluxe Smile, which is more comprehensive treatment. Should a consumer, after their scan and their visual, choose to move forward, we help them find a doctor. We ask them, "How would you like to work with your doctor? You want somebody near your work, near your home?" Based on a zip code search of our Invisalign networked doctors for their pilot location, we help them find somebody near there that would be convenient for them. Then, of course, cost always comes up. We do have an arrangement with LendingPoint, and through the store, consumers can go onto LendingPoint and get pre-approved for a loan.
We have these two treatment options, let me just walk through the differences of these two. The Signature Smile is, again, that social six selfie smile, okay? It's really the teeth from about canine to canine. It includes up to 14 aligner sets, and we do have a price to the consumer of $2,499, an agreed-upon price with our network doctors on the back end. The Invisalign Deluxe Smile does not have a cost associated with it because we don't know the complexity of the case, and this is really where we rely on our doctor partners to work with the consumers on that fee. The doctor sets their fee to the consumer for the Deluxe Smile. Early learnings. I've been asked a lot today to tell me how's it going.
We're six months in, we thought we'd share with you just a couple of things that we're starting to see in the stores. The primary walk-in traffic, it's female 67% of the time, and the average age is 32. This is pretty consistent with what we see from our other consumer marketing activities, of those that respond, fill out smile assessments, go on the website. Here's, I think, what's interesting, and we're going to talk a little bit about the power of visualization here. I was taking some polls this morning about how often some of you thought people chose Signature over Deluxe, and I heard, "Oh, I bet Signature's 80% of the time." I heard 90, 75. It's actually 51%. Of the cases that we've shipped coming from the store, 71%, and again, this is early.
It's six months in, but these are Deluxe cases. What is this starting to show us? I think it goes back to what Zeljko was talking about. Consumers want options. Invisalign is the only one that gives them the option from whether you want the lifestyle that fits your lifestyle of a lower-end treatment or something that's shorter, or you're going for a graduation, as in the case that Raph showed on Jessica, or if you want full bite correction. When consumers can see the option side by side, most, 51% will take Signature, but 49% of the time, they're saying, "You know what?
I should probably treat the whole thing." When they go into their doctor's offices, the doctor sits down, talks to them about their treatment option, talks to them about why they may have wanted to get into treatment, then helps them get into a treatment. 71% of the time, again, in this early pilot, the percent of cases shipped are Deluxe. I think one of the most encouraging statistics so far is that if they sit down in the chair and get a scan, 80% of the time, they elect to move forward to find a doctor. Our biggest challenge is to get them to sit, and if we can get them to sit and show them, again, this just shows the power of that visualization.
This is their teeth and their mouth moving, and they can see the difference of what their teeth could look like, either in a limited with 14 aligners or full correction. I think probably one of the most beneficial learnings we've had has been partnering with our doctors in this new initiative. For those of you who were at the AAO in May and just a couple of weeks ago, Dr. David Borsk has been one of our pilot doctors for both stores. He was in the booth talking about his experience as a pilot doctor. What he was saying, and one of the things I haven't shared with you yet, is that of the appointments that we have, 70% of those appointments take place when our doctors are usually closed. This is for after-business hours.
Again, this hits right on the themes of convenience, and for us meeting people where they are at shopping, dining, on their way to yoga. They weren't intending to get Invisalign, yet they happened to stop by the store. What David Borsk was talking about is how we're kind of an extension of his practice. We're scanning these consumers. We take their photos. When the 80% of them opt in to find a doctor, we help them find a doctor. By the time David gets into his office the next morning, he has some consumers that are waiting, then we work with our concierge team and his treatment coordinator, Nicole, to get them scheduled as quick as possible because these are consumers, not patients.
These are consumers who weren't thinking about it, who made a decision, and it's up to us to work with our doctors to get them in and to get their questions answered as quickly as possible. I appreciate partners like Dave. We have a number of them in the pilot, but I really love that he said essentially that Invisalign has become an extension of his practice when he's not working. How's the pilot going? It's really a learning curve. Retail is new to Invisalign, it's new to our company. We're building in core capabilities in a number of our functions. We leveraged experts.
When we first decided to go towards this strategy, one of the first things we did is looked at the landscape of retail and said, "Okay, who are companies that are doing it well in a disruptive manner of changing a brand experience to get to a service or product?" Two names kept coming up. It was Tesla and Apple. The common thread in both of those is a man named George Blankenship. I gave George a call, thought we'd have lunch for an hour. 3 hours later, he signed on as a consultant of ours, and has really helped shape this strategy. What he's done for us is not only from the design aspect, but he was able to bring partners to us as well that are experts in this space, in everything from real estate to design to construction, et cetera.
We've been able to leverage his 30 years of expertise in this type of a branded experience in a disruptive manner, and he's been a huge benefit to us. I think one of the biggest learnings also, and what we've been working on in this pilot, is just how important this back-end experience is for our doctors, as it is just as important for the front-end consumer experience in the store. Through this pilot, what we've done is relied on our doctors to provide us feedback on how we can streamline this, how we can transfer consumers faster, how we can help to get them more qualified, and they've given us tons of feedback. In addition, we survey our consumers quite frequently that are leaving the store. We've had third-party research. They help us inform what we should do next, even from a design perspective.
In a true manner, this continues to be a pilot, and we look forward to more learnings. I think the last piece I want to talk about is, this is new to doctors. I think where we could have done a better job is telling them what this is and isn't. When we went out to market with the store, there was a lot of misperceptions that this was really a B2C initiative, and that we were cutting out the doctor, and it couldn't be further from the truth. We have to do a better job of telling that story. I think a lot of people told that story in our absence. This is not SmileDirectClub. Our doctors are firmly in the center of this.
A consumer cannot get started without a physical visit to the doctor's office for an oral health check, as well as fitting them the aligners. That relationship is crucial to this. It is not a B2C. We need to do a better job of helping them understand that. That's a lot of the reason why we put the pop-up booth at the AAO, which is to invite our doctors to come in, do a little bit of myth-busting, answer their questions and any of their concerns. I promise you we'll do a better job and have a commitment to doing that as we move forward. Next steps, we talked about the two stores. They'll open up this summer.
We're going to continue to connect these interested consumers, essentially bring Invisalign to the masses, catch consumers where they're eating, shopping, dining, yoga-ing, maybe if they're at an analyst day and have a little extra time on their hands during breaks, and get them into treatment. With that, I would encourage you, if you have time. I want to say, I was really surprised. I had so many good sports in this room to sit down, go through the whole process. Our store team is here to answer your questions. I'm ever a salesperson at heart. Look, if you want to go forward with treatment, we have doctors here in New York that'll be part of the store pilot. They'll be happy to get you some aligners. Okay? With that, I just want to thank you for your time.
Thank you for taking the interest in visiting the store. That will conclude this part of the morning. We're going to dismiss to lunch, and then we'll be back in the afternoon for more. Thank you guys very much.
Ladies and gentlemen, please take your seats. Our program will begin in just a few minutes. Thank you. Ladies and gentlemen, please take your seats. Our program will begin now.
Good afternoon, everybody. Hope you enjoyed lunch as much as I did. The challenge with meetings like this when you work for a dental company is that you don't get to brush your teeth after you eat, and I'm feeling really guilty about that. We're heading into the final stretch here, and you're going to have two presenters this afternoon. The first one is Emory Wright, who's been with the company over 18 years, and has been on this wild ride from the beginning, really. He's going to talk to you about operations globally. You're going to hear from John Morici, Johnny Dollar, who's going to come up here and bat clean up and tell the financial story. What we're going to do is have the entire executive team come up on this little stage for Q&A.
I hope you're looking forward to all of that, and I will turn it over now to Emory Wright. Thank you.
Good afternoon. It's always a pleasure to go right after lunch. I got to see if I can talk somebody about getting moved up in the agenda. You've heard this morning, really, the whole gamut of Align's capabilities from the enormous market opportunity we have, as well as the scanner technology, and all the way through to the power of the stores that Jen just finished up a bit ago. What I want to talk to you a little bit about is really how our innovation and manufacturing technology, our know-how and the scale that we've developed over the past 21 years has really created a competitive advantage for Align now and into the future.
Before I do that, I wanted to remind those of you who've been close to us over the years and maybe point out to the people who are maybe a little newer, how hard it is to do what we do. It seems super simple. You look at the aligner. It's a small piece of plastic, doesn't seem like there's much to it. There's an incredible amount of complexity that goes into making that product cost effectively hundreds of thousands of parts. The complexity kind of is twofold, one on the manufacturing side and then one on the, call it, the business model side. On the manufacturing side, we make 350,000-plus parts every day in our factory. Every one of them is different. No two of them are the same. They're very small. They weigh less than an ounce. They're virtually invisible.
They all look the same, but they're not the same. They're organic shapes. If you think about manufacturing technology and how do you process these parts, how do you track the parts in the process, how do you ensure kind of consistent quality, because you can't plug it in and test it, you can't measure it because every single one of them is different. There's a lot of complexities there that nobody has really had to solve until we came along. That's one. The second one is on the business model. Think about our model is, it's on-demand. It's on-demand for a customer base that has kind of a normal weekly business cycle, if you will, if you take the whole globe together. Then they also have a very kind of predetermined lead time that they expect from us.
To be able to manage capacity in that environment without getting too ahead of yourself and without getting behind creates a challenge. Certainly created a challenge in the early days. We've been able to solve all these problems, and along the way, found new opportunities for us to do really out of necessity. You can't go and buy equipment off a shelf that can produce aligners. You can't go to somebody in the industry and say, "Tell me how to do this." We had to invent it all ourselves. Over the years, as we've invented and learned, we've built up quite a bit of capacity and really solved problems that the industry experts couldn't solve, or really, that they didn't even know there was a problem.
Because of our 21 years of know-how and capability, we're able to develop and produce the highest quality aligners on the market. Our capability, we're able to reproduce patient anatomy and reproduce, we make aligners within 100 microns, which to put that in perspective, is about the width of a human hair. We're kind of that good. Because of those capabilities, we're able to make the most comfortable aligners. We're able to make the best fitting aligners, which then drives our ability to drive shorter treatment times. That's certainly one of the advantages we have. When you think about technology that goes into the manufacturing process, really one of the foundational technology that made this all possible was 3D printing. 3D printing is a pretty exciting industry. It's talked a lot about.
Really, we're pioneers in that industry, in that we took what largely is still today a prototyping technology, which people will run their machine two or three times a day. They might make a couple parts at a time. We've taken it from prototyping to mass customized production, and no one else has done that. We run our equipment 24 hours a day, seven days a week, 365 days a year at high uptime. Even the suppliers of the hardware that we buy, they don't really even understand how we do that. They never dreamt that was possible.
I still remember when I started back in 2000, we were having conversations along the way with some of these providers, and we were giving our cost targets and our build time targets and things of that nature, and the inventors of 3D printing told us it was not possible. Through our experience and really kind of a little bit of a "We're not going to be told we can't do something," we went and figured it out. Today, we're the largest user of 3D printing in the world. We're not just the largest, we're also the most effective. We have build times that are about 10 times-20 times faster than others in the space. We use 40 times-50 times less material than others in the space. We have a cost that's about 10 times lower than anyone else in the space.
We really leverage that cost advantage to help drive more investment in innovation in the business, whether it's in manufacturing innovation, whether it's on the product side with Zeljko's team, et cetera. Really, again, driving advantage for us. Because of our kind of mastery of 3D printing, foundational technology, we've been able to really evolve that technology and create the biggest mass customized manufacturing process on the planet. We continue to innovate beyond where others are in the industry. One of those kind of future innovations is direct printing of aligners. I think most people know, but you might not know, we print a mold, and then we form a piece of plastic over the mold. That's kind of the current technology, if you will.
Taking that mold part out, that half of the process out, just direct printing aligners is kind of a logical, natural next step, but something that's not possible today. There's a lot of information out there. You might talk to some of the providers of the technology. You might talk to labs or customers that will say, "I'm printing aligners in my office or in my lab." It is really not true. They're printing molds and forming aligners over those molds. The reason why is there's the kind of three fundamental problems, or call them hurdles, that you have to get over in order to direct print an aligner. One is you need a material that has the right mechanical properties to be able to move teeth effectively.
You need a material that is clear, then you need a material that is biocompatible, meaning you can put it in the mouth. There's materials out there that have one of those three components, but no material that has all three of those components. Once you kind of get past that obstacle and the unique material properties you require to move teeth directly with a printed product, you need to find a manufacturing kind of a piece of hardware, a printer, that can actually print that material. Based on our experience, we believe that the material properties are going to be such that the current commercially available printers won't be able to handle that material. You're going to need to have a new platform that's developed on the market.
The third, I think, which is less discussed, it's something that I personally think it's kind of the additive manufacturing dirty little secret, is post-processing. There's a significant amount of post-processing that happens after you print a part. You need to finish that part, essentially polish it, surface finish most parts. We have a fairly automated post-processing system right now, but the other technologies out there don't. They're very manual. They're very labor-intensive, you'll have to solve that problem, too. We continue to invest heavily in this area. We're very close to the experts in the industry as well as experts in material science in the academic arena. Based on our competency in this space, we believe we're best positioned to kind of crack the code on direct printing of aligners. A lot more to come on that in the future.
We've had a 21-year first-mover advantage. We've been in it for the long haul. We are in it for the long haul. We consider this kind of a marathon, not a sprint. Competition, others are going to come in, and they're going to use 3D printing, and they're going to use CAD/CAM technologies to kind of start playing the game, the game of making aligners. There's a pretty significant difference between kind of playing in the game and mastering the game, and we're certainly the masters of this game. For those of you in the audience that run, I like to use an analogy of running a marathon. There's a difference between qualifying for the Boston Marathon and winning the Boston Marathon. That's kind of how, for me, I keep it in my head. 3D printing and CAD/CAM technology is really only part of the equation.
Zeljko talked a little bit about this. You have to really know how to move teeth with plastic in order to really be able to treat the wide range of cases out there. Based on our database of over five and a half million patients and all of our experience, through Zeljko's team and our technologists, we've been able to figure out what's the right material, what's the right physical features that we build into the aligners in the manufacturing process, such that we can move teeth effectively with plastic.
Really, the combination of 3D printing, CAD/CAM technology, the manufacturing automation that we have that you've seen in the video, and some of you have actually been in the factory and seen, and really understanding how to move teeth all integrated into this end-to-end digital ecosystem we talk about, is really what creates a significant competitive mode around our business. The end-to-end system is impressive. It's something that we spent a lot of time today talking about, and it's something that's kind of tangible. You can see it. Really, something that's equally impressive is what I call the central nervous system behind that or the back end. It's the amount of data processing that we need to go through in order to make every single aligner, make every single treatment plan.
Zeljko talked about some of this thing, 2 million computations per aligner, 10 million measurements per treatment plan. We have to integrate local and enterprise systems and databases. All of this data has to be accessed real time. The system kind of learns from itself. No one has a system like that in industry. It's something that, again, we had to create internally, and we know that our competitors would love to get it. We hear from our suppliers all the time. People really want to learn how to do what you guys do with the management of your data and the integration of that through your entire value chain. In order for us to build a system like that, this end-to-end ecosystem, it's really required the accumulation of skill sets in a wide variety of disciplines.
From machine learning, which is a big one, 3D software development, you got IT, you get CAD designers, more standard manufacturing engineering. You've got a clinical, we have a huge clinical component to our business. I never really realized how unique it was, being on the inside, sometimes you take some of these things for granted, how unique it is to have deep experience in all those diverse skill sets under one roof, working together to drive a business forward. I had the opportunity to sit in at a Stanford Business School session where they used Align as a case study, the topic was really around adaptive business models in the age of digital industrial transformation.
One of the things that they talked about, or they identified, we certainly didn't tee them off, was how hard it is and how unique it is to have all these skill sets together and be able to leverage that. Most businesses have one or two, maybe adjacent skill sets, but that's about it. That's their core competency. Over the years, we've amassed tens of thousands of years of experience in all these diverse disciplines that have gone in to creating this know-how that's helped develop our technology, certainly on the manufacturing side, absolutely, and our capabilities, and really helped us solve some problems that the industry's experts, they couldn't solve. I want to give you just one small example of that, of one of those kind of problems, it's around OCR, which stands for Optical Character Recognition.
In order to track the hundreds of thousands of parts we have in our factory every day, we mark a unique identifier on each part. All these parts look the same. They're all clear, they're all small. Imagine trying to figure out which part is which if you don't mark it with a number. Essentially, it's in a human-readable format such that employees can read these things, patients can read them, doctors can read them, and they know which aligner goes in what sequence. But if we relied on humans to read these things in the factory hundreds of thousands of times a day to keep track of them and sequence them and move them through the process, there'd be huge opportunity for error. That would be kind of a non-starter.
We went to the experts in industry on Optical Character Recognition and asked them to help us develop a vision system that could read these parts, read this human-readable number automatically. Now, human-readable is more complicated for a system to read. If you had a 2D barcode or a barcode, those are pretty simple. This was a hard problem to solve just out of the gate. But given that the aligner is clear, and that we print on a very uneven surface, we print on one of the molars, which is like printing on a mountain almost. It's very hard for a vision system to read that. They came in and helped us out, based on where they could take it, they were able to get us to about a 60% success rate, but that's as far as it went.
They essentially said, "Uncle, we can't go any further. This is as good as we can do." We turned to our machine learning team within the business, and they mulled around the problem for a while and really thought about, we have this huge database of cases that we've made and millions of aligners we've made for these cases. We have a picture of every single aligner that we make that shows the laser marking. Why don't we use that to teach this vision system how to read those parts? They took hundreds of thousands of samples through hundreds of iterations, essentially, I don't know what you call them, class sessions, to teach this vision system how to actually read that part and read it accurately.
They were able to take our read rate from 60% to 98%, which is pretty phenomenal given our application. It's not 100%, so they also had to teach it how to identify when it can't read something, right? It has to pick out the bad parts. It also has to be able to be very robust, that when it reads a part, it has to be the right number. It can't mistake a five for a six. It can't mistake a three for a nine. It has to be accurate. They were able to do that using machine learning in our database of cases, which is great. Just an example of a problem that the experts in the industry couldn't solve, and that based on our database and experience and our skill sets, we were able to actually move past the industry.
In addition to that, some of the technical skill sets we have, engineering, machine learning, software development, there's a fairly extensive amount of clinical experience and treatment planning experience that goes into our product. This is what we do in Costa Rica, what we've done there for years. Early on, I learned how complicated orthodontics is. It's kind of a complex marriage between art and science. The joke that orthodontists will tell you, or at least they told me, is you have five orthodontists in a room, and they're all evaluating one treatment, you'll get 10 opinions. It's because every orthodontist or every doctor has a different philosophy on how to treat. Every patient has a different chief concern. They're interested in something different.
There's different norms that they essentially studied or they believe in, and they have their own preferences, their own little preferences that are important. To manage all that complexity, doing millions of cases a year, really requires you to put that kind of orthodontic smarts into the software. That's what we've started to do over the past few years, is really to integrate that into the software, use our 100 million of treatment plans that we've done over the years, the thousands of treatment planning years of experience we've had to get that into the software to a point that kind of becomes the engine that Joe could talk about, that drives our ability to do these multiple treatment plans, good, better, best. It's really kind of taken this to the next level.
Talk about, to bring mass customized manufacturing of hundreds of thousands of aligners every day to hundreds of thousands of doctors around the globe, requires this fully integrated end-to-end digital manufacturing system and ecosystem, and a ton of automation that we have in our factory. For those that have had the opportunity to see what we do in the factory, and we talk about this, there's still a high degree of labor in the process, right? It's not labor free. Although, as I mentioned earlier, and Joe mentioned it, our digital workflow, the data flow through our process is all manual. We don't have to manual process data. Actually physically making the aligners, there's a lot of manual work that goes on there. To put that in perspective, we have competitors that are in the market. They're making aligners, doing treatment plans.
We saw some new entrants in AAO. We believe they are coming in the market 10+ years ago from a technology perspective, so they're very far behind. If they had to try to make aligners at the scale in which we make them, they would need three to four times the number of people that we have in our process. That just kind of puts into perspective where we are from a scale. The last piece of scale I want to touch on here is really around the footprint. Selling to hundreds of thousands of doctors across the globe requires you to have a footprint in the region, in the country.
The commercial leaders, Raf, Julie, and Chris all talked about, or not Raf, I'm sorry, Simon, Julie, and Chris all talked about the commercial footprint we have in all of our main markets and our expansion markets. We've talked a bit in the past about the operational footprint we're putting in the markets. We've started treatment planning in Chengdu, China. We're working on fabrication in China, as has been mentioned before, the second half of this year. We've got order acquisition in Amsterdam that Simon talked about. Treatment planning in Cologne, treatment planning in Spain in the second half of the year. Significant presence on the border between the U.S. and Mexico, our Costa Rica operation. We kind of cover the regions well.
As an example of how that helps us relative to some of the other smaller players is, one example is, if you think about the complexity of selling to 100 countries around the globe, every country has their own regulatory requirements, their own customs regulations, and they change frequently, especially for a product like ours. It's a custom Class 2 medical device. Many countries don't have a categorization for that. They don't know how to treat it, one day they treat it this way, another day they treat it another way. Without that presence on the ground, that knowledge on the ground, your supply chain gets substantially disrupted for 90 days, 180 days, and that's a great way to completely throw off your growth in a region.
We're set up from a commercial footprint and operational footprint to kind of best support our customers globally. To summarize, from the beginning, we've pushed our technology and the industry essentially beyond what many thought possible. We continue to do that. Through our state-of-the-art manufacturing technology and integration of all that technology in this digital ecosystem, the know-how we've accumulated over the years, the scale at which we operate, and we're capable of delivering hundreds of millions of aligners to hundreds of thousands of customers across the globe. We'll continue to invest in our technology such that it'll continue to elevate our product quality. It'll continue to drive efficiency in our process and shorten delivery times. The capabilities and focus and investment here, we believe we're best positioned to essentially take this technology to the 300 million consumers around the globe.
Before I hand it over to John, our CFO, I want to tell a short story that I just heard this morning. One of our colleagues, David Lopes, who works with us, he was at a conference, I think it was a conference, and he met a guy from Lawrence Livermore Lab, which is one of the top research institutes probably in the nation. They were talking, and he found out that David worked for Align, and the guy went crazy and was trying to negotiate a factory tour, and he really wanted to learn about our technology and how we make product. It kind of struck me odd, and I don't know why.
Again, it's probably I've been here for so long, I take some of these things for granted, but that someone from one of the best research institutes and some of the smartest people on the planet wants to get inside Align to kind of learn how we use technology and how we manufacture things. I just thought that was kind of an interesting story. That's it for me. Thanks a lot for your time. I appreciate it. Here's John to show you the financials.
Thank you, Emory. John Morici. I am thrilled to be here, and I get to take you through some of the finances. Really, we've seen nine presentations, during my presentations, I'm going to try to stitch all this together and give you a view of what this all means financially. Starting with more of a historical view, we'll talk a little bit about the investment allocation that we use, long-term business model. Some of that was updated, as you probably saw this morning, then a quick summary, then we'll get into Q&A after that.
When you look at our financial results and having been at the company just under a couple of years, you kind of have to take a step back and say, "Wow, this is an amazing company growth for what we see now, a 21-year-old company." To see that in a couple of years, revenue growth of 1.7x, growing 32% a year, tremendous growth. I'll get into some of the specifics. Earnings per share showing here on a reported basis 1.6 times over this time. It's really 2x when you factor in some of the tax changes. Revenue growth translating to EPS, and it's translating in a way that with some of the profitability that we have on an op margin basis, we're seeing that leverage come through. We're using cash. Some of our cash, I'll talk a little bit about where we're using it and why.
From a free cash flow standpoint, we're investing back in the business. Some of the things that you saw with Emory in terms of some of the investments that we're making from a manufacturing standpoint, treatment planning, so on, and we'll talk a little bit more about that. You can see the tremendous growth that we've seen in market cap. It's a reflection of the growth that we talked about that we've seen all day in terms of the revenue growth. Growing in a profitable way, being able to drive that to an accretive basis. The future growth that we're talking about, what we're expecting to do in the future, really driving that market cap improvement.
When you think about the revenue by segment, just starting from a top-line basis, we're growing, at least over this time period from 2015 to 2017, 32% on a CAGR basis across the company. We're seeing great growth from a clear aligner standpoint, up 28% on a year-over-year basis. Really, what you saw throughout these presentations is just that digital workflow, iTero being a key part of our overall business, growing on a 90% basis year-over-year, going from 5% of our business from a revenue standpoint to 11% in 2017. That is really an engine that we have from a growth standpoint, being able to have that digital workflow.
We know that once we have not only get great revenue from our scanner business, but we know once that scanner is installed, we saw a lot of different ways that we could see additional aligner growth, it really drives that aligner growth. Very positive to see this type of growth. When you look at it on a more regional basis, really what I wanted to highlight on this is you've seen kind of at the outset, two years ago, 70% of our business was domestic, 30% international. Now it's shifted to 60/40. Really what you're seeing, I think it was very evident when you saw some of the regions like EMEA and APAC, just the growth that we're seeing in those areas. China is a great example, 100% growth on a year-over-year basis.
If I had to step back to think about just two years ago, China wasn't in our top five, and now it's our number 2 largest market and growing at this very large rate. It's growing in a way that when we get into the gross margins, we're growing in areas that are more complicated cases. That helps us from a mix standpoint. They're higher ASPs. Unlike some of the traditional med tech and so on, we're outside the U.S., maybe you don't have as profitable a business. This is the opposite way. We see good growth internationally, helps us from a mix standpoint, and helps us from a margin standpoint. When you look at gross margin, and you can see where we're getting the benefits, essentially over these three years or so, flat from a margin standpoint, but there's dynamics that are underneath it.
We see, as we talked about, the international mix that helps us from a margin rate standpoint, higher list prices, higher mix, very complicated cases. We're getting that scale and leverage in certain places. You could see that, as we have more and more product going through, Emory talked about 350,000 units being produced in a day. You start to get some of those leverages from a manufacturing standpoint. Going the opposite way, but being able to balance, we have scanner mix as we have more and more scanner, because this is an overall gross margin look. Scanner gross margin is lower. It's closer to 60%, so that hurts us from an overall gross margin standpoint. Product complexity, we're taking on those more and more complicated cases.
There's additional aligners, there's refinements, there's other parts of the product that we have to support, and there's some cost to that. We also are expanding, and you saw a large part of that from Joe's presentation all the way to most recent with Emory. We're expanding our footprint. We're in different regions, different locations. Soon to have manufacturing in China, treatment planning in other places. There's some costs offset to that. Through all that, we know how to grow in a way that is maintaining profitability. In gross margins, given the expansion that we had and increasing our footprint, we're happy to keep this within the range that we've seen.
When we look at the investment allocation that we've done over the last three years, I'll kind of summarize it this way, and I'll get into the various pieces here between the R&D and the go-to-market, kind of the OpEx side, and then the CapEx and share repurchase. Our number 1 priority, and it continues to be our priority, is to invest in our business. That is where we see the biggest growth opportunity. About two-thirds of the investment that we have will go on a P&L basis, and I'll get into the R&D and the OpEx, a large part of what you saw today in terms of some of the investments we're making.
About a third of that investment that we have will go to supporting the operations in CapEx spending and then excess cash going to the share repurchase that we announced today, additional share repurchase, but with the mindset that that excess cash goes to our shareholders. When we look at R&D, Zeljko's presentation, you can see the innovations that we have to increase the applicability and the opportunity for two sides of it. One is the appliance, the innovation in the appliance to make that clear aligner more capable to treat these more complicated cases. Things that you're seeing with Mandibular Advancement, showed the palate expansion. Products that are going to increase the ability for us to take on these more and more complicated cases. Treatment planning is another key piece of it.
We want to make something that provides those doctors the tools to be able to treat, whether it's a complicated case or a simple case, and to be able to have that flexibility and that ease to be able to really integrate that treatment planning into their overall practice, and that's a real goal for us. The end result of what we want is better clinical results and increasing that doctor confidence, and that's something that all these investments are going to. We've been historically in the 6.5%-7% of revenue. We don't target that specifically and say, "This is the % that we have." We're looking at the investment opportunities, looking at what is going to drive additional profitability, what's going to drive additional growth to our company, and investing in products and technology that get us to that.
When we think about the go-to-market investments and really seeing from the regions and some of the presentation from Raph and so on, we're trying to get, in this case, the spend that we have. In some cases, we're just trying to get coverage. We want to be able to have that coverage in certain countries where we might have had a distributor, and now we're going direct. We might have been in a tier 2 city, and now we're going to a tier 3 city. Some of it's just going broad and trying to get into the marketplace. In other cases, where we've been here for a while, in the U.S. or Western Europe, it's training those doctors, teaching those doctors how to do maybe more complicated cases, trying Mandibular Advancement so that we can get at more and more of those teen cases.
Doing things from a sales standpoint to get coverage and go deep where needed. We're continuing to invest like we have, like you've seen in several of the presentations around the marketing. Making sure people understand what is real and what is not about our product, making sure that teenagers who are a really great growth opportunity for us from a segment standpoint, understand what our products can do, dispelling some of the myths that might be out there, whether they're from a doctor or from a parent, and being able to try to grow. In teenage, for example, just the return on investment, we know that 75% of the cases are teen, and it's up to us to be able to reach those teenagers and be able to make sure that they ask for our product by name in many cases.
This is one where it's investing in our sales team, going as broad and as deep as needed, and being able to, in regions that make sense, have the marketing that works. Some cases, we can't advertise as much in a certain region. We'll find other ways to be able to make things work. In other cases, like in the U.S., we can advertise and continue as we have. When you look at our operating margin and take all those pieces together, if we looked at where we were in 2015-2017, added 170 basis points or so from a margin standpoint. We've been able to grow. You saw our gross margin essentially flat. We've been able to grow and grow in a profitable way. We're getting some leverage in terms of some of the R&D and the G&A, which is good where it makes sense.
We are continuing to invest, we have over this period, from a sales and marketing standpoint, going into regions where we haven't been before, going into regions where we had a distributor, and now we're going direct. There's a certain amount of cost that goes into that, we feel that that leverage that you get from going direct and being in those marketplaces pays off. When you think it all the way down the line and take it to earnings per share, we're getting a revenue growth that's translating back. We're getting high-quality earnings per share growth. Almost all of our EPS growth is related to business improvements. Like I said, if you took out some of that, the tax impact on a more normalized basis, we're seeing the 2x improvement from 2015-2017 on an EPS basis.
That revenue growth is translating to EPS. That profitability that we saw on a previous page is translating to earnings growth. That's something that makes the company very healthy. When we think about the other pieces of our investment allocation, $320 million of CapEx, it's to support our global expansion. In many cases, factory-driven, where we had to add capacity. You saw with Emory's slides and some of the volumes that we see in the various regions, we're adding capacity to support that volume increase, and that's a piece of it. We're doing it in a way that's going to be the most productive and the most efficient way as we start to expand out. In this case, in the future, where we're outside of Mexico, we'll be in China.
The treatment planning outside of Costa Rica to the regions, we think that gives us a tremendous volume opportunity, a tremendous sales opportunity to be in the regions. That's supported with the various CapEx that we have. Think about it from a long-term average of 4%-5% or so of revenue. Once you get past that initial factory that you put in or some of that initial CapEx on a more normal basis, you're adding different capacity to support your growth. Then share repurchase. Over the last 3 years or so, we bought back 3.4 million shares. We have 100 million left under the 2016 repurchase. That'll get used the remaining part of this year. Then we announced today the $600 million authorization. It's really over a 3-year period. Think about that starting in 2019.
It's investing in our business, taking the additional cash that we have, and being able to try to put it back to our shareholders. When you look at our cash flow and our cash balances that we have, you can see the CFOA coming from the business ramping up dramatically in 2017. You can see we're spending from a CapEx standpoint, and that's some of the new facilities and other investments that we've made. From a free cash flow standpoint, being able to support that from our overall business. You can also see too, from a cash balance standpoint, despite the investments, despite the growth that we've had, being able to increase from a cash standpoint.
This will give us some flexibility now that the tax changes have happened, where this is a year-end number, but for 2017, we can look at repatriating and doing some things to give us some flexibility in terms of what we're going to use for the U.S. It's great coming from my standpoint to be at a company where not having debt, not being levered in a way that we've got to support that debt. We can really focus on investing back in the business, and that's very positive for us. When you look at it and you look at the pieces that are delivering shareholder value, we're looking at growing top line. Growing top line is investing in our brand. You saw a lot of that with Raphael and the marketing that's going on. Expanding our go-to-market activities.
You saw it with the various region leaders in terms of how we're going to market every market. I hope you got a sense for even the countries within, there's different strategies and different ways that you go about it. One size doesn't fit all. The investments we make in the various countries, some are at their early stages. We're going to invest more to get that infrastructure in. Whereas others, you don't have to invest as much, and you can make those trade-offs. It really goes country by country, region by region, as part of our overall global expansion. We're going to continue to invest in innovation. This is the lifeblood of our company around product, clinical efficacy, using this to expand the TAM. We talked about the 12 million orthodontic case starts and how we want to be a part of that.
Investing in iTero, you saw from Yuval and really throughout the presentations on the digital workflow, how that's so important upfront to have that a part of our process and the uplift that that drives, not only with the volume that we see in iTero, but the utilization that comes from the clear aligners afterwards. Then new technologies. There's Palatal expansion. There's new technologies, 3D printing, other technologies that we want to be a part of. We want to be a leader in this space. There's a certain amount of research that goes into this to be able to support this innovation. Which I hope you also get a sense for, is the consistent earnings that we're trying to drive. We're diversifying within our space, being much more global, 60/40.
Growing in places like China and others that have tremendous growth opportunities, doing it in a way where we can support and balance the growth opportunities that we have with the profitability. We want to grow, but we want to grow in a profitable way and something that adds to our bottom line. Finishing with the capital allocation, we want to continue to invest, and we are going to continue to invest to fund growth. We're going to invest in new business models that make sense, that give a return for that investment, similar to what we saw with the stores. New ideas, ultimately, to try to turn those consumers into patients via a doctor. Those are investments that we want to continue to make. Excess cash that we have through stock buybacks to be able to return that back to our shareholders.
With that, the highlight of this page, and really just trying to give you a view of our three to five-year financial model targets. The highlight for this presentation that you saw from earlier releases is really the top line. When we think about our revenue year-over-year growth, the previous long-term growth model was 15%-25%. We've upped it to 20%-30%. What that is a reflection of the fact that we feel that the market that is available, and when we look at the capability of our product, at 70-plus%, and yet we're 10% market share. We look at that as a tremendous growth opportunity where it's up to us to be able to execute and be able to grow into that market and gain market share.
We talked a lot about that $300 million or so consumers that are out there, being able to access them, being able to get them into our product line, and be able to get them to be aware of our product and turn that awareness and those potential consumers into patients through a doctor. We feel that this is up to us to execute for all the different things that you saw earlier today to be able to get this to that 20%-30%. No change to gross margin, OpEx, Op margin, and free cash flow. We think that we can operate within these parameters as we go forward in the next three to five years. Talked a little bit about the $600 million. That's just the authorization.
Like I said, we've done some of that $300 million back from 2016, $100 million more to go this year. Then the new authorization, the $600 million, starts in 2019. In summary, when we look at what we're trying to drive, we are accelerating our long-term business model. That's the 20%-30% that we're talking about. We feel that based on the dramatic market opportunity that still exists, our capability in that marketplace, and the execution that we know we can drive, we can accelerate our long-term business model and continue to grow in that 20%-30%. It's about having balanced investments to drive the top-line growth while maintaining the profitability. We want to grow. We want to grow in a profitable basis. We want to be able to always be flat to slightly up from a margin standpoint. That's the philosophy that we have.
That's the approach we take when we're investing back in the business, and ultimately, that should be able to return back to shareholders. Excess cash profitability that we have that as we're not investing in the business, whether it's on an OpEx or a CapEx basis, taking that cash and investing it and giving it back to our shareholders. We're committed for that. Through all this, we feel we're well-positioned to deliver for you, the shareholders, to continue the value creation that we started. With that, I guess it's what Joe started with, and I guess I'll end with is, our unique opportunity is enormous. We have a huge opportunity as a business to continue to grow in the space we've had. We've seen tremendous growth over the last couple of years. It's a 21-year-old company that's gone through its history.
We look at our opportunity and think that it's bigger than it ever has been, and we're excited to be a part of it. Thank you for attending this. From that, I think we're going to go to Q&A. Thank you.
Simon, last call, Mr. Chairman. A reminder
All right. Yeah. Get started, John. Jon Krieger.
Okay.
Oh, okay.
Hey, Steve.
Hey, Joe. How you doing? Steve Beuchel, Morgan Stanley. Just a couple of little curiosities I have. One, John, I wonder if you could spend a minute or two on where you might see opportunities to optimize the tax rate, given some of the changes we've seen in the last couple of years. Joe, one technical point, one technology point that I'm always curious about your thoughts on is treatment accelerators. It seems like this year we might get some clinical data that could validate some of the acceleration technology out there. Are we any closer to the point where we could think about taking the cases even faster with an adjunctive technology? Thanks.
I'll start with the tax piece of it. We had made some tax changes a couple years ago. We saw some tax benefits from that in moving our intellectual property and how that was going to flow throug and transact . We saw that, kind of the pre-Trump tax changes. We saw some benefit there. We're making some changes to optimize the current environment for tax. It's one where, given a U.S. company, we ideally don't want to be above 21%. We want to do things to be able to minimize that going forward. That'll be something that this year, we've talked to being in the upper teens. That's something that, as we make some changes, we would like to hold in that area, that range as well. Hey, Steve, on the acceleration piece, I'd just break it up that there's three categories of acceleration.
You have Propel, which is invasive, drives cytokine levels to move teeth faster. You've got AcceleDent. You have Biolux, where you use near-infrared to excite mitochondria to move. I'd say, look, I think we know clinically that Propel works. It's just how many people want to have holes drilled inside of their gums in order to accelerate their teeth is, it's an invasive kind of a technique. The acceleration piece, either on Biolux and AcceleDent, both. AcceleDent is vibrational and Biolux is light. I think that really meant something back when we were doing two-week wear times. Now we're down to seven day wear times, one week. Accelerating it to five days, we're not quite sure that that makes a whole lot of sense or would be something that would attract consumers more than just the one-week wear.
We obviously, and Zeljko can talk about this, we do a lot of work, to try to figure out the acceleration piece. We have a lot of data on it. We're much more acute, seven-day wear time. Zeljko?
Oh, yeah, I agree with you, Joe. I'm an engineer. I look for data. Right now, there isn't a whole lot of compelling to tell you that there is a lot more room for improvement from seven days, that are also price-conscious and makes sense from the overall treatment experience. I think it was more exciting when it was two weeks, and maybe some of these accelerators claim to be faster than Invisalign because Invisalign was fast to start with. I don't know, this is less of a big topic for us at the moment.
Thanks. For the skeptical orthodontists, I think there's maybe a third of them, that are not big Invisalign fans at this point, what would you sort of summarize to be where you've got clear clinical superiority over wires and brackets, from your point of view?
You have to listen to me, I'm a business guy, though, John. I'll just say, I think we have some real clear areas as far as speed and consistency, but I give that one to Zeljko and Raph. Go ahead, Zeljko. Where's the clinical superiority overall?
We continue to invest a lot of money in research and development. For us, applicability and predictability of our plans is first and foremost. I can't tell you that in every single malocclusion and every single movement, we beat braces. I'm not going to tell you that. I think we are doing much better than some doctors would like to make it look, and there are a lot of doctors that are very successful treating all patients with our plans. There are areas, as I mentioned, where we are definitely, have clinically proven that we can have a better control over tooth movement and better outcomes. I think there is a subjective level to that, and there is objective, and I can just tell you we're going to continue to look for every single opportunity to make clear aligner therapy equal or superior to those braces.
From my perspective, I think it just makes sense for the patients to have clear aligner therapy as opposed to wires and brackets. I think we see that all the time. There's not really any more reason clinically not to do clear aligners. What I can understand from an orthodontist perspective, though, is that integrating Invisalign into their practice, whether to do analog and digital, can be complicated. For those doctors, I think we need to do a better job at helping them integrating Invisalign, and I think if we do that, we'll see that adoption growing much faster. I think from a pure clinical and a consumer desire perspective, I'm really struggling to understand why we would do wires and brackets anymore. Maybe for Class 3s, because we complement those with Invisalign, but outside of that, I'm struggling.
There's other reasons which are more economical and workflow-related that we need to work on.
If I could just add, when you look at quality of life and, for example, periodontal health, there is absolutely no comparison. If you really look at holistically comparing clear aligner therapy removal plans with fixed braces, there is plenty of elements to our favor.
Hi. Hey, guys. Jonathan Block with Stifel. I'll try to throw in two or two and change. I guess the first one is, seems to be a big focus today on the $10 million-$12 million TAM, Joe, going to the $300 million TAM that you mentioned. I guess the first question is, can you get there effectively with the $2,500 price point with what you see today? The other part B to that would be, how do you better spread the word to your customers that you are going B2C, back to B2B? In talking to a lot of your customers, there just seems to be that confusion in throwing you into SmileDirectClub, so what can you do to better spread the word there? Zeljko, I'll go back to you for one.
I agree that it doesn't seem to make a big difference to go from seven days to five. What about on the R&D side? Do you need to consistently exert force? How about something about wearing these for 12 or 14 hours at night? That would be a lifestyle change. Can you still get the tooth movement? Thanks, guys.
John, we almost got a job for you here.
I'll take it over.
John, you know as well as anybody, there's a big price elasticity curve in this business that hasn't been played well. The moment an orthodontist does the case for $68,000, that's going to keep it in that 5% population kind of a range. We've seen with SmileDirectClub's $1,800, $2,000, they pull in a lot of patients that are interested in orthodontic care just for anterior teeth and the work done. I felt, to tell you how much of that $300 million we can access and where they fall around that price elasticity line, we need more data points to understand. We certainly know that that $2,000, $2,500 one for simple straightening of those anterior teeth is a sweet spot in the marketplace. We see that with our stores. We actually see it with SmileDirectClub.
Your comment about how we get that information out to doctors, like Jen said in her store discussion, we just have to do a better job of explaining to doctors that D to C to B model, I teed up in the morning. This is a doctor office centered model. We're recruiting these patients to do that. Remember, in the end, a lot of orthodontists just don't trust us. It's like, "We know what these guys are going to do. They're going to screw us at some point in time." That's not our business model. Our business model's always been doc based. We believe in it. Whether it's on a GP base or it's on an orthodontist base, and we genuinely are out there with these stores and with Smile Concierge, is educating consumers and walking those consumers into a doctor so they can build their practice.
That's been our business model, and that's what we're approaching. We just have to do a better job, as you indicated, of getting that information out to the doctors. I think they just have more time to be comfortable that that's what we're doing and experience it. Jen can tell you that the doctors that were most skeptical in California, in San Jose and also San Francisco when we first started, were very skeptical, are now on board with the program because they've seen how it worked and they're seeing more patient flow through in that sense. Broadly, I think when we get more stores out there, too, that message will come across more clearly.
On the acceleration side, I didn't mean to make a judgment on whether accelerator devices work or not. We look for data, and I link to those companies to prove their efficacy. What I meant to say is the difference between two weeks and one week is much bigger than seven days and five days. There are other things you have to do to make that. There are a lot of doctors that are currently changing Invisalign aligners for their patients for less than seven days, five days, even less. It's really up to doctor how to do that. Now, we do look at what it takes to move teeth consistently and how fast we can do that, and also can we do it with fewer hours in a day.
More hours you wear it, better off it is, because as you move teeth, if you don't apply this force, they're going to tend to go back. At least, there is some elastic part of that. We do look at, is it 22 hours? Is it 18 hours? Yes, we're also looking at options, whether it's just a nightly wear. You're asking a good question. We have that in mind. We look at these things, and we'll let you know as soon as we have conclusive answers.
Shirley's our big test ball on the nighttime wear. You can ask Shirley how it's coming.
Five days a week.
Yeah.
Erin Wright, Credit Suisse. Just quickly on sort of, you've highlighted several global or diverse global drivers across your business. From an international perspective, can you break down what the higher long-term growth assumptions imply from an underlying growth across North America versus international? Also, what's your game plan internationally for your retail offering? How far can that potentially reach? Can you speak maybe a little bit about that true conversion rate? I think you spoke about the conversion rate at retail to the practitioner, but not necessarily to actual sales. Thanks.
I could start with the overall, if you want to get into the consumer piece. As we look at our long-term growth model, we factor in, just as we do with any forecast factor and a lot of the different considerations, we are seeing this dramatic increase internationally for the various reasons that we've said, where just from the adoption standpoint it's lower on the curve or we haven't had iTero as part of the business like we have, say, in Brazil now or in China, and that lends to that future growth. We factor that in. It's one where for us, when you're single-digit market share, and especially in teens pretty much everywhere, we know that we can when it's 75% of the orthodontic cases, we know that we can continue to grow in this space.
When it can treat what we know we can treat 60%-80% of the cases, let's just say, that's something that we know we can grow and continue to drive. It's the international, it's the utilization that we have. We'll factor all those in terms of where we're at, that gets rolled into our long-term model.
As far as the question on international stores, right now we have these four pilot stores in the U.S., they're truly a pilot. I was mentioning with some of you on the break, we're iterating on that pilot. There's things that you'll see in one that you won't see in another. Really our commitment is to this pilot to continue learning through it. If there is success, we determine that at some point, we'll consider future investment. For now, there's just the four.
Thanks. Robert Jones at Goldman Sachs. You talked about the Asia Pac TAM of about $4 million, I was hoping maybe you could talk a little bit about the penetration in Asia Pac today, and more specifically China, given just the size of that opportunity and the time you guys spent highlighting that opportunity. As we think about China, the growth CAGR, you guys highlighted 100% over the last four years, how should we be thinking about the growth potential there, especially in light of the fact that you're just recently bringing iTero to that market?
Julie, go get them. Come on.
We see a tremendous growth. Again, I like to take everybody back to, we just launched China about seven years ago. We're really just scratching the surface. We're currently in tier 1, tier 2 cities, going to tier 3. iTero is going to land a different uplift altogether because we're going to have that available, where doctors are going to be able to submit cases much faster. At the end of the day, the growth is tremendous. In terms of penetration, it is still in its single digits. If you look at the opportunities that we present, the numbers that Ralph look at, four in five patient wants the product in a sense. Yeah.
Bob, I've just got to caution you. When you ask a question like that to Julie, she's afraid I'll take her numbers up, depending on what she says. Her nickname's the sandbagger here on staff. You know. She's being very cautious there, let's say.
Hi, thanks for taking the question. Ravi Misra from Berenberg. Joe, you talked about demand pattern being way outside orthodontic cases. If we think about just that orthodontic market, how are you guys viewing that core customer? Is it a focus of, in North America, just focusing on the high volume guys saying, all right, these are the ones that we want to be promoting our product, and a little bit less on onboarding new guys?
How does the store pilot and the Smile Concierge fit into that? If I'm a new orthodontist starting a business, where does the Align kind of focus come to me? Secondly, we're all thinking about what we're doing with these three- to five-year outlook that you guys provided us. Just from a cadence perspective, law of large numbers coming in, you're 30% plus this year. Should we think of that as kind of like 30/30/30 or 25/25/25 evenly throughout the year? Help us out with a little bit of a cadence there. Thank you.
I'll let Chris talk about North America and how we pick our orthodontists. Right, Chris?
Yeah. I'd say that it's a lot about interest, honestly. We cover every orthodontist at every level. We've got programming. We've got a lot of support at every level. If they're interested to do more, I showed you three programs specifically that help that happen. If it's entry and I just want to get involved and I haven't gotten involved, we'll support that, too. It's really more a matter of building out our support structure based on the interest we see. We're playing on all levels. We do like to see interest, and we do like to see growth because there is a lot to do. We're not choosing a level.
I think they're more choosing us, and we're doing a lot to show that as we move the industry along and when we start to really show what their number one, and this is from the AAO's own surveys, not ours, is the number one thing an orthodontist wants are more patients. We are the only ones who bring more patients, along with a top product. We also like to see them, I think as Joe said, they get more comfortable with what we're doing. They understand this is really driving patients into their practice. I think we'll even see more of that.
Chris has taught me also that there's two parts to this sell. There's a clinical sell to an ortho to convince them, as Zeljko indicated, that equivalence or superiority of Invisalign in some cases. The other one is a business equation. Those orthos, if you're going to run a digital process differently, you do an analog process. That's a big commitment and a big change, and we're ready to embrace when they want to make that change. Putting one foot in analog and one foot in digital and thinking you're going to get productivity doesn't work. It's really clear in the sense of who really wants to step forward with a predominantly digital piece is going to have to change their workflow. We're prepared to help and explain how that works also.
Okay.
In terms of the range, just to kind of get how we're thinking, we look at all the opportunities that we have. The under-penetration that we have, the capability that we have to be able to grow within the marketplace. That 20%-30% growth, that's how we're thinking as a company. That's how when we invest and we think about where do we want to put that extra dollar into the business where we can get that return, we're thinking in the 20%-30% growth range. That's how we would look at it over the long term.
All right. Rich Newitter from Leerink Partners . Two questions. Maybe the first one for Joe.
You've been reluctant in the past to answer the question, are we at or when are we going to hit the inflection point for teens? You look at all the slides that you put up across regions, teen is accelerating nicely and the momentum is picking up into 2017 and so far into the first quarter of 2018. You're also talking about what Mandibular has done in the regions that you've launched it in and how it's actually really accelerated teen there and Mandibular is shortly coming in North America. I guess, are you ready to call the inflection point for teen? If not, how far are we? Then I have a follow-up for John.
I'd say, no, I'm not ready to call it. I'd say when we don't have to push as hard. In other words, when we don't have to spend as much money as we're spending to catch teens' attention and to push our orthodontists to do more teens, that's when we know when there's more pull than push, we'll know we're at that inflection point. We still got a lot of push going on. You can see the OpEx that John showed in his charts in the sense of what we're spending in order to do that. That's $1 billion of OpEx a year, a significant amount of that is around, there's some R&D piece to allow the docs to be more comfortable with it, but a big part of it too is to educate consumers and educate docs what's going on. We can't call it yet.
These are our most protected customers. They're not even customers, they're patients. They walk into that practice as a patient, they know they can do those patients in wires and brackets, and if they're more comfortable in that business model, that's what they're going to keep doing. It's our responsibility to keep educating consumers and working with doctors so they're more comfortable with on both sides. When we feel the pull, you'll see it happen. We'll announce it, but we're not there yet. We can tell, right, John? We know.
That's helpful. John, with respect to the long-range plan operating margins, the range you provided there, I'm sure there are some of your businesses, particularly APAC or some of the international regions where you're getting better pricing or higher ASPs. You're probably either at the upper end or even maybe north of that long range total company plan. Can you just tell us where some of your best regional margins are and what those levels are as a proxy?
In certain regions, like you said, higher ASPs, in some of those, we're also spending a lot to get the coverage, where we're spending the OpEx around some of the sales coverage or where we can market, it makes some sense. Other places where we've been for a while, and we pretty much have that coverage, in some cases, we could be above 30% op margin related to that. It really just depends on how long we've been in the market, what kind of the dynamics are going on within the market. We look at it region by region, look at that return on investment, what's happening there, what we can do to drive that return, and that's why really we kept the 25%-30% as our long-term model consistent because that's the philosophy that we have.
We want to be able to grow, but we want to be able to grow in that profitable way, and it varies by region, like you said.
Yeah.
Yeah.
Thanks, Joe. Jeff Johnson with Baird. Joe, maybe I could just take your pulse on a couple secular issues here, if I could. Emory, maybe start with you. Just how far away do you think we are on 3D printing in the factory and 3D printing clear aligners in the office? I'm assuming those two time periods might be a little bit different, but regardless of Emory's answer there, I guess, my question for you, Joe, is when I look at in-office fabrication of clear aligners, you have to do the 3D printing, you have to do the suck down, you have to maybe laser etch it or polish the edges. Does that even register on your list of concerns of things you might have to fight someday?
Is that such a labor-intensive in-office process that it's not even something you think you're going to have to deal with?
To say that we just ignore it, Jeff, wouldn't be right. We look at it. To me, in a digital model, if an ortho really wants to do a digital model, throwing a bunch of people in the back office to print and trim. Did you ever see one of these MakerBots? My kid has one. He's studying for his PhD. He's got it in my garage in Montana. It's a pain in the ass, right? You'd rather throw your money out front in the sense of marketing your product line, making sure that you have a demand. That digital format doesn't make sense to me, but there's 10,000 orthos out there. Everybody kind of has a game, and we know that they're looking at it. Like Emory said, they're printing molds today.
They're vacuum forming EX30 or some kind of polyester over top of that and use it in some way. They're just trying to compensate for five aligners or less, 10 aligners less, whatever. There's several ways we can go after that, the idea that we're going to have printers in an office and it's just something doesn't make sense to me. Can we be more efficient in the sense of five aligners or less and trying to help our customers out? I think so. As far as your question on when will be the next truly 3D printed aligner, Zeljko is so much more qualified to answer that question than me. We obviously track this, and we work this very closely, and we have several programs, and we have vectors in the sense of how this could be done, if it could be done.
The answer to your question is years. It's not imminent, okay. I don't have enough time to explain it in detail, Zeljko, do you have just some thoughts on sure how you'd deal with it?
I don't want to predict. It's not possible to do it today. As Emory said, current technologies have limitations that prevent you from doing it. We have to find the chemistry formulations. You have to find a process
We had a pretty high bar with SmartTrack. It is going to happen for sure. I can tell you, we are investing a lot of money in figuring it out. I hope we're going to be the first one to do it, whoever says they can do it today, they're not telling the truth, and I don't anticipate this anytime soon.
Maybe one other secular kind of item. We're starting to hear some others talk about disaggregating kind of the treatment planning and the aligner manufacturing, then where maybe if the dentist wants to design the case in office and then pay per aligner, and they could send it even to a couple different labs, whatever lab they want to send it to, things like that. Same question. Is that a viable model? Is that a model that at all concerns you or that you would see as a real competitive threat anytime down the road?
Jeff, I think there's going to be a low end of this market that we've talked about before in these kinds of sessions, and that's 15 aligners or less. This is where companies that don't have the capabilities Align have, they're going to have to play in that segment. There's going to be a scrum in that marketplace to a certain extent. I don't want to necessarily blur the Invisalign brand name down that rat hole, if it becomes that in some way. Labs want to make it, people want to do it in the back office or whatever. We'll be competitive in that segment, but we want to make sure that we continue the value offering that we have, which you understand, our digital front end, back end, SmartTrack, SmartForce stage, all the systems that we have.
Not just get caught in a price game in that sense, too. We're going to watch that really closely, but we're not afraid to compete, but I want to make sure that we compete with our capabilities, and it just doesn't become a black hole in pricing that is. I hope that helps.
Hi, it's Steve Valiquette from Barclays. This was touched on a little bit, but we heard some of the new competitors at AAO talk about really as a primary marketing message, the ability for practitioners to do hybrid treatments using both traditional braces and clear aligners on an individual patient. Yes, sorry. Hopefully you heard that question, basically, my question about that is, can you address that marketing angle from those competitors? It seemed to be a primary marketing angle to practitioners. Also just curious, does that further speak to the limited capabilities of some of those competitor clear aligners as well? Thanks.
Where's Raf?
Yeah. I'm not understanding the question too well. I'm sorry. Can.
He's talking about combo treatment.
Combo treatment?
Do you think that is a viable option?
Are you referring to back to what Shine is proposing?
No, this had to do with the hybrid treatment using both clear aligners and traditional braces on a single individual patient.
Right.
Without naming the competitors, it seemed like some of the more larger competitors really focused on that in their presentations at AAO to practitioners as their main marketing pitch, if you will. I'm curious to hear your response to that.
I think if you stand from their position, like if you're an Ormco or you're a Unitek at 3M or whatever, and you don't have experience in clear aligners like we have, you're going to try to leverage your wires and brackets business. The idea of a combo, I think as they try to ramp up in this business, makes some sense for them. For us, it never has and never will. We feel, right, Raf? We can handle it.
Yeah. I was going to say, I think the reason they're doing that is because they probably can't offer the full treatment yet. They're trying to get to a complex treatment to be able to answer the orthodontist's question when their clear aligners actually can't treat complex cases, so they do a digitalization first. I think for us, we have no need to do a combo treatment. Our product can pretty much cover every single malocclusions out there, the complexity. It will be a step back, especially in the digital practice that we're trying to build today. It's a no for us.
I might add one other thing also is that they're in a wire and bracket business. There could be something in that, too, that we got to promote both.
I would just add, those are the people that years ago said you can't move teeth with plastic at all. They can't say that now, they want to say that it's better to move it in combination, it's just a matter of time, and you're going to have to ask yourself, why do you need anything but plastic? Combo treatment is not going to be ultimately more efficient. Maybe there are some movements today you can do successfully. Long term, it's like, will the cars be electric or gas or a combo? It's our call, but to all of us to make. I think it's just a path that they have to go through, and right now they're probably a lot more comfortable keeping their core competency with wires and adding plastic to it. Just one other point.
I think I tried to say it a bit this morning, but there is a lot of confusion being created on the marketplace today because those competitors are coming in. A big part of our job over the next few months is going to, and maybe you guys can help us as well, is really to try to diffuse this confusion by reiterating the standards that we set in our clinical efficacy and our digital workflow and all this stuff that we talked about today. There's confusion, we just need to take care of that with our communication. Laurie, I think this is a very important question. If you look at also toolkit SmartTrack versus the old material, with all the advancements in digital treatment planning, we couldn't get those outcomes, the force systems, without a SmartTrack as a material.
There is always a combination of what kind of material you have, what are your biomechanical capabilities, what is your treatment planning, how good it is.
As you see this evolution to better and better materials, better treatment planning, you will see plastic winning over fixed braces.
I agree with him. To finish off that question, I just hope that someday we're thinking about patients first, what would a patient rather have? Do you rather have wires and brackets in your mouth and 70% white spot lesions and permanent dentition damage that happens in 70% of the cases, or not eat the food you want to eat, or would you rather just do this with I hope that that really comes into the discussion, is what you would want. That if you're educated enough, and we help educate you as much as we can, what the options are. I think in the end, let's hope that it becomes a patient-centered world and a patient-centered decision.
Okay. We're going to take maybe two more questions.
Hi, Elizabeth Anderson from Evercore ISI. Could you talk a little bit more about the restorative opportunity and how you see that sort of layering and additional utilization growth on the GP side?
I have two restorative zealots here. I don't know who to go to, Zeljko or Raph, you know?
Oh, yeah, we can both talk together if you want.
Yeah.
We do that a lot. We do duos on stage.
They still miss each other.
We call them Beavis and Butt-Head in the company, you know that? No, go on.
Beavis and Butt-Head, huh?
Yeah.
Beavis and Butt-Head. I truly think this is the future. You can straighten my teeth as much as you want, I still have some chips, and with little restoration, non-invasive, composite additive, I am going to have a much better smile. I truly think that very few restorations are better without tooth alignment, and I think many orthodontic treatments will have better outcomes if you add restoration. Going with comprehensive interdisciplinary treatment is the future. I think the consumers and patients will get to learn about it more and more, and they will demand that.
I would expect in the future, the treatments will be comprehensive, and that is why our strategic focus and investment on providing the tools to doctors to plan the best outcomes, so it is not how does ortho see this patient, how does GP, it is what this patient needs and what the best outcomes are. I think this is the future. I am sure of that. When you add visualization and being able to show it to the consumer, to the patient, so they can understand what their options are, make the choice, that is going to be the norm.
I agree with him. It is already happening today. This is not a new concept. Align, Bleach and Bond has been around for a long time. We are just trying to make it simpler for people to do. Doctors do it today, Invisalign really, doing a clear aligner for space management, all these things we spoke about makes so much sense. It is just that the way we have been approaching GPs up to now has been to try to get them to do orthodontics. We are changing that to try to make them do better dentistry. Our messaging, our tools are changing to adapt to that. There is 1.5 million GPs around the world. There is a lot of GPs out there who are doing it today. All the high-end GPs are doing it today already.
I am sorry. When we work with doctors, GPs and orthos, when we show them those tools, our ideas, they all like it. There is not a single GP that said, "Does it make sense?" There is not a single ortho that said, "I do not want these tools." They work together. They really do work together. For us to bring them closer together and put the patient in the center and provide the best options in a comprehensive digital orthodontic system, I think it makes perfect sense.
Hey, Sri, come here. These two people didn't present today, okay? They're really important to Align. Sri runs senior vice president of our IT. IT is so buried within everything that you saw today. It's the most sophisticated IT networking into engineering that I've ever seen in my life. Sri's been with us how many years?
15.
15 years. She reminds us of it every day, okay? She knows a lot. Now, Stuart, senior vice president of HR, you can imagine with all the growth we've had going on in the business and recruiting, he's been phenomenal since he's joined us, in bringing incredible talent on. From Wales, so we put up with his football analogies, but I just want you to see these guys. They didn't present today, but don't think in any way they don't have an incredible importance for the company. Back in your corner, Sri.
Before we wrap up, I wanted to just remind everyone that our Invisalign store pilot pop-up is still available. If anyone didn't get a chance to be scanned, please feel free to go back there. The team will be on site as long as you need them. Joe, do you have any closing comments?
I felt good about today. I hope you did too. I think obviously having the Invisalign store back there, that maybe you could experience it and see what we talk about here and feel the realization of it. I'll just end the way I started today. We have this whole convergence of demand and technology and capability to deliver. We have a new vision, an overall vision of bringing orthodontics to the masses. I hope you can feel the truth to that, and that from a competitive standpoint, hopefully, we've represented your questions and where we stand today. I think as any company in the world that can take advantage of that demand equation, an opportunity that's out there today to straighten teeth, and that's our goal. I hope you'll walk away with that feeling and continued trust in our ability to deliver.
Thanks for attending, and we'll certainly be in contact.