"Before 32Co, I thought having 2, 3 or 4 refinements for a case was normal."
That's Dr. Daniel Paton from Middlesbrough, and he's not alone. Across the UK, dentists who've been doing Invisalign for years are discovering that the endless refinement cycles they'd accepted as inevitable weren't actually necessary. They were just badly planned.
The numbers are stark. Industry-wide, clear aligner cases now average 2.5 refinements, with patients needing 64 aligners total instead of the 20-30 they were promised. What should take 6 months drags on for 22 months. Invisalign providers have gotten so used to this that they've stopped seeing it as a failure – "unlimited refinements" has become a selling point rather than an admission that the initial plan rarely works.
Enter 32Co, a UK startup that's done something seemingly obvious yet revolutionary: replaced overseas technicians with UK orthodontists for treatment planning. The result? Over 95% of cases finish with one refinement or fewer. Half need no refinements at all.
The established players are nervous. And they should be.
The Technician Problem Nobody Talks About
Here's what actually happens when you start Invisalign treatment at most UK practices: Your dentist takes scans, sends them to Invisalign, and receives back a ClinCheck treatment plan created by a technician. Not an orthodontist. Not even a dentist. A technician, often based in Costa Rica or the Philippines, who's been trained to use software but has never actually treated a patient.
Your dentist then "reviews" this plan, but here's the uncomfortable truth – most UK dentists offering Invisalign have done a weekend course and maybe 20-50 cases total. They're reviewing complex orthodontic movements planned by someone with even less clinical experience than they have.
Dr. Sonia Szamocki, 32Co's founder, puts it bluntly: "The average case involves over 800 tooth movements. Traditional manufacturers delegate this to non-dental technicians, leading to inconsistent, unpredictable results that rarely succeed first time."
The evidence backs her up. That American Journal of Orthodontics study showing only 6% of Invisalign cases completing without refinement? Those weren't complex cases. They were standard treatments that should have been predictable.
How 32Co Actually Works
Instead of technicians, every 32Co case is planned by a UK orthodontist. Not reviewed by one – actually planned by one. The company offers two workflows: SOLO for experienced dentists who want orthodontist-planned treatments at speed, and DUO for those who want ongoing orthodontist mentorship throughout.
The SOLO service is particularly clever. Lab fees start at £400 (Invisalign's wholesale cost to dentists starts around £1,200), plans come back in 48 hours instead of two weeks, and they include a price-match guarantee. If you find cheaper, they'll match it.
But the real innovation isn't the price. It's that 32Co has built a system where orthodontists can actually afford to spend time on each case. By cutting out Invisalign's massive marketing budget and Costa Rican call centers, they can pay UK specialists properly while still charging less.
Professor Ama Johal, who leads 32Co's clinical team, explains: "We're providing support to colleagues to help them deliver reliable, effective treatment. Every plan factors in the patient's goals, what's physically possible, and how to get there in the safest way possible."
The Material Marketplace That Changes Everything
While Invisalign locks you into their SmartTrack material, 32Co has created something unprecedented: a marketplace where different aligner manufacturers compete for each case. Zendura FLX (used by ClearCorrect), CA Pro+, and other premium materials are all available, with the orthodontist recommending which suits each specific case.
For patients, this means getting the exact material properties needed for their specific movements. Flexible materials for sensitive teeth, rigid materials for stubborn rotations. For dentists, it means lab fees that adjust to case complexity rather than Invisalign's one-size-fits-all pricing.
The competition between manufacturers on 32Co's platform has driven prices down 30-40% below traditional rates. A moderate complexity case that would cost a dentist £1,800 in Invisalign lab fees might cost £600-800 through 32Co, savings that practices can pass on to patients.
Why Refinement Rates Actually Matter
Every refinement means more appointments, more time off work, more frustration. It means missing the wedding date you were aiming for, or still having braces in holiday photos you'd hoped to smile freely in.
The financial impact is significant too. Each refinement adds 3-4 appointments. At typical UK practice rates, that's £400-600 in chair time. For practices, endless refinements mean unhappy patients and online reviews mentioning "longer than expected" and "still not finished after 18 months."
Dr. Vicky Griffiths from Cheshire switched to 32Co after years of Invisalign frustration: "32Co offers much more than clear aligners – a product, a service, and the drive to provide the best for our patients. My refinement rates have dropped dramatically."
The knock-on effects are profound. Practices report that predictable treatment times mean they can actually schedule properly. Patients finish when expected. Word-of-mouth referrals increase because people are genuinely happy with their experience rather than relieved it's finally over.
The Training Revolution
Invisalign training courses typically cost £450-950, with many dentists treating their first cases while still learning the system. 32Co flipped this model entirely – all their training is free, including their four-week Clear Aligner Starter Course led by specialist orthodontists.
More importantly, the training is contextual. As Dr. Szamocki explains: "Content is specific to the case dentists are currently working on, taking into account their skill level, treatment stage, and case complexity. We think this is the future of training in healthcare."
The results speak for themselves. Dentists report feeling "twice as confident" after 32Co training. Dr. Matt Manikam notes that having an orthodontist review his treatments and help correct tracking issues has transformed his practice.
What This Means for Patients
For patients, the 32Co vs Invisalign choice comes down to what matters more: brand recognition or clinical outcomes.
Invisalign has treated 14 million patients worldwide. The brand is synonymous with clear aligners. If your case goes perfectly, the experience is smooth. But with average refinement rates of 2.5 and only 6% of cases completing as initially planned, "perfect" is the exception, not the rule.
32Co has the clinical edge. UK orthodontists planning every case, 50% fewer refinements, and prices that typically run £1,000-1,500 less than Invisalign for comparable treatment. The company is only three years old, but they're already the UK's fastest-growing clear aligner provider.
Dr. Adam Gardiner from Bristol summarizes what many dentists are discovering: "I've taken on more complex cases and exceeded patients' expectations with results beyond what they imagined. The orthodontist support makes all the difference."
The Uncomfortable Truth About Clear Aligners
The clear aligner industry has been broken for years. Patients were told six months and got 22. Dentists were sold "simple" systems that required endless troubleshooting. Everyone pretended this was normal because Invisalign's marketing budget convinced patients to ask for it by name.
32Co's success isn't just about being cheaper. It's about fixing fundamental problems the industry had accepted as unchangeable. When you put actual orthodontists in charge of orthodontic treatment, outcomes improve dramatically. Revolutionary, really.
The established players are now scrambling to respond. Invisalign has started promoting their "doctor-directed" treatment more heavily, conveniently forgetting to mention the technician who actually creates the plan. Other companies are suddenly talking about "refinement rates" after years of hiding them.
But 32Co has a three-year head start on building the infrastructure that makes orthodontist-planned treatment economically viable. Their marketplace model, free training, and collaborative platform aren't things competitors can quickly copy.
For UK patients choosing between 32Co and Invisalign, the decision increasingly comes down to a simple question: Do you want the famous brand that needs multiple refinements, or the UK company that gets it right the first time?
The dentists have already decided. As Dr. Paton puts it: "From day one I realised that 32Co will put me, my team and most importantly my patients' interests as top priority."
That's not something you hear about Invisalign very often.