Align Technology, Inc. (ALGN) Earnings Call Transcript & Summary

All right. Thanks, everyone, for joining us. Welcome to Jefferies 2021 London Healthcare Conference Virtual Edition. I'm Brandon Couillard. I cover the dental space here at Jefferies. Very happy to have Align Technology with us back at the conference this year. And joining us for this fireside conversation today, CFO, John Morici. John, thanks so much for being here.

Thanks, Brandon.

I guess to kick off, John, I would like to get your perspective. We've had several competitor data points recently in the past few weeks from x-ray as well as SmileDirectClub, kind of [ warning ] about growth prospects in their respective businesses with citing -- some citing macro factors, some inflation concerns, shifting consumer preferences. Just curious, what are you seeing in terms of those dynamics in Align's business?

I think, Brandon, when you look at our business and you fundamentally get down to the key components of our business, one, we're based on technology. And when you look at some of the other notes that come out from other competitors, when we look at the spend that we have, we'll spend over $250 million this year in R&D to really drive and innovate and come up with the best products that provide our doctors with predictable and reliable results. That's a key component to our strategy. And as we go to market, that's different than many other competitors and certainly, what they spend in comparison. And I think the other aspect that's different, too, is we have a direct sales force, a sales force that goes and meets with doctors, answers their questions, helps them understand new products that we have, new innovations and others that can help them treat the cases within their practice. So I think those differences really give us an advantage as we go to market, where we've got the best products that we've developed almost over 25 years over this time and to be able to have that direct sales force that -- their time with those doctors to help them drive utilization, that's a combination that we've had since the beginning. And it's helped us as we've navigated through these times where there's going to be uncertainty in the marketplace, there certainly is. Consumers kind of shifting their spending and so on, patients and so on. But one thing that we can control is our go-to-market strategy with great products and that touch to those doctors, and we think that helps us differentiate.

There are other fundamental differences in terms of the type of customer that may be going and seeking treatment in a dentist's office as opposed to those other brands in the ecosystem. And are there differences in terms of how you do marketing to drive demand generation beyond just kind of the direct sales force in terms of how you communicate in design brands to consumers?

I think there's 2 parts to that, Brandon. When you think about -- when people are going to their doctor, either a general dentist or an orthodontist, they have some problem. They're coming in with a problem or they're coming in for cleaning. They're coming in for a filling. And that doctor has that opportunity to be able to explain to them, hey, this problem that you have is caused by your teeth need to be adjusted and you might need treatment. And we have the opportunity then, especially on those doctors that we sell to that they can provide that treatment, and we can get -- we can try to get that conversion with Invisalign. Whereas I think if you're just kind of in the marketplace, you've got to then do something to say, okay, I saw something, and now I'm going to go into whatever their capture mechanism is for some of these DTCs, not always the most convenient in many cases or in others. It's just not -- you might have a minor correction, whereas when you go to your doctor, they can show you with an iTero scan. Here's where your teeth have shifted over the period of time. Here's what treatment would look like and what we can correct and make your bite better, alleviate pain, whatever you're having at the time and be able to provide that. So I think that's one big part of the fact that we've got products that can treat a wide variety of cases, from the more simple cases that maybe some of the DTCs would have, all the way to the more complicated teenage cases or other cases where there's a lot of movement that needs to happen, and we have products to be able to do that. And I think on the other side, our marketing has evolved over time where we provide that awareness. We want to be able to make sure these potential patients understand that what Invisalign is and the brand leader and been around for 25 years and be able to have our products, which we think are great products that we've innovated over time, are best used with a doctor and are best used with that orthodontist that you see on a regular basis, that you see that general dentist on a regular basis and really explaining that and going through that process. But I think it's an evolution of what we've had over time. And I think, in the end, the products that we have, the way we communicate over time, it will shift. I mean there's certainly shifts that we have in communication, but it's getting that messaging to those potential patients. And then when they come in for treatment, they can ask for our products by name.

In terms of your own fourth quarter outlook, which you reported a few weeks ago and guided to for the fourth quarter, I think it implies fourth quarter case volumes about flat sequentially. You tell me if I'm wrong. Historically, seasonality has been up somewhere mid-single-digit range, third quarter to fourth quarter, in terms of overall volumes. Have you seen any improvement in October, November as COVID cases have receded and consumer confidence has maybe gotten a little bit better? What are some of the factors that kind of informed that outlook?

I think when -- I would broadly say, Brandon, what -- before COVID, you had maybe more of those normal patterns that would happen. Things would kind of progress from one quarter to the next quarter and so on. I think now, as we've kind of in the recovery from COVID and as things start to open up, you're going to get some variation. And we try to give that reflection in our guidance so that as things start to open up, they'll become more normal. But you still have countries that are facing more or less COVID impacts, some of them additional lockdowns and other things that happened. You have some other areas that there is -- there could be concerned about inflation or other things that happen that are outside of our control. So when we gave a guidance, we gave the best view that we see based on what's happening. And I think you're going to get into next year, and things will become a little bit more normal as we get further and further behind COVID. But just as we saw a huge impact during the time when things were shut down, and we've seen -- we're happy with the growth that we've seen as we've kind of recovered from COVID. But it's -- it will be into next year before things get a little bit more normalized.

Reflect back to your Investor Day meeting in Vegas a couple of weeks ago. You talked about a TAM globally of orthodontic case starts, about 21 million cases globally. How many of those can Invisalign address today? What types of cases are still untreatable?

Yes, it's a good question. The TAM that we see, 21 million, approximately 7 million in each of the 3 regions. When we look at the cases that we can, through our doctors' help solve, it's 90-plus percent when we look at it. There's maybe some dramatic molar shifts or we still don't have the rapid pallet expansion, which we're developing, but that will be a rapid palate expansion that will clip to the top of a child's mouth to be able to really expand that upper palate and bear to create the space. Once we have that, most cases will be able to be addressed. But of the 21 million, 90-plus percent should be a bit be addressed. And many doctors that we have, they -- 100% of their cases are being done with Invisalign. So some of it depends on the doctor's capabilities. But we're developing products and not resting until we have the ability to give those doctors confidence to do all cases. And we're continuing to see that development. And you'll see new products from us to help with that.

Just one point of clarification. I think you previously talked about a 12 million case start number, that's 21 million. Can you help us just kind of understand the delta in that update sort of between those 2 numbers? I don't think the orthodontic market is growing that fast, but just help us understand kind of the more refined TAM assessment.

Yes, that's a good question, too. I mean, Brandon, when you think about it, yes, so the orthodontic market is growing at 3%, 4%, I'd just say, but it really is a reflection of some of our capabilities, both in the product and so that we are able to address now a bigger addressable market in product innovations and other products that we've been able to develop. And it's also a reflection of us going into other markets, growing in South America that we haven't been before. You go back to 2018, we're just starting there. Same way in the Middle East. Same way in Southeast Asia. So it's really a combination of 2 factors. It's our products, being able to expand and be able to address this expanded market. And it's also how we've gone to market in new locations to be able to help us expand the TAM.

Let's break down that TAM a little bit, and dig into teens and adults. But just starting with teens, I think the lion's share of teens globally is around 5%. Just how did that compare Americas versus rest of world? Do you have those figures?

Yes. America is higher. That's the same. Americas is maybe in the -- across Americas is probably in the high single digit. And outside of the Americas, OUS, it's in the low single digits. So teens, when we talk about that TAM and we think of 21 million case starts every year, 75%, 80% of those are teens. So there's a huge opportunity there, and that's with quality of products, training doctors, getting them to start with our products, be able to build into more and more complicated cases, be able to treat -- in many cases, we talk about teens, but we're also talking about preteens. We're talking about children that are 7, 8, 9 years old who need space as those permanent teeth come in. And that's really where our products are addressing even pre-teenagers as well as teens. But it's a huge opportunity for us. When we think of our case volume roughly in total, 75% of our cases that we treat or that we have through our doctors treat adults and [ 25 teen ]. And really, the market has flipped. The market from those 21 million orthodontic case starts, a vast majority of them are teenagers. And it just shows the opportunity that we have. It shows that driving the utilization, being able to have that direct touch with those doctors that I talked about with the sales team, making sure that those teenagers understand, and we could talk more about some of the marketing tactics that we do to understand our products through either social media or influencers or other general advertising, making sure their parents understand the benefits that this can drive and then it's the doctor education and the doctor utilization that we ultimately try to drive. So it's all those factors that help with this. But we look at this as a huge opportunity for us and in our business, and we're going to keep pushing to try to increase the teen volumes.

I'd love to dig into some of the dynamics in just a moment. But as I think about the penetration rate today and where it can go over time, what structural barriers remain, if any, for teen penetration to go a lot higher and ultimately, I think, kind of approach that of the adult market, which is closer to 30%, especially now that you can treat the vast majority of teen cases. What structure varies still exist [Audio Gap] do you still encounter in terms of friction to that being a lot higher number?

The 2 friction points that we have, it used to be -- before it used to be about product. Hey, your product doesn't really give us what we need. This would be an orthodontist. And I don't have the predictability and reliability to use your product to be able to get the treatment outcome that they want. That's gone. That's passed. We now have products that they -- we don't hear those product complaints. Doctors are very comfortable or very -- doctors who understand our products are very comfortable using our products because it's predictable and reliable and gives them the results that they want. And we also don't get -- teenagers, especially the young, they'll want just to have the flexibility in their life and to not have to go back to the doctor as much and so on. They love the fact that to be able to use Invisalign because it will give them, in many cases, a faster outcome, much more flexible outcome. They can live their lives and play sports and musical instruments or whatever and just kind of pop those aligners in and out. But it really comes down to its doctors, its doctors to be able to help them understand that they can use Invisalign and training those doctors. Many doctors will say that there's a compliance where perhaps patients don't wear their aligners as much as they should or would need to. That's actually what we see in our studies. Teenagers wear their aligners even more than adults. They wear them almost all the time, even some will do it while they're eating. They're kind of really compliant with it because they've [Technical Difficulty] done. Nobody wants anything on their teeth, and teenagers are very self-conscious of this. So the real barrier is just making sure that doctors understand kind of the benefits. Sometimes it comes down to economics, making sure that they understand the economics of using Invisalign versus wires and brackets. Programs like ADAPT, where we have the aligned digital and practice transformation, help with the understanding for doctors so that doctors can understand that not only can you using Invisalign and having that become part of your practice drive productivity, which it does, less chair time, less emergencies, less all the other things that we've talked about, but they can also now see more patients, driving more patients to those doctors. They can then increase their revenue and ultimately, their profitability. So that's all those dynamics that are kind of there. But from a quality of product standpoint and the capability of the product and the demand, either from parents who say, yes, I should put my son or daughter in treatment and certainly those children, they want Invisalign. It's just making the -- all this work with the doctors.

I want to circle back and close a loop on some of the things you mentioned in terms of social media and how do you market to teens. How is that fundamentally different today than, say, it was 3 years ago? Just how big of a percent of your budget is social media? And I imagine the returns on those teen investments have to outstrip that kind of the more adult targeted spending. Is that the case?

Yes. No, those are good data points. When you think about it in total, we're spending a lot more just because we spent -- as a percent of revenue, our revenue has grown so much over this time period. If we look back at the last 5 years or so, even including this year, we're averaging about 29% revenue growth over the last 5 years. And obviously, as that revenue has grown as a company, we've been able to invest more and more into marketing, and that's a key component for us. So being able to invest in things to drive general awareness. So you see things on TV and other places. I think one of the big changes that we've done in the last couple of years is we're not just spending in the U.S., we're spending in every market that we're in. Every market where it makes sense, we've got an established team there where we can spend. Some markets don't let you spend as much on a -- with a prescribed product like we have and so on. But where we can spend, we're definitely spending. So you see this in spending in EMEA and in APAC and other places. And I think what we've really learned, especially during this most recent kind of COVID and pandemic recovery, is let's try different things. Something might work in the U.S., let's see if it works in Brazil. Let's see if it works in Europe. And then even within the U.S., we try things where you've got social media or you might have an influencer that becomes very popular. Well, can we spend more with that influencer? Maybe that influencer isn't as popular? Do we shift things? So I think the key that we've learned as we've gone through this crisis and now recovery is just be really flexible. We've got dollars to spend. Let's spend them in a way that drives that biggest return, and that's what's been exciting about this. We know where we invest. We talk about some of the impressions and awareness and kind of those top-of-the-funnel metrics. We're seeing really, really good awareness and an action by these potential patients, get them to the office, get them to ask their doctor for Invisalign by name. Many cases, we're advertising to the parents, letting them know of alternatives, letting them know the benefits, letting them know that there are other choices and options. And then the parents are more aware of it as well. And those are things that we've taken from kind of the recovery that we've been in, and we're going to continue to try different things to drive that right conversion. And again, we're spending more dollars, but we're not necessarily spending more as a percent of revenue. It's just that we're able to now have bigger dollars to be able to spend. And we look at this year, we'll spend as much or even a little bit more than we did in R&D. We'll spend about $250 million, actually plus, in R&D, and we'll spend $250 million plus in marketing. So $500 million in developing products that we're spending on this year as well as driving demand to those doctors. And that's significant, and it's something that in success, we're going to continue to make these investments.

Probably dwarfs the cumulative OpEx of all of your competitors combined.

We think so. And I think that's a big differentiator, brand and awareness, but you've got to have the product to be able to back it up. You can talk about having a product, you can talk about doing all these other things, treating these complicated teen cases and so on. You've got to be able to have the history and the products to be able to develop that. If you look back at our history, early on, we weren't really treating teen cases. It was much more of an adult market, and that's really, quite honestly, what was the capability of our products, through innovation and investments, multibillion dollars of spend that we've had over the time in R&D to really be able to drive better performance with our products, giving those doctors confidence that they can take our products and they can be able to finish a case on a predictable and reliable basis, that's invaluable. And so when companies talk about what they're trying to do, we're already doing it. And it's just a matter of making sure people understand that.

I want to shift gears over to the adult market, just to close the loop on this TAM discussion. I think your share of adult cases, about 28% globally today. You did a similar sort of breakdown in terms of what that looks like in Americas and then rest of the world, so we have a frame or reference?

Yes. So just as we've been in the U.S., longer and U.S. being the dominant part of the Americas be a little bit higher in adults to be in the 30s, maybe close to 40 from an adult standpoint. And then the rest of the world outside the U.S., you'll be in -- it will fluctuate in the 10% to 20% range, depending on the country. And it's a reflection of the fact that we've been in the U.S. longer, more of an established market, but it also highlights the incredible opportunity that we have. And why -- on your previous question, why we're investing in other places and what we're doing from a marketing standpoint, we want to drive that awareness. We want to be in countries where maybe we haven't advertised as much because fundamentally, that opportunity is there. And we want to make -- in the end, and Joe and I talk a lot about this, but it's really true Brandon, and it's a multivariable equation. And you've got to -- certain regions and markets are further along in that equation in that journey. But we're always trying different things, whether it's adding salespeople, adding marketing, developing our products, expanding out with operations to get closer to our customers like we are in Poland or we had branched out into China for manufacturing plus treatment planning scattered throughout the world, things to get closer to our customers to be able to help drive that conversion. There's always things that we're trying to be able to do. And in the end with such a big market opportunity, we know that these investments are ultimately going to lead to Invisalign being the standard of care. We're not there yet, and that's why it takes these investments. And we spend upwards of 50% of our revenue in OpEx to try to unlock and kind of get past this friction that's there. But ultimately, we're going to get there. It's just a matter of time.

Got it. I'd like to shift gears maybe for a minute. You talk about exocad. Honestly, investors never asked me about it, the acquisition, honestly. And it's a little bit difficult to sort of visualize, right, sort of how it fits into the Invisalign workflow and how it helps you sell more scanners or sell more aligners from -- but how -- just articulate sort of how it has strengthened your core capabilities. Does it help you sell more scanners? What does it do for you strategically?

Well, it will help us -- it's a great question. And the best way to think about it is it will help us sell more scanners and more Invisalign, and here's why. Many general dentists, they'll take a scan, they'll look at your teeth and they'll say, okay, here's where your teeth are now. They're grinding or you've got this chip, too, there are other things, and we need to provide some type of treatment to be able to fix whatever your problem is. And where exocad fits in is exocad is a part of helping the doctors as well as the labs visualize what that restorative component is going to be. So when we combine the orthodontic work that needs to happen, plus the restorative work, which is what exocad helps, it provides a holistic solution for the doctors and ultimately the patient. So you think of it as you come in and you've got a chipped tooth, but your tooth is chipped because your teeth are not straight. So what our solution is -- with the doctor is let's align the teeth and, at the same time, understand what the restorative part will be. And the whole goal of it is move your teeth and save as much of a healthy enamel as you can. Don't have a healthy tooth worn away and only then provide, after the -- your teeth are aligned, some of the cosmetic work that you need to actually provide the restorative. So in this case, where, say, you have a tooth that's out, you would move space, move your teeth through aligners and provide that space that's needed and align all your teeth. And now, through the exocad software, they can understand exactly that new tooth, that implant that's going to go in and have that completely set up right from the beginning as to where the teeth are going to be moved, so that you can get that implant to fit perfectly within that space that's now created after you aligned your teeth. And then the interface to the lab is -- the beauty of the exocad software is, the lab knows exactly what to make. They know exactly what to do. There's no physical impressions or other things that are needed. It's move the teeth to the proper place, then provide the restorative work. And in my example here, an implant. That implant gets made by the lab. It gets sent to the dentist. Dentist puts that implant in after the teeth are properly aligned. It's a perfect fit. It's a perfect part of the workflow. And ultimately, it's a better result for the patient. The patient is moving teeth and having their teeth moved. So that when they do whatever restorative work that happens, it's as minimally invasive as can be, keep that healthy teeth, that enamel, and be able to then provide the restorative work. And exocad is in the middle of that. And they have a great relationship with labs and a large installed base. And for us, it will -- that will help drive -- it drive sales on its own for exocad, but the added part is it drives more iTero sales. And we know when we have iTero and the example that I just provided, it will drive, in this case, an Invisalign case to straighten your teeth that you might not have had before.

Excellent. The thing about other adjacent sort of technologies that are becoming more prevalent in the dental office, 3D printing seems to be one that it's hitting stride. We've seen at least one big DSO recently announced a big rollout of 3D printers in offices. Do you see that as a competitive threat either for the Invisalign franchise for retainers? And do you need to put a stake in the ground there longer term? Sort of how do you think about that market and that technology as a tool that's predominantly used in offices?

I think there's 2 parts to that, Brandon. I think, look, doctors will find ways to -- especially if they're talking about retainers here and maybe they want to make their own or maybe a couple of aligners here and there that they make, I think we have to be able to, in many cases, sell the way the doctor wants to buy. And for us, we have huge opportunities. We've been talking about all these complicated cases. But in many cases, it's either retainers or some minor movement, we have products that can address that. We just have to make sure that in doctors' minds, it fits into their workflow. Can we get to them quickly on this? And can we do it at a price that's affordable? So you've seen us -- we talked about some of these subscription programs and some things to be able to help doctors kind of -- they're doing a lot of volume with us, but then they're kind of doing their own on these retainers and so on. And we've had tremendous success with some of these programs to be able to get incremental volume. Our attach rate on retention is less than 10%. So when we do a case, most of those cases are being done by the retainers, and some of those touch-up cases are being done by doctors. And they make their own, and they're not using our product. So can we find a way to be able to have a higher attach rate? So things that we're doing with retainers to be able to make them affordable and ship them quickly, some of those benefits, we're seeing good results with. And that will help. Because doctors, in the end, they don't want to be doing this themselves. They want to have a company like us that can provide the more complicated cases, all the way to the minor movement, touch-up cases and even retention. And then we can provide them products to be able to help supply that. So I think doctors that come across us now are finding it very valuable, and that's a positive. And I think also when you look at the next generation of Invisalign and what we're providing from a clear aligner standpoint, I think rest assured that as a company, we're looking at this. We're coming up with the right R&D to be able to commercialize some of the true 3D printing. So instead of all the 3D printing of the mold and then vacuum-forming the aligner on top of it, which is the traditional even in these labs, to be able to have true 3D printing and have a printed aligner that's true 3D printed, that's something that we're actively working on. And you'll see, over the next couple of years here, various products come out that have those capabilities. It's not easy. It's complicated. There's a lot of things that go into it. But that will address directly some of those where if a doctor needs it right away, they need certain characteristics of an aligner that just can't be provided right now. It will give them a lot more flexibility. So we're actively working on this. It's not easy, but it really is the next generation. I mean we're going to have kind of that current technology for a number of years, but you're going to see various products come in, maybe even the rapid palate expansion, I talked about earlier, where that's like the one to try to get us to close to 100% of being know to help doctors treat teenagers, that rapid palate expansion will be exactly that. That would be a true 3D printed product that would be custom designed for that child where they need space in their upper palate, that gets printed, that gets used. The child puts it in for a couple of days, pops out one out, puts the next one in, it's all 3D printed. You're going to see various products like that in the future that we'll have. And from a company that is the largest 3D -- customized 3D printed company in the world, we'll find ways to be able to find different forms to be able to provide true 3D printed products versus the current technology.

That's great. We've only got a few minutes left. I have to touch on the iTero business. Growth has just been on fire, growing sequentially, 5 straight quarters now. Just help us understand how sustainable this growth trajectory is in your view. The iTero 5D Plus seems like it's still very early in its product cycle. And then secondarily, when I think about your commercial power and the fact that you're the only manufacturer that has a direct channel into GP offices, how significant is that of a competitive advantage?

Well, there's multiple parts to your question. I would say when you think of iTero, it starts with the overall TAM and the opportunity that we have. Just as we talked earlier about Invisalign opportunity and the fact that we have so many opportunities there, it's just as much of an opportunity on the iTero side and digital scanning side because it's a vastly underpenetrated market. Most general dentists do not have a scanner, none, zero. And some that have one need another one, some ortho that has one needs another one. And so there's a vastly underpenetrated market to start. I think the iTero and the product portfolio that we've created has really done a good job of providing a wide variety of products to be able to suit those needs within those doctors' offices. So you've got some that are more basic with the Element 2 and some of the Flex, where if you just want to get in and get a scanner, that will all provide that. You mentioned 5D and 5D Plus, those are the more high-end scanners that are designed to be able to help a patient get scanned. Every time they come into treatment, they can look at -- the doctor can look at what's going on inside the teeth with the infrared technology to be able to understand if there's cracks, lesions, other things going on, and it helps to become more of a diagnostic tool. So it becomes part of their workflow. They're scanning every patient. They're understanding how teeth are moving. They're understanding what's happening within the teeth, and then they can provide better treatment. And it's a huge benefit to that. So you take the huge market opportunity as underpenetrated as Invisalign is and you take the great product portfolio that we have, it's a really great combination. And so you've seen us 5 sequential growth quarters. It really -- when you look at what was happening in the world for doctors to be able to say, you know what? I don't have a scanner and there's all these things happening in the world, but I'm going to digitize my practice. It's a very powerful statement, and it's something that we think that is the right direction. It helps digitize their practice. It's better for them to not have to take, in some cases, with 5D X-rays and provide that radiation. It's better for patients to be able to understand how their teeth are changing over time, so they can do more preventive work. And through that growth, we think that it will drive more adoption of iTero, which is a real positive for us because we know that leads to more Invisalign. There's case after case that we see where a doctor goes in. And many of the new doctors that we've seen come through, especially as the COVID recovery has happened, those new doctors come in buying a new scanner. And they buy that new scanner, they help digitize their practice, they get trained and then they start to use Invisalign with it. And that combination is very powerful for us, and we're excited about the opportunities. There's a lot of new technology that's going to be coming out with iTero to help further our growth and ultimately get placements, and we want that. And we want that practice to digitize. iTero is a great way to start with that, but then ultimately drive more Invisalign and all the other things that we talked about.

Just to cap the conversation here until we close out the time. As we look at next year, could you sort of articulate the sources of your confidence in being able to deliver on that 20% to 30% growth algorithm, even though near-term seasonality may be a little bit softer? And what are maybe 2 or 3 things that investors should sort of think about as far as key growth drivers, specifically for next year?

Yes. So when we look at it, Brandon, I mean, we still have this huge market opportunity. We talked about the 21 million new orthodontic case starts every year that we could try to address, we're a low market share of that. You have 500 million, we've sized the market as potential patients that are out there that are going to their dentists on a regular basis, that could benefit from some type of teeth straightening, about 200 million in the Americas and 150 million in each of EMEA and APAC. So you have this huge opportunity, market opportunity, traditional orthodontics plus this expansive market there. And I think what you'll see from us is continue to execute on our strategies, growing internationally where it makes sense, adding more salespeople in different regions to be able to expand into the marketplace and help train doctors and get them to utilize products more. You'll see us continuing to invest in trying to grow that orthodontic utilization. That's a teen component that we talked about, better products, better education and marketing to be able to help unlock that friction that's there. You'll see us working with general dentists more and more getting them an iTero, leveraging the exocad acquisition to help turn this to a -- from just a restorative to an ortho restorative outcome for those general dentists. And to bring it all together, you'll continue to see us advertise in a way that lets people know that there's differences between companies. There's differences in technology. There's differences in how we interact with doctors on a direct basis. And through all that, when we give our long-term growth model, we feel comfortable with that 20% to 30% range. We've, like I said, over the last 5 years, grown about 29%. Prior to that, in the 19 years before that, we were growing about 23%. So we feel like we're accelerating things. We'll keep it in the 20% to 30%, but there's a lot of things that we need to do, but we feel good about our positioning.

Good. We'll have to leave it there, unfortunately. John, thanks so much for being here and everyone on the line, thanks for joining us, and have a great day.

Thanks, Brandon. Appreciate it.