Oral health companies, orthodontists, dentists and regulators are engaged in a high-stakes war over how to best straighten your teeth.

The big picture: Products like Invisalign and SmileDirectClub have taken a big bite out of orthodontists' profits, pitting old-school professionals against new upstarts against state dental boards, with millions of dollars in marketing and legal bills piling up along the way.

State of play: Invisalign owner Align Technology and SmileDirectClub — as well as a slew of smaller companies — are increasingly sidelining orthodontists and taking market share away from wire-and-bracket braces.

The big picture: The pandemic triggered a boom in sales of teeth aligners. Invisalign and SmileDirectClub's sales soared as customers figured it was a good time to fix their crooked teeth, a medical condition known as malocclusion.

Threat level: Hoping to carve out additional runway for growth, SmileDirectClub has attacked state dental boards that it views as protecting the orthodontics industry.

How it works: People looking to straighten their teeth without wire braces have some options.

The other side: The American Association of Orthodontics did not respond to requests seeking comment, but the organization has argued that an orthodontist should oversee teeth straightening and that direct-to-consumer treatments should be avoided.

What we’re watching: Braces still have the upper hand: They're used in about 8 in 10 cases, including most children, Couillard says — which means there's plenty more room for the aligners industry to grow.