October 11, 2022
by Dr. Ben Gregg, DDS, MS
It’s easy to allow our traditional bracket training or past aligner procedures to drive the way we approach today’s aesthetic treatment cases. But as treatment options continue to evolve, we have a responsibility to our patients to offer the best choices for their specific needs.
We’re fortunate to be treating patients in a time where clear aligners are an accessible treatment option. But before I go any further, let me tell you the truth about aligner therapy: It uses the same approach as treating with traditional brackets.
Just like you wouldn’t send a patient home with a box of brackets and wires and say, “See you in 10 weeks,” you’re not sending patients off with a clear aligner system to use on their own. Aligner therapy uses the same traditional approach you’re used to in order to get the tooth to move, but now we just employ plastic and attachments throughout the therapy.
If you’re hesitant to add clear aligners to your treatment arsenal, let me help. In the twelve years I’ve utilized aligners, I’ve encountered two common misunderstandings that often leave orthodontists unsure of how to approach clear aligner therapy or deter them from utilizing clear aligner treatment altogether.
Let’s dig into these common misunderstandings and explore how to rethink the perceptions so you can start comfortably taking advantage of aligner therapy’s many benefits that I’ve seen firsthand.
Deemphasize the brand
I’ve seen many orthodontists misinterpret the role of the manufacturer. Many clinicians and consumers assume that the manufacturer of the aligners carries the treatment and guarantees success. But aligners, and their manufacturers, do not run the show on their own.
As orthodontists, it still remains our responsibility to provide a thorough diagnosis, treatment staging, planning, clinical observation and follow-up to create the desired result for our patients. Most aligner systems can be effective in the hands of an experienced clinician, so you can use your expertise and experience to research products and decide on one that works for you and your patient-regardless of the brand name.
When you’re evaluating different aligner systems, be sure to look at the digital aspect of the management, too. This important digital work also falls to us as clinicians-the manufacturer doesn’t manage this part either. In my experience, an effective digital platform will help you work with better precision. For example, in the system I use, I can design a smile upfront, and show a patient the result we are shooting for before even starting treatment. This helps me with case acceptance and allows the patient to envision the outcome, all of which can motivate a patient’s aligner compliance and serves as a useful guide throughout treatment.
When I added aligner treatment to my practice, I deemphasized the brand, looking at product benefits and digital workflow just like I’m recommending you do. I personally chose my practice’s aligner system (3M™ Clarity™ Aligners) because it both helps me more easily get the results I need for my patients, and matches the aesthetics my patients are looking for. In my experience, the workflow process for these aligners is simpler than others that I’ve previously used. I’ve experienced less clean-up needed with the attachment template, plus, the ordering process is catered to my needs as an orthodontist.
When you’re considering aligner treatment, I encourage you to do the same evaluative work I did: deemphasize the brand, use your expertise and experience to research products and decide on one that works for you and your patients.
Embrace your rightful role
I’ve also seen many orthodontists assume they’re the “middleman” between the manufacturer and patient. That’s simply not the case. Successful treatment management requires a thorough diagnostic evaluation prior to beginning treatment, and there should be multiple check-ins throughout the treatment to ensure proper progress-and all of this is the responsibility of the orthodontist.
With aligner systems, you remain the leader of your patients’ treatment. Part of that responsibility includes communicating with the lab technician from the start, which is more than checking boxes-it will also impact the way the teeth move. For optimal results, be sure to evaluate the setup to ensure it is void of mistakes. Lab technicians aren’t as well-versed in biomechanics as orthodontists are, so as the case’s doctor, embrace your role and double check that setup is correct.
As the treating clinician, you also still need to be involved throughout treatment in order to provide a correct diagnosis, treatment staging and setup, as well as the necessary refinements and follow-up appointments. This is critical to ensure the treatment is going as planned to achieve a predictable outcome.
In my experience, if a tooth isn’t moving exactly how I envision, or the occlusion isn’t fitting, I have the option of rescanning my patient and having new trays made. These kinds of diagnostic measures can only be achieved through regular in-person checkups with patients. With that said, I often experience that in-person check-ups can become more difficult to schedule whenever my patients happen to be going to college in another city or state. With aligners, the door is open to more flexibility with treatment management. As long as we are on the right foot before they go off to college, I can send my patient with a set of aligners and manage the treatment with process pictures taken by the patient and only host an office visit every three months (instead of every eight weeks for bracket cases).
Aligners keep me as the leader of my patients’ treatment. And because I’m never the “middleman” when using aligner systems, I get to continue giving hands-on management to a patient’s treatment while giving them more flexibility in their lives.
Clarify how aligners could fit into your practice
As with everyone we treat, it is important that we use the preparation from residency and our existing training to apply it toward new methods. Patient results are completely reliant on our skill level as orthodontists, the patient’s own compliance, and our ability to manage, motivate and advise for aesthetic outcomes.
Clear aligners may still feel like a new or unknown method, but I hope I’ve helped demystify the common barriers to their adoption. With proper training, education and practice, utilizing these tools to straighten teeth can help open new doors for patients in your practice.